ATI Maternal Newborn Proctored Exam: Study Set 2 (focused reviews) questions and answers well illustrated.

ATI Maternal Newborn Proctored Exam: Study Set 2 (focused reviews) questions and answers well illustrated. A baby with neonatal abstinence syndrome may have a wide range of symtoms including CNS, metabolic, vasomotor, respiratory, and GI. These include: (list 3 or more for each) - correct answers.CNS: -increased wakefulness -high-pitched cry, incessant crying -irritability -tremors -hyperactive w/increased Moro reflex -increased DTRs -increased muscle tone -abrasions and/or excoriations on the face & knees -convulsions Metabolic, Vasomotor, Respiratory: -nasal congestion w/flaring -frequent yawning -skin mottling -tachypnea 60/min -sweating -temp than 37.2 C (99 F) GI: -poor feeding -regurgitation (projectile vomiting) -diarrhea -excessive uncoordinated constant sucking Hypoglycemia in the newborn findings: - correct answers.-poor feeding -jitteriness/tremors -hypothermia -diaphoresis -weak shrill cry -lethargy -flaccid muscle tone -seizures/coma -irregular respirations -cyanosis -apnea normal newborn blood glucose= normal infant (up to 2 yrs) blood glucose= - correct answers.40-80 mg/dl 50-80 mg/dl newborn dehydration s/s: - correct answers.-urine output less than 1 mL/kg/hr -urine specific gravity more than 1.015 -weight loss -dry mucous membranes -absent skin turgor -depressed/sunken fontanels postterm infant s/s: - correct answers.-wasted appearance, thin w/loose skin -peeling, cracked, dry skin, also leathery -long, thin body -meconium staining of fingernails and umbilical cord -long hair and nails -may be more alert -hypoglycemic -macrosomic -cold stress Birth injuries: subarachnoid hemorrhage s/s - correct answers.-seizures within the 1st 72 hours -decreased levels of consciousness -irritability Birth injuries: facial paralysis s/s - correct answers.-facial flattening -unresponsiveness to grimace that accompanies crying or stimulation -eyes remaining open Sun-setting sign is common with this newborn complication, in which the whites of the eyes are visible above the iris and the head is enlarged and fontanels are bulging: - correct answers.Hydrocephalus Manifestations include murmurs, abnormal heart rate or rhythm, breathlessness, and fatigue when feeding: - correct t ductus arteriosus Manifestations include respiratory difficulties, cyanosis, tachycardia, tachypnea, and diaphoresis: - correct answers.Tetralogy of Fallot How to suction with a bulb syringe for a newborn: - correct answers.1. compress bulb before insertion into 1 side of the mouth 2. Avoid center of the mouth to prevent stimulating gag reflex 3. Aspirate mouth 1st, one nostril, then 2nd nostril Maternal Adaptation Dependent: Taking in Phase - correct answers.-first 24-48 hours -focus is on meeting personal needs -rely on others for assistance -excited, talkative, need to share experience Maternal Adaptation Dependent-Independent: Taking-Hold Phase - correct answers.-begins on day 2-3 -focus on baby & improving care-giving competency -wants to take charge but needs acceptance from others -wants to learn and practice Maternal Adaptation Independent: Letting-Go Phase - correct answers.-focus on family as a unit -resumption of role (intimate partner, individual) How to relieve breast engorgement: - correct answers.-completely empty breasts at each feeding -nurse often -massaging during feeding helps w/emptying -alternate breasts w/each feeding -apply cool compresses between feedings -warm compresses (or warm shower) prior to feeding -nonlactating clients: cold cabbage leaves in the bra, mild analgesics PMI (point of maximal impulse) refers to the location in which fetal heart tones are best heard based on the position of the fetus. List the location the nurse should place the doppler based on fetal position: Vertex presentation= Breech presentation= - correct x= PMI is either in the right or left-lower quadrant or below the maternal umbilicus breech=right or left upper quadrant above the maternal umbilicus The nurse places the doppler in the right or left-lower quadrant or below the umbilicus to auscultate fetal heart tones in a baby that is in the _______presentation. - correct x The nurse places the doppler in the right or left upper quadrant above the maternal umbilicus to auscultate fetal heart tones in a baby that is in the ______presentation. - correct h findings of false labor (braxton-hick's contractions) include: - correct answers.-painless, irregular frequency, and intermittent -decrease in frequency, duration, and intensity w/walking or position change -felt in the lower back or abdomen above umbilicus -often stop w/sleep or comfort measures such as oral hydration or emptying the bladder Breast milk may be stored at room temp in clean conditions for up to: - correct answers.8 hrs Breast milk may be refrigerated in sterile bottles for use within: - correct answers.8 days Breast milk may be frozen in sterile containers in the freezer compartment of a 2-door fridge for up to: - correct answers.6 months Thawing the breast milk in the refrigerator for ______is the best way to preserve the immunoglobulins in it. DO NOT... - correct answers.-24 hours DO NOT refreeze thawed milk Used portions of breast milk must be... - correct rded Prepared formula can be refrigerated for up to: - correct answers.48 hr Teach parents to do what with the formula can prior to opening it? - correct the lid of a can of concentrated formula with hot soapy water Expected changes during the second trimester: - correct answers.-skin changes (stretch marks, hyperpigmentation) (chloasma, linea nigra, striae gravidarum) -breast & abdomen enlargement -fatigue -BP decreases 5-10 mmHg for both diastolic & systolic -heartburn -constipation -hemorrhoids -backaches -shortness of breath & dyspnea -varicose veins & lower-extremity edema -braxton hicks contractions -gingivitis, nasal stuffiness, epistaxis (nose bleeds) Safe Immunizations for Pregnancy: - correct answers.-Tdap (given at 27-36 weeks) -influenza (1st or 2nd trimester)