A baby who is sga is born precipitously in the er. the nurse’s initial action should be to:

Notes

Inhaltsverzeichnis Show

Maternal & Child Practice Exam 11 (Newborn Care) PM
Which intervention would the nurse perform as soon as a newborn is delivered?
When performing nursing care for a neonate after birth which intervention has the highest priority?
Which nursing actions should be performed initially to a 2 hour baby with Acrocyanosis?
Which action should the nurse take immediately after the newborn is circumcised?

Description

A post-term pregnancy is one that extends beyond 42 weeks’ gestation. The post-term infant may be LGA, AGA, SGA, or dysmature, depending on placental function.

Etiology

The cause of prolonged pregnancy is unknown. Factors associated with postmaturity include anencephaly and trisomy 16 to 18.

Pathophysiolgy

If the placenta continues to function well, the fetus will continue to grow, which results in an LGA infant who may manifest problems such as birth trauma and hypoglycemia.
If placental function decreases, the fetus may not receive adequate nutrition. The fetus will utilize its subcutaneous fat stores for energy. Wasting of subcutaneous fat occurs, resulting in fetal dysmaturity syndrome. There are three stages of fetal dysmaturity syndrome.
- Stage 1- Chronic placental insufficiency
1. - Dry, cracked, peeling, loose, and wrinkled skin
  - Malnourished appearance
  - Open-eyed and alert baby
- Stage 2– Acute placental insufficiency
1. - All features of stage 1 except point iii
  - Meconium staining
  - Perinatal depression
- Stage 3– Subacute placental insufficiency
1. - Findings of stage 1 and 2 except point iii
  - Green staining of skin, nails, cord, and placental membrane
  - A higher risk of fetal inrapartum or neonatal death
The newborn is at increased risk for developing complications related to compromised uteroplacental perfusion and hypoxia (e.g., meconium aspiration syndrome MAS)
Chronic intrauterine hypoxia causes increased fetal erythropoietin and red blood cell production resulting in polycythemia.
Post-term infants are susceptible to hypoglycemia because of the rapid use of glycogen stores.

Assessment Findings

Clinical manifestations include:

A long, thin newborn with wasted appearance, parchment-like skin, and meconium-stained skin, nails, and umbilical cor. Fingernails are long and lanugo is absent.
Meconium aspiration syndrome is manifested by fetal hypoxia, meconium staining of amniotic fluid, respiratory distress at delivery, and meconium-stained vocal cords.

Nursing Management

1. Manage meconium aspiration syndrome.

Suction the infant’s mouth and nares while the head is on the perineum and before the first breath is taken to prevent aspiration of meconium that is in the airway.
Once the infant is dry and on the warmer, intubate with direct tracheal suctioning.
Perform chest physiotherapy with suctioning to remove excess meconium and secretions.
Provide supplemental oxygen and respiratory support as needed.

2. Obtain serial blood glucose measurements.

3. Provide early feeding to prevent hypoglycemia, if not contraindicated by respiratory status.

4. Maintain skin integrity.

Keep the skin clean and dry.
Avoid the use of powders, creams, and lotions.
Avoid the use of tape.

Exam

Maternal & Child Practice Exam 11 (Newborn Care) PM

Choose the letter of the correct answer. Good luck!

Congratulations - you have completed Maternal & Child Practice Exam 11 (Newborn Care) PM. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%

Your answers are highlighted below.

Shaded items are complete.

1	2	3	4	5
6	7	8	9	10
11	12	13	14	15
16	17	18	19	20
21	22	23	24	25
26	27	28	29	30
31	32	33	34	35
36	37	38	39	40
End

Which intervention would the nurse perform as soon as a newborn is delivered?

Immediate care for the newborn One of the first checks is the Apgar test. The Apgar test is a scoring system to evaluate the condition of the newborn at 1 minute and 5 minutes after birth. The healthcare provider or midwife and nurses will evaluate these signs and give a point value: Activity; muscle tone.

When performing nursing care for a neonate after birth which intervention has the highest priority?

When performing nursing care for a neonate after a birth, which intervention has the highest nursing priority? 4. Covering the neonates head with a cap helps prevent cold stress due to excessive evaporative heat loss from the neonate's wet head and has the highest nursing priority.

Which nursing actions should be performed initially to a 2 hour baby with Acrocyanosis?

While assessing a 2-hour old neonate, the nurse observes the neonate to have acrocyanosis..

Activate the code blue or emergency system..

Do nothing because acrocyanosis is normal in the neonate..

Immediately take the newborn's temperature according to hospital policy..

Notify the physician of the need for a cardiac consult..

Which action should the nurse take immediately after the newborn is circumcised?

14a At completion of procedure, don gloves and immediately apply dressing to penis using sterile petroleum jelly liberally applied around penis and then cover with sterile gauze, or use petroleum gauze packet if Gomco-type circumcision. If Plastibell type, apply antibiotic ointment as ordered by healthcare prescriber.