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Price: Pediatric Nursing, 10th Edition

Open Book Quizzes Chapter 4: The Newborn Infant 1. The need for resuscitation often can be anticipated from the history of the mothers pregnancy, abnormal progression of labor, the size of the neonate, and the difficulty of delivery. 2. The Apgar scoring system provides a quick and accurate way of evaluating a babys physical status right at birth, regardless of any combination of weaknesses or debilities. The physician or nurse observes five signs and records the score for each. Each sign is evaluated according to the degree to which it is present: 0 (poor), 1 (fair), or 2 (good). The five scores are then added together. Apgar scores range from 0 to 10. A score of 10 means the baby is in the best possible condition. A score of 9 or 8 indicates good condition; 7, 6, 5, or 4 indicate fair condition. A score of 3, 2, 1, or 0 indicates poor condition and the need for prompt diagnosis and treatment of specific disorders. 3. The temperature is not taken rectally because this method could cause perforation of the mucosa. 4. Respirations may be irregular. The normal respiration rate of the newborn is 40 to 60 breaths per minute; this drops to 30 to 50 breaths per minute after the first 24 hours. Respirations are typically shallow and unlabored. 5. The tonic neck reflex is a postural reflex that is sometimes assumed by babies while asleep. The head is turned to one side, with the arm and leg extended on the same side, whereas the opposite arm and leg are flexed in a fencing position. 6. The circulation of the fetus differs from that of the newborn in that most of the blood bypasses the lungs. Some of the blood goes from the right atrium to the left atrium of the heart through an opening, the foramen ovale, in the septum. Some of the blood goes from the pulmonary artery to the thoracic aorta by way of the ductus arteriosus. 7. Physiological jaundice is characterized by a yellow tinge to the skin. It is caused by the rapid destruction of excess red blood cells that the newborn no longer needs. 8. The American Academy of Pediatrics recommends that infants be placed on their backs (supine) to sleep to reduce the incidence of sudden infant death syndrome. 9. The following are the three forms of prepared formula: (1) ready to use in cans (use as-is without dilution); (2) in concentrated form (which must be diluted with an equal amount of water); (3) in powdered form (1 scoop of powdered formula for every 2 ounces of water). 10. The following are signs and symptoms of infection in newborns: temperature above 100 F (37.8 C) or below 97 F (36 C); refusal to take nourishment; rashes or skin lesions; loose or watery stools; discharge from eyes, nose, or umbilicus; vomiting;

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lethargy or irritability; and others as indicated in Table 4-5 in your textbook.

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