Internship workshop 1 st work shop Pediatric nursing Nursing management of newborn Prepared by : miss/ Amira Ali

1. A neonate weighing 1,503 g is born at 32 weeks’ gestation. During assessment 12 hours after birth, the nurse notices these signs and symptoms: hyperactivity, persistent shrill cry, frequent yawning and sneezing, and jitteriness. These symptoms indicate 1. sepsis. 2. hepatitis. 3. drug dependence. 4. Hypoglycemia 3

2-A neonate was delivered 1 hour ago. He’s pink with acrocyanosis and exhibits occasional shivering movements of his upper extremities. Which nursing action should take priority? 1. Obtain vital signs. 2. Provide warmth with swaddling. 3. Perform a neurologic assessment. 4. Evaluate blood glucose 4

3. A nurse is assessing a 4-hour-old neonate. Which finding should be a cause of concern? 1.Anterior fontanel is 3/4" (1.9 cm) wide, head is molded, and sutures are overriding 2. Hands and feet are cyanotic, abdomen is rounded, and the neonate hasn’t voided or passed meconium 3.Color is dusky, axillary temperature is (35.6° C), and the neonate is spitting up excessive mucus 4. The neonate exhibits irregular abdominal respirations and intermittent tremors in the extremities 3

4. Which neonate is at greatest risk for developing respiratory distress syndrome? 1. A neonate with a history of intrauterine growth retardation 2. A neonate born at less than 35 weeks’ gestation 3. A neonate whose mother experienced prolonged rupture of membranes 4. A neonate born at 38 weeks’ gestation 2

5. A nurse is doing a neurologic assessment on a 1- day-old neonate in the nursery. Which findings indicate possible asphyxia in utero? Select all that apply. 1.The neonate grasps the nurse’s finger when she puts it in the palm of his hand 2.The neonate does stepping move ments when help upright 3.sole of his foot touching a surface. The neonate’s toes don’t curl down ward when the soles of his feet are Stroked 4. The neonate doesn’t respond when the nurse claps her hands above him 5. The neonate turns toward the nurse’s finger when she touches his cheek 6. The neonate displays weak, ineffective sucking. 3,4,6

6. A nurse assesses a neonate’s respiratory rate at 46 breaths/minute 6 hours after birth. Respirations are shallow, with periods of apnea lasting up to 5 seconds. Which action should the nurse take next? 1. Attach an apnea monitor. 2. Continue routine monitoring. 3. Follow respiratory arrest protocol. 4. Call the pediatrician immediately to report findings 2

7. The best way to prevent fetal alcohol syndrome (FAS) is for a pregnant woman to: 1. only drink on social occasions. 2. stop drinking when she becomes pregnant. 3. decrease alcohol intake while attempting to become pregnant. 4. abstain from drinking before becoming pregnant and during the entire pregnancy 2

8. A baby girl delivered at 38 weeks’ gestation weighs 2,325 g and is having difficulty maintaining body temperatureWhich nursing action would best prevent cold stress? 1. Immediately after birth, dry the neonate and place her under a radiant warmer for 2 hours. 2. Administer oxygen for the first 30 minutes after birth 3. Decrease integumentary stimulation after birth 4. Maintain the environmental temperature at a constant level 1

9. A nurse is caring for a drug-dependent neonate. Which intervention should the nurse perform? 1. Limit sensory stimulation of the neonate. 2. Cluster activities. 3. Wrap the neonate loosely in blankets. 4. Increase environmental stimuli 1

10. A nurse is assessing a neonate with tracheoesophageal fistula. Which finding should the nurse expect to encounter? 1. Increase in saliva 2. Gastric tube easily passed 3. Feeding without difficulty 4. Normal chest X-ray 1

12. Which nursing intervention has priority when feeding a neonate with a cleft lip or palate? 1. Directing the flow of milk in the center of the mouth 2. Providing frequent, small feedings 3. Avoiding breast-feeding 4. Infrequent burping 2

13. At age 5 minutes, a neonate is pink with acrocyanosis, has his knees flexed and fist clenched, has a whimpering cry, has a heart rate of 128 beats/minute, and with draws his foot when slapped on the sole. What 5-minuteApgar score should the nurse record for this neonate?

APGAR Score Score / Item 21zero Heart beats> 100 b/min Strong < 100 b/min Or weak beats No heart beats Cry & breathing Strong crying weak crying / irregular breathing No cry / breathing ColorPink body & face Pink body & blue extremities Pale or blue body Movement & tone ActiveSome movementsFlaccid GrimaceTry to keep cath. away Grimace of faceNo response 14

14. When assessing a neonate 1 hour afterdelivery, the nurse measures an axillary temperatureof 95.8° F (35.4° C), an apical pulse of 110 beats/minute, and a respiratory rate of64 breaths/minute. Which nursing diagnosis takes highest priority?

1. Hypothermia related to heat loss 2. Impaired parenting related to the addition of a new family member 3. Risk for deficient fluid volume related to insensible fluid losses 4. Risk for infection related to transition to the extra uterine environment 1

15. A nurse assesses a 1-day-old neonate. Which finding indicates that the neonate’s oxygen needs aren’t being adequately met? 1. Respiratory rate of 54 breaths/minute 2. Abdominal breathing 3. Nasal flaring 4. Acrocyanosis 3

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