Which neonatal behavior is most commonly associated with fetal alcohol syndrome (FAS)?
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Solution
Poor wake and sleep patterns.
Altered sleep patterns are caused by disturbances in the CNS from alcohol exposure in utero. Hyperactivity is a characteristic generally noted. Low birth weight is a physical defect seen in neonates with FAS. Neonates with FAS generally have a low threshold for stimulation.
A healthy term neonate born by C-section was admitted to the transitional nursery 30 minutes ago and placed under a radiant warmer. The neonate has an axillary temperature ºF, a respiratory rate of 80 breaths/minute, and a heel stick glucose value of 60 mg/dl. Which action should the nurse take?
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Solution
Obtain an order for IV fluid administration.
Assessment findings indicate that the neonate is in respiratory distress—most likely from transient tachypnea, which is common after cesarean delivery. A neonate with a rate of 80 breaths a minute shouldn’t be fed but should receive IV fluids until the respiratory rate returns to normal. To allow for close observation for worsening respiratory distress, the neonate should be kept unclothed in the radiant warmer.
A woman delivers a 3,250 g neonate at 42 weeks’ gestation. Which physical finding is expected during an examination if this neonate?
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Solution
Leathery, cracked, and wrinkled skin.
Neonatal skin thickens with maturity and is often peeling by post term.
When performing an assessment on a neonate, which assessment finding is most suggestive of hypothermia?
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Solution
Bradycardia.
Hypothermic neonates become bradycardic proportional to the degree of core temperature. Hypoglycemia is seen in hypothermic neonates.
When performing nursing care for a neonate after a birth, which intervention has the highest nursing priority?
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Solution
Cover the neonate’s head with a cap.
Covering the neonate’s head with a cap helps prevent cold stress due to excessive evaporative heat loss from the neonate’s wet head. Vitamin K can be given up to 4 hours after birth.
Which condition or treatment best ensures lung maturity in an infant?
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Solution
Lecithin to sphingomyelin ratio more than 2:1.
Lecithin and sphingomyelin are phospholipids that help compose surfactant in the lungs; lecithin peaks at 36 weeks and sphingomyelin concentrations remain stable.
A mother of a term neonate asks what the thick, white, cheesy coating is on his skin. Which correctly describes this finding?
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Solution
Vernix.
When teaching umbilical cord care to a new mother, the nurse would include which information?
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Solution
Keep the cord dry and open to air.
Keeping the cord dry and open to air helps reduce infection and hastens drying.
When attempting to interact with a neonate experiencing drug withdrawal, which behavior would indicate that the neonate is willing to interact?
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Solution
Quiet alert state.
When caring for a neonate experiencing drug withdrawal, the nurse needs to be alert for distress signals from the neonate. Stimuli should be introduced one at a time when the neonate is in a quiet and alert state. Gaze aversion, yawning, sneezing, hiccups, and body arching are distress signals that the neonate cannot handle stimuli at that time.
The most common neonatal sepsis and meningitis infections seen within 24 hours after birth are caused by which organism?
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Solution
Group B beta-hemolytic streptococci.
Transmission of Group B beta-hemolytic streptococci to the fetus results in respiratory distress that can rapidly lead to septic shock.