Maternal Newborn Nursing Exams ,question and answers fully solved
The neonatal period – answers from birth through the first 28 days of life
Approximately _______ of amniotic fluid is forced out of the lungs in the delivery process. -
answers30mL
Ductus venous – answers Clamping of the cord causes constriction of the vessels and closure of
the ductus venous immediately.
- closes by the 3rd day of life
Foramen ovale – answer sopening between the right atrium and the left atrium
- closes when the left atrial pressure is higher than the right atrial pressure
Ductus arteriosus – answer rsconnects the pulmonary artery with the descending aorta
- usually closes within 15 hours post birth
Signs of Respiratory Distress – answers Cyanosis
Apnea/tachypnea
Retractions
Grunting
Flaring of nostrils
Hypotonia
Apgar scoring - answersTaken at 1 and 5 minutes after birth
Neutral thermal environment [NTE] - answersAn environment that maintains body temperature
with minimal metabolic changes and /or oxygen consumption.
Factors that negatively affect thermoregulation - answersDecreased subcutaneous fat
Decreased brown fat in preterm infants
Large body surface
Loss of heat from convection, radiation, conduction, and/or evaporation
Brown fat / Non-shivering thermogenesis - answersLocated in the neck, thorax, axilla, scapular
areas, around adrenal glands and kidneys. It increases metabolism, heat production once used it
is not replenished. Neonates are at higher risk of thermoregulatory issues because of higher
,body surface area to body mass ratio, higher metabolic rates, and immature thermoregulatory
abilities.
Evaporation - answersLoss of heat through conversion of liquid to vapor
Directly after birth or bathing
Convection - answersLoss of heat from infant's warm body to cooler air currents.
Drafts from windows, AC or oxygen masks
Conduction - answersTransfer of heat from cooler surface by direct contact.
Cold hands, cold equipment
Radiation - answersTransfer of heat to a colder solid object not in contact with infant.
Cold wall of isolette or cold equipment near infant
Temperature that indicates cold stress - answersLess than or equal to 36 C / 97.6 F
Who is at risk for cold stress - answersPremature infants, SGA, hypoglycemia, prolonged
resuscitation efforts, sepsis , neurological, endocrine or cardiorespiratory problems
Signs and symptoms of cold stress - answersCool skin, lethargy, pallor, tachypnea, grunting,
hypoglycemia, hypotonia, jitteriness, weak suck
Blood glucose that indicates hypoglycemia - answersLess than 40
Who is at risk for hypoglycemia - answersDiabetic moms, LGA, post/ preterm infants, SGA,
hypothermia, infection, respiratory distress, resuscitation, birth trauma
Signs and symptoms of hypoglycemia - answersJitteriness, hypotonia, lethargy, irritability,
apnea, temperature instability
Indirect Bilirubin - answersFat soluable, produced from breakdown of RBC
Direct Bilirubin - answersWater soluble, converted from indirect bilirubin by liver enzymes
Hyperbilirubinemia - answersJaundice occurs in the 2nd-3rd day of life in about 50% of
newborns as the results of the breakdown of RBCs.
Vitamin K - answersGiven at birth. IM 0.23-0.5 ml. Infant doesn't have the intestinal flora to
produce this vitamin in the first week of life. Promotes formation of clotting factors, 11,7,9, and
10.
, Meconium Stool - answersBegins to form during the 4th gestational month and is the first stool
eliminated by the neonate. It is sticky, thick, black, and odorless. It is first passed within 24-48
hours.
Transitional Stool - answersBegins around the 3rd day and can continue for 3-4 days. The stool
transitions from black to greenish black, to greenish brown, to greenish yellow.
Breastfed Stool - answersYellow and semi formed. Later it becomes golden yellow with a pasty
consistency and has a sour odor.
Formula Fed Stool - answersDrier and more formed that breastfed stools. It is a paler yellow or
brownish yellow and has an unpleasant odor.
Diarrhea - answersLoose and green stools
Normal newborn urinary excretion - answersNewborns typically excrete 15-60 ml/kg of urine for
the first few days and increases to 250-400 ml by the end of the first month.
IgA - answersPresent in breast milk to provide passive immunity for breastfed infants.
Found in secretions of all mucous membranes.
Neonates usually lose _______ of birth weight in the first week of life due to diuresis. -
answers5-10 percent
Risk for Infection - answersImmature defense mechanism
Lack of experience with and exposure to organisms [delayed response to antigens]
Breakdown of skin and mucous membranes that provides a portal of entry for bacteria
Head circumference - answers33-35.5 cm [13-14 inches] normal measurements
Microcephaly - answersHead circumference is below the 10th percentile of newborn's
gestational age. This is often related to congenital malformation, maternal drug or alcohol
ingestion, or maternal infection during pregnancy.
Macrocephaly - answersHead circumference is >90th percentile. This can be related to
hydrocephalus.
Chest circumference - answers30.5-33 cm [12-13 inches] or 2-3 cm less than head
circumference
Length - answers45-53 cm [19-21 inches]
Weight - answers- 2,500-4,000 g [5 lbs 8 oz- 8 lbs 13 oz]
The neonatal period – answers from birth through the first 28 days of life
Approximately _______ of amniotic fluid is forced out of the lungs in the delivery process. -
answers30mL
Ductus venous – answers Clamping of the cord causes constriction of the vessels and closure of
the ductus venous immediately.
- closes by the 3rd day of life
Foramen ovale – answer sopening between the right atrium and the left atrium
- closes when the left atrial pressure is higher than the right atrial pressure
Ductus arteriosus – answer rsconnects the pulmonary artery with the descending aorta
- usually closes within 15 hours post birth
Signs of Respiratory Distress – answers Cyanosis
Apnea/tachypnea
Retractions
Grunting
Flaring of nostrils
Hypotonia
Apgar scoring - answersTaken at 1 and 5 minutes after birth
Neutral thermal environment [NTE] - answersAn environment that maintains body temperature
with minimal metabolic changes and /or oxygen consumption.
Factors that negatively affect thermoregulation - answersDecreased subcutaneous fat
Decreased brown fat in preterm infants
Large body surface
Loss of heat from convection, radiation, conduction, and/or evaporation
Brown fat / Non-shivering thermogenesis - answersLocated in the neck, thorax, axilla, scapular
areas, around adrenal glands and kidneys. It increases metabolism, heat production once used it
is not replenished. Neonates are at higher risk of thermoregulatory issues because of higher
,body surface area to body mass ratio, higher metabolic rates, and immature thermoregulatory
abilities.
Evaporation - answersLoss of heat through conversion of liquid to vapor
Directly after birth or bathing
Convection - answersLoss of heat from infant's warm body to cooler air currents.
Drafts from windows, AC or oxygen masks
Conduction - answersTransfer of heat from cooler surface by direct contact.
Cold hands, cold equipment
Radiation - answersTransfer of heat to a colder solid object not in contact with infant.
Cold wall of isolette or cold equipment near infant
Temperature that indicates cold stress - answersLess than or equal to 36 C / 97.6 F
Who is at risk for cold stress - answersPremature infants, SGA, hypoglycemia, prolonged
resuscitation efforts, sepsis , neurological, endocrine or cardiorespiratory problems
Signs and symptoms of cold stress - answersCool skin, lethargy, pallor, tachypnea, grunting,
hypoglycemia, hypotonia, jitteriness, weak suck
Blood glucose that indicates hypoglycemia - answersLess than 40
Who is at risk for hypoglycemia - answersDiabetic moms, LGA, post/ preterm infants, SGA,
hypothermia, infection, respiratory distress, resuscitation, birth trauma
Signs and symptoms of hypoglycemia - answersJitteriness, hypotonia, lethargy, irritability,
apnea, temperature instability
Indirect Bilirubin - answersFat soluable, produced from breakdown of RBC
Direct Bilirubin - answersWater soluble, converted from indirect bilirubin by liver enzymes
Hyperbilirubinemia - answersJaundice occurs in the 2nd-3rd day of life in about 50% of
newborns as the results of the breakdown of RBCs.
Vitamin K - answersGiven at birth. IM 0.23-0.5 ml. Infant doesn't have the intestinal flora to
produce this vitamin in the first week of life. Promotes formation of clotting factors, 11,7,9, and
10.
, Meconium Stool - answersBegins to form during the 4th gestational month and is the first stool
eliminated by the neonate. It is sticky, thick, black, and odorless. It is first passed within 24-48
hours.
Transitional Stool - answersBegins around the 3rd day and can continue for 3-4 days. The stool
transitions from black to greenish black, to greenish brown, to greenish yellow.
Breastfed Stool - answersYellow and semi formed. Later it becomes golden yellow with a pasty
consistency and has a sour odor.
Formula Fed Stool - answersDrier and more formed that breastfed stools. It is a paler yellow or
brownish yellow and has an unpleasant odor.
Diarrhea - answersLoose and green stools
Normal newborn urinary excretion - answersNewborns typically excrete 15-60 ml/kg of urine for
the first few days and increases to 250-400 ml by the end of the first month.
IgA - answersPresent in breast milk to provide passive immunity for breastfed infants.
Found in secretions of all mucous membranes.
Neonates usually lose _______ of birth weight in the first week of life due to diuresis. -
answers5-10 percent
Risk for Infection - answersImmature defense mechanism
Lack of experience with and exposure to organisms [delayed response to antigens]
Breakdown of skin and mucous membranes that provides a portal of entry for bacteria
Head circumference - answers33-35.5 cm [13-14 inches] normal measurements
Microcephaly - answersHead circumference is below the 10th percentile of newborn's
gestational age. This is often related to congenital malformation, maternal drug or alcohol
ingestion, or maternal infection during pregnancy.
Macrocephaly - answersHead circumference is >90th percentile. This can be related to
hydrocephalus.
Chest circumference - answers30.5-33 cm [12-13 inches] or 2-3 cm less than head
circumference
Length - answers45-53 cm [19-21 inches]
Weight - answers- 2,500-4,000 g [5 lbs 8 oz- 8 lbs 13 oz]
