Maternal Child Nursing Care - Chapter 25: The High-
Risk Newborn Questions with accurate answers
A careful review of the literature on the various recreational and illicit
drugs reveals that:
a. more longer-term studies are needed to assess the lasting effects on
infants when
mothers have taken or are taking illegal drugs.
b. heroin and methadone cross the placenta; marijuana, cocaine, and
phencyclidine
(PCP) do not.
c. mothers should discontinue heroin use (detox) any time they can
during
pregnancy.
d. methadone withdrawal for infants is less severe and shorter than
heroin
withdrawal. Ans✓✓✓ ANS: A
Studies on the effects of marijuana and cocaine use by mothers are
somewhat contradictory. More long-range studies are needed. Just about
all these drugs cross the placenta, including marijuana, cocaine, and
PCP. Drug withdrawal is accompanied by fetal withdrawal, which can
lead to fetal death. Therefore, detoxification from heroin is not
recommended, particularly later in pregnancy. Methadone withdrawal is
more severe and more prolonged than heroin withdrawal.
A macrosomic infant is born after a difficult forceps-assisted delivery.
After stabilization the infant is weighed, and the birth weight is 4550 g
(9 lbs, 6 ounces). The nurse's most appropriate action is to:
,a. leave the infant in the room with the mother.
b. take the infant immediately to the nursery.
c. perform a gestational age assessment to determine whether the infant
is large for gestational age.
d. monitor blood glucose levels frequently and observe closely for signs
of hypoglycemia. Ans✓✓✓ ANS: D
This infant is macrosomic (more than 4000 g) and is at high risk for
hypoglycemia. Blood glucose levels should be monitored frequently,
and the infant should be observed closely for signs of hypoglycemia.
Observation may occur in the nursery or in the mother's room,
depending on the condition of the fetus. Regardless of gestational age,
this infant is macrosomic.
A newborn was admitted to the neonatal intensive care unit after being
delivered at 29 weeks of gestation to a 28-year-old multiparous, married,
Caucasian woman whose pregnancy was uncomplicated until premature
rupture of membranes and preterm birth. The newborn's parents arrive
for their first visit after the birth. The parents walk toward the bedside
but remain approximately 5 feet away from the bed. The nurse's most
appropriate action would be to:
a. wait quietly at the newborn's bedside until the parents come closer.
b. go to the parents, introduce himself or herself, and gently encourage
the parents to come meet their infant; explain the equipment first, and
then focus on the newborn.
c. leave the parents at the bedside while they are visiting so they can
have some privacy.
, d. tell the parents only about the newborn's physical condition, and
caution them to avoid touching their baby. Ans✓✓✓ ANS: B
The nurse is instrumental in the initial interactions with the infant. The
nurse can help the parents "see" the infant, rather than focus on the
equipment. The importance and purpose of the apparatus that surrounds
their infant also should be explained to them. Parents often need
encouragement and recognition from the nurse to acknowledge the
reality of the infant's condition. Parents need to see and touch their infant
as soon as possible to acknowledge the reality of the birth and the
infant's appearance and condition. Encouragement from the nurse is
instrumental in this process. Telling the parents only about the
newborn's physical condition and cautioning them to avoid touching
their baby is an inappropriate action.
A plan of care for an infant experiencing symptoms of drug withdrawal
should include:
a. administering chloral hydrate for sedation.
b. feeding every 4 to 6 hours to allow extra rest.
c. swaddling the infant snugly and holding the baby tightly.
d. playing soft music during feeding. Ans✓✓✓ ANS: C
The infant should be wrapped snugly to reduce self-stimulation
behaviors and protect the skin from abrasions. Phenobarbital or
diazepam may be administered to decrease central nervous system
(CNS) irritability. The infant should be fed in small, frequent amounts,
and burped well to diminish aspiration and maintain hydration. The
infant should not be stimulated (such as with music) because this will
increase activity and potentially increase CNS irritability.
Risk Newborn Questions with accurate answers
A careful review of the literature on the various recreational and illicit
drugs reveals that:
a. more longer-term studies are needed to assess the lasting effects on
infants when
mothers have taken or are taking illegal drugs.
b. heroin and methadone cross the placenta; marijuana, cocaine, and
phencyclidine
(PCP) do not.
c. mothers should discontinue heroin use (detox) any time they can
during
pregnancy.
d. methadone withdrawal for infants is less severe and shorter than
heroin
withdrawal. Ans✓✓✓ ANS: A
Studies on the effects of marijuana and cocaine use by mothers are
somewhat contradictory. More long-range studies are needed. Just about
all these drugs cross the placenta, including marijuana, cocaine, and
PCP. Drug withdrawal is accompanied by fetal withdrawal, which can
lead to fetal death. Therefore, detoxification from heroin is not
recommended, particularly later in pregnancy. Methadone withdrawal is
more severe and more prolonged than heroin withdrawal.
A macrosomic infant is born after a difficult forceps-assisted delivery.
After stabilization the infant is weighed, and the birth weight is 4550 g
(9 lbs, 6 ounces). The nurse's most appropriate action is to:
,a. leave the infant in the room with the mother.
b. take the infant immediately to the nursery.
c. perform a gestational age assessment to determine whether the infant
is large for gestational age.
d. monitor blood glucose levels frequently and observe closely for signs
of hypoglycemia. Ans✓✓✓ ANS: D
This infant is macrosomic (more than 4000 g) and is at high risk for
hypoglycemia. Blood glucose levels should be monitored frequently,
and the infant should be observed closely for signs of hypoglycemia.
Observation may occur in the nursery or in the mother's room,
depending on the condition of the fetus. Regardless of gestational age,
this infant is macrosomic.
A newborn was admitted to the neonatal intensive care unit after being
delivered at 29 weeks of gestation to a 28-year-old multiparous, married,
Caucasian woman whose pregnancy was uncomplicated until premature
rupture of membranes and preterm birth. The newborn's parents arrive
for their first visit after the birth. The parents walk toward the bedside
but remain approximately 5 feet away from the bed. The nurse's most
appropriate action would be to:
a. wait quietly at the newborn's bedside until the parents come closer.
b. go to the parents, introduce himself or herself, and gently encourage
the parents to come meet their infant; explain the equipment first, and
then focus on the newborn.
c. leave the parents at the bedside while they are visiting so they can
have some privacy.
, d. tell the parents only about the newborn's physical condition, and
caution them to avoid touching their baby. Ans✓✓✓ ANS: B
The nurse is instrumental in the initial interactions with the infant. The
nurse can help the parents "see" the infant, rather than focus on the
equipment. The importance and purpose of the apparatus that surrounds
their infant also should be explained to them. Parents often need
encouragement and recognition from the nurse to acknowledge the
reality of the infant's condition. Parents need to see and touch their infant
as soon as possible to acknowledge the reality of the birth and the
infant's appearance and condition. Encouragement from the nurse is
instrumental in this process. Telling the parents only about the
newborn's physical condition and cautioning them to avoid touching
their baby is an inappropriate action.
A plan of care for an infant experiencing symptoms of drug withdrawal
should include:
a. administering chloral hydrate for sedation.
b. feeding every 4 to 6 hours to allow extra rest.
c. swaddling the infant snugly and holding the baby tightly.
d. playing soft music during feeding. Ans✓✓✓ ANS: C
The infant should be wrapped snugly to reduce self-stimulation
behaviors and protect the skin from abrasions. Phenobarbital or
diazepam may be administered to decrease central nervous system
(CNS) irritability. The infant should be fed in small, frequent amounts,
and burped well to diminish aspiration and maintain hydration. The
infant should not be stimulated (such as with music) because this will
increase activity and potentially increase CNS irritability.
