NURS-242 CONCEPTS OF NURSING II

CONCEPT: REPRODUCTION

EXEMPLAR NEWBORN CARE

CLASS PREP-bring this completed assignment to class

Required readings:

McKinney, 6th Ch. 16 Table 16.3 Apgar Score p. 328

edition (2022) Chapter 21: The Normal Newborn: pp. 430-438, 441-466
Adaptation and Assessment

Chapter 22: The Normal Newborn: pp. 469-483

Nursing Care

Chapter 23: Newborn Feeding pp. 487-498 (thru

common breast
problems), 499-500
(Patient-Centered
Teaching)

Ch. 16 p. 328 (Table 16.3)

1. Indicate the Apgar score for the following newborn at 5 minutes after birth:

Score
Heart rate-150 beats/min
Respiratory effort-strong, loud cry
Muscle tone-some flexion of extremities
Reflex irritability-cries when suctioned
Color-acrocyanosis
1-minute Apgar score=

Cardiovascular Adaptation: Transition from Fetal to Neonatal Circulation (Ch. 21 p. 432)

2. Which fetal circulatory structure will initially close soon after birth as the newborn's
breathing is established and blood flow changes from fetal circulation and becomes like
that of a normal adult?
a. Ductus venosus
b. Umbilical vein
c. Foramen ovale
d. Umbilical artery

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Neurologic Adaptation: Thermoregulation (Ch. 21 pp. 432-33)

3. What characteristics put preterm newborns at greater risk for heat loss than infants
born at term?

4. While caring for an infant, which method should the nurse implement to prevent heat
loss caused by evaporation?
a. Place the crib away from the window
b. Dry the baby immediately after a bath
c. Warm hands before touching the baby
d. Position the crib away from air vents

Immediate Newborn Care (Ch. 21, 22)

5. The nurse is called to the labor and delivery room to provide newborn care at the time
of birth. The nurse receives report that birth is imminent. Maternal history includes
uncomplicated gestational diabetes with spontaneous labor. Gestational age is 39 weeks
and the mother plans to breastfeed the newborn.

Choose the most likely options for the information missing from the statements below
by selecting from the lists of options provided.

Based on the assessment data above, the nurse provides immediate newborn care. The
nurse knows that the priority in immediate newborn care is to establish effective
_____1______. Routine care includes placing the full-term newborn safely____2_____.
Following the initial assessment, the nurse teaches the parents about newborn
_______3______. Given the client history, the nurse monitors the newborn carefully for
signs of ____4_____.

Options for 1 Options for 2 Options for 3 Options for 4

Respirations Under the radiant Diapering Hyperbilirubinemia
warmer
Feeding In a swaddle Swaddling Prematurity
Urination Skin-to-skin Feeding cues Neonatal abstinence
syndrome
Thermoregulation In the newborn Bathing Hypoglycemia
nursery

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Ch. 21 Psychosocial Adaptation p. 441

6. What behaviors seen by the nurse would indicate that the newborn is in the active alert
state?

Ch. 21 Assessment of Body Systems Neurologic System (Fig 21.14, Table 21.3)

7. The nurse is about to elicit the Babinski reflex. Which response should the nurse expect
to see?
a. When a loud noise is made next to baby’s ear, the newborn’s arms straighten
outward and the knees flex.
b. When the baby is placed on his back with the head turned to one side, the arm
on that side extends out.
c. When the cheek of the baby is touched lightly, the baby turns toward the side
that was touched.
d. When the lateral aspect of the baby’s foot is stroked, the toes extend and fan
out.

Ch. 21 Assessment of Gestational Age (pp. 461-465)

8. The nurse estimates a newborn male infant to be at 40 weeks gestation after conducting
an assessment using the New Ballard Scale. What findings by the nurse are consistent
with this newborn’s full-term status? Select all that apply.
a. Testes descended into the scrotum
b. Thinning of lanugo with bald areas
c. Resting posture, hypertonic flexion of all extremities
d. Weight of 2800 grams, placing him at 10th percentile
e. Respiratory rate of 50 breaths/minute, no retractions
f. Elbow does not pass midline when arm pulled across chest

Ch. 21 Hepatic System (pp. 436-37; 473-74)

9. In your own words, explain newborn physiologic (nonpathologic) jaundice.

10. Identify 4 risk factors for developing newborn jaundice.

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11. Explain how bilirubin is removed from the body.

Ch. 21 Assessment (pp. 441-460)

12. The nurse is assessing a newborn born by uncomplicated vaginal birth 6 hours ago. The
newborn was 39 weeks and 5 days gestation at the time of birth.

Choose the most likely options for the information missing from the statements below by
selecting from the lists of options provided.

The nurse assesses the newborn’s ____1______temperature and then counts the number of
respirations for ____2_______. The nurse measures the newborn in centimeters from___3____
to ____4____ and assesses the umbilical cord expecting to see____5___artery(ies) and
_____6___vein(s).

Option 1 Option 2 Option 3 Option 4 Option 5 Option 6

Rectal 1 minute Heel Forehead 1 1
Oral 30 seconds Foot Scalp 2 2
Axillary 6 seconds Toe Top of head 3 3

13. Following the physical assessment of a newborn, the nurse suspects developmental hip
dysplasia and notifies the health care provider. Which assessment finding obtained by
the nurse supports the likely diagnosis?
a. Presence of acrocyanosis
b. Asymmetrical gluteal folds
c. Pressure on soles of feet elicit curling of toes
d. Legs equal length with infant in prone position

Ch. 22 Normal Newborn: Nursing Care

14. Why are vitamin K levels low in newborns at birth?

15. The nurse notes an infant sleeping on its back in the crib in the mother’s room. What
should the nurse do?
a. Turn the infant to avoid aspiration
b. Suggest that the mother hold the infant to enhance bonding
c. Praise the mother for positioning the infant correctly
d. Explain the importance of infants being in prone position for sleep

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16. Why is the newborn hearing screen important?

Ch. 23 Newborn Feeding

17. How would you explain the physiology of lactation and the composition of breast milk
to a group of new parents?

18. What information should be included in the teaching plan for a client who plans to
bottle feed her infant?

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