Chapter 29 Contemporary Maternal Newborn Nursing Care Maternal Newborn Nursing Care Nurse, Family, 8th Edition

Chapter 29 Contemporary Maternal Newborn Nursing Care Maternal Newborn Nursing Care Nurse, Family, 8th Edition

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

A laboring mother has recurrent late decelerations. At birth, the infant has a heart rate of 100, is not breathing, and is limp and bluish in color. What nursing action is best?

1. Begin chest compressions.
2. Deep suction the airways.
3. Begin bag-and-mask ventilation.
4. Assess blood pressure.

Correct Answer: 3

Rationale 1: Chest compressions are not initiated until the heart rate is less than 60 and respirations have been established.

Rationale 2: This would be appropriate if there were meconium-stained fluid. There is no information about the amniotic fluid.

Rationale 3: When an infant is not breathing and has poor muscle tone, bag-and-mask ventilation is the appropriate resuscitation measure.

Rationale 4: Establishment of airway and breathing take priority over assessment of blood pressure.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO01 – Describe how to identify infants in need of resuscitation and the appropriate method of resuscitation based on the antepartum/labor record and physiologic indicators.

 

Question 2

Type: MCSA

The nurse is assessing a 2-hour-old newborn delivered by cesarean at 38 weeks. The amniotic fluid was clear. His mother had preeclampsia. His respiratory rate is 80; he is grunting and has nasal flaring. What is the most likely cause of this infant’s condition?

1. Meconium aspiration syndrome
2. Transient tachypnea of the newborn
3. Respiratory distress syndrome
4. Prematurity of the neonate

Correct Answer: 2

Rationale 1: There was no meconium in the amniotic fluid, which rules out meconium aspiration syndrome.

Rationale 2: The infant is term and born by cesarean. He is most likely experiencing transient tachypnea of the newborn.

Rationale 3: The infant is not premature and therefore is not likely to be experiencing respiratory distress syndrome.

Rationale 4: The infant is not premature. Prematurity alone does not cause respiratory distress; the lack of surfactant causes respiratory distress syndrome.

Global Rationale:

 

Cognitive Level: Understanding

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO02 – Differentiate, based on clinical manifestations, among the various types of respiratory distress (respiratory distress syndrome, transient tachypnea of the newborn, and meconium aspiration syndrome) in the newborn and the nursing care related to each type.

 

Question 3

Type: MCSA

A nurse is caring for a newborn on a ventilator who has respiratory distress syndrome (RDS). The nurse informs the parents that the newborn is improving. Which of the following data supports the nurse’s assessment?

1. Decreased urine output
2. Increased pulmonary vascular resistance
3. Increased PCO₂
4. Increased urination

Correct Answer: 4

Rationale 1: As fluid moves out of the lungs and into the bloodstream, alveoli open, and kidney perfusion increases, thereby increasing urine output.

Rationale 2: Pulmonary vascular resistance increases with hypoxia.

Rationale 3: Increased PCO₂ results from alveolar hypoventilation.

Rationale 4: Increased urination could be an indication that the newborn’s condition is improving.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: LO02 – Differentiate, based on clinical manifestations, among the various types of respiratory distress (respiratory distress syndrome, transient tachypnea of the newborn, and meconium aspiration syndrome) in the newborn and the nursing care related to each type.

 

Question 4

Type: MCSA

The nurse is caring for an infant who delivered in a car on the way to the hospital and who has developed cold stress. Which finding requires immediate intervention?

1. Vasoconstriction and pallor
2. Blood glucose level of 45
3. Room temperature IV running
4. Positioned under radiant warmer

Correct Answer: 3

Rationale 1: Vasoconstriction is the first physiologic response to a lowering temperature and will cause pallor.

Rationale 2: This is an adequate blood sugar in a neonate. Less than 40 is hypoglycemic.

Rationale 3: IV fluids should be warmed prior to administration and wrapped in a blanket or other insulating material to keep them warm. Room temperature IV fluids will increase the cold stress.

Rationale 4: Radiant warmers are used to gradually increase the neonate’s temperature.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO03 – Discuss the types of metabolic abnormalities (cold stress and hypoglycemia), their effects on the newborn, and their nursing interventions.