Nur 335 Exam 4 Questions And Answers With Complete Solution!!

NUR 335 EXAM 4 QUESTIONS AND ANSWERS WITH COMPLETE SOLUTION!! What is the APGAR scale? What score requires resuscitation? Answers: - Appearance, Pulse, Grimace, Activity, Respiration; - measure for evaluating newborn baby taken at 1 minute and 5 minutes (each category scored from 0 -2) - Score less than 6 indicates need for resuscitation What are the reflexes that newborns should have? Answers:Rooting Sucking Fencing/tonic Moro/startle Palmer Plantar Babinski Stepping/dancing What are the three things t hat initial respirations in the neonate? Answers:Chemical stimuli: mild hypoxia Mechanical stimuli: compression of chest during labor Sensory stimuli: thermal, tactile, auditory, and light stimuli (leads to crying which requires inspiration) What are th e 2 factors that negatively impact the transition to breathing independently for a neonate? Answers: - Decreased lung surfactant as a result of immature lungs (often in premature infants) - Severe or persistent hypoxemia and acidosis (hypoxia can result in hypotonia which can increase the difficulty of respirations) What are the signs of respiratory distress in a neonate? Answers:Central cyanosis (around mouth and nose) Tachypnea or apnea for more than 10 seconds Grunting Nostril flaring Chest retractions Hypotonia What are the three heart shunts that close as a neonate transitions to relying on it's own circulatory system? Answers:Ductus venosus: allows the oxygenated blood from the umbilical cord to bypass the liver and go directly to the i nferior vena cava Foramen ovale: opening between the right and left atria Ductus arteriosus: connects the pulmonary artery and the aorta What is the neonatal response to cold? Answers:Increased metabolic rate and increased O2 consumption Increased mu scle activity and flexion Increased peripheral vasoconstriction Metabolism of brown adipose tissue ** all of these can result in hypoglycemia What is the function of brown adipose tissue? Answers:heat production What is cold stress? Answers:heat lo ss through convection, conduction, evaporation and radiation that results in a temperature decrease, which requires the body to consume more energy What are the risk factors of developing cold stress? Answers:Being born prematurely SGA Hypoglycemia Prolonged resuscitation Sepsis Problems with the infant's neuro, endocrine, or cardiorespiratory systems What are the four types of energy loss and examples in neonates? Answers: - Evaporation: transfer of heat when water on infant's skin is converted into water vapor; sweating (especially on radiant warmers), crying - Conduction: transfer of heat from infant to a cooler surface; placing infant on warmer that is not preheated - Convection: transfer of heat through drafts passing over infant's skin; AC hi tting uncovered infant - Radiation: Occurs through transfer of heat to the cooler air; heat leaves infant's head is uncovered What are the signs and symptoms of cold stress? Answers:Axillary temperature at or below 36.5°C (97.7°F) Cool skin Lethargy Pallor/Mottled skin/Acrocyanosis Tachypnea Grunting Hypoglycemia Hypotonia Jitteriness Weak suck What nursing interventions can we do to prevent neonatal heat loss? Answers: - Provide a neutral thermal environment - Skin to skin with parent and blanket ove r neonate and place on a pre -warmed warming bed - Remove wet linens after drying off neonate - Delay first bath - Keep infants head covered What is a normal newborn blood glucose level? Answers:40+ mg/dL What are the signs and symptoms of hypoglycemia in the neonate? Answers:Jitteriness/tremors Irritability