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ATI Simulation Real Life 3.0 RN Maternal Newborn Teaching Prenatal and Newborn Care BA _ Simulation: Real Life 3.0 @ CLOSE ati. Module: RN Maternal Newborn Teaching Prenatal and Newborn Care Ce) Scenario Overview The teaching prenatal and newborn care scenario focuses on a 28-year-old female who is in her third trimester of pregnancy, her attendance at a prenatal teaching class, and her educational needs in the postpartum unit following the delivery of her newborn. Primary characters you will meet in this scenario: Viewing 1 | of 1 Claire Collins Kyle Fox Toni Long Sandra Pierce Client Client's Partner Registered Nurse Charge Nurse ae . Simulation: Real Life 3.0 @ CLOSE ati Module: RN Maternal Newborn Teaching Prenatal and Newborn Care Nurse Toni is reviewing the handout about IV pain medications during labor with Claire. Which of the following statements should Nurse Toni make? Opioid analgesics cross the placenta and can cause respiratory depression in the newborn. Opioid analgesics should not be given within 1 to 4 hr of birth. v "You can receive meperidine up until 4 hours prior to birth." "Butorphanol can increase your baby’s risk of developing jaundice." "Nalbuphine can be given once per hour during labor." "Your labor will be shorter if you receive fentanyl." @ CLOSE Nurse Toni is reviewing Apgar scoring with charge nurse Sandra. Identify the score nurse Toni should assign to a newborn who has the following findings at 1 minute after birth: Heart Rate: 90/min Slow, weak cry Well-flexed extremities Grimacing Acrocyanosis Enter the score in the field below and then submit. © Simulation: Real Life 3.0 ati Module: RN Maternal Newborn Teaching Prenatal and Newborn Care The nurse should calculate the Apgar score at 1 and 5 minutes after birth. One point is given for a heart rate less than 100/min; one point is given for a slow, weak cry; two points are given for well-flexed extremities; one point is given for grimacing; and one point is given for acrocyanosis. The nurse should therefore give this newborn an Apgar score of 6. Enter answer : 6 ae . Simulation: Real Life 3.0 @ CLOSE ati Module: RN Maternal Newborn Teaching Prenatal and Newborn Care Nurse Toni is reviewing routine newborn medications with Claire. Which of the following medications should Nurse Toni include? Erythromycin ophthalmic ointment is administered to a newborn within 2 hr of birth to prevent ophthalmia neonatorum, an infection caused by bacteria that can be transmitted via the maternal birth canal. Hepatitis A vaccine Rh immune globulin 7] Erythromycin ophthalmic ointment Phytonadione ©? Simulation: Real Life 3.0 @ CLOSE ati Module: RN Maternal Newborn Teaching Prenatal and Newborn Care Nurse Toni is teaching Claire about collecting a blood specimen from a newborn via a heel stick. Which of the following locations should Nurse Toni ask Claire to identify as the location for the heel puncture? (You will find hot spots to select in the artwork below. Select only the hot spot that corresponds to your answer.) The outer aspect of the heel should be used for the puncture site on a newborn. Osteochondritis is a potentially serious adverse effect of a heel stick. The risk for osteochondritis is significantly reduced when the outer aspect of the heel is used. ©? Simulation: Real Life 3.0 @ CLOSE ati Module: RN Maternal Newborn Teaching Prenatal and Newborn Care Nurse Toni is reviewing manifestations of newborn hypoglycemia with Claire. Which of the following manifestations should Nurse Toni include? Jitteriness is a manifestation of hypoglycemia in a newborn. Other manifestations include a weak cry, tachypnea, episodes of apnea, and seizures. Dilated pupils v Jitteriness Loud cry Hypersalivation ae . Simulation: Real Life 3.0 @ CLOSE ati Module: RN Maternal Newborn Teaching Prenatal and Newborn Care Nurse Toni is teaching Claire and Kyle about newborn feeding-readiness cues that indicate hunger. Which of the following should Nurse Toni include in the teaching? (Select all that apply.) The nurse should identify that feeding-readiness cues include rooting, sucking on hands, and an open mouth. Other cues include hand-to-hand movements and mouthing. @ Rooting Spitting up Decreased movement ae . Simulation: Real Life 3.0 @ CLOSE ati Module: RN Maternal Newborn Teaching Prenatal and Newborn Care Nurse Toni is teaching Claire about colostrum. Which of the following statements should Nurse Toni include? Colostrum is rich in antibodies, which provide passive immunity for the newborn, decreasing the risk for infection. "Colostrum is high in fat and low in protein." "Colostrum decreases the number of stools your baby has." v "Colostrum helps protect your baby from infection." "Colostrum decreases your baby’s risk of bleeding." Simulation: Real Life 3.0 @ CLOSE ras ati. Module: RN Maternal Newborn Teaching Prenatal and Newborn Care Nurse Toni is teaching Claire and Kyle about the hepatitis B vaccine. Which of the following statements by Claire indicates an understanding of the teaching? The hepatitis B vaccine requires the parent or guardian to sign an informed consent form prior to administration. Once the informed consent is signed, the hepatitis B vaccine is administered intramuscularly into the vastus lateralis in a newborn. @ "| will need to sign an informed consent form for this vaccine." "The nurse will administer the vaccine in our baby’s upper arm." "This vaccine is given in a series of five doses over 3 years." “This vaccine is administered into subcutaneous tissue." Simulation: Real Life 3.0 @ CLOSE aan ras ati. Module: RN Maternal Newborn Teaching Prenatal and Newborn Care Nurse Toni is teaching Claire and Kyle about swaddling. Which of the following statements by Kyle indicates an understanding of the teaching? There should be enough space for two to three adult fingers between the blanket and the baby’s chest. This prevents overheating or compromising the newborn’s ability to breathe. Additionally, the newborn’s legs should be slightly flexed and abducted when swaddled, and the blanket should be loose enough to allow free movement of the knees. “We can prop our baby on his side to sleep when he is swaddled." “We will swaddle our baby with his knees and hips slightly flexed." “We can swaddle our baby until he is 4 months old." & "We should be able to fit two to three fingers between the blanket and our baby’s chest." = Simulation: Real Life 3.0 @ CLOSE ou ati. Module: RN Maternal Newborn Teaching Prenatal and Newborn Care Nurse Toni is teaching Claire about newborn elimination. Which of the following statements should Nurse Toni make? Term newborns of adequate birth weight should begin passing meconium within 24 to 48 hours after birth. "Your baby should have a wet diaper three to four times a day once he is a week old." @ "Your baby should pass his first meconium stool within 24 to 48 hours of birth." "You should expect your baby to have clay-colored stools beginning around the third day of life." "You should notify your baby’s provider if his urine has a pink tinge during the first week of life." Simulation: Real Life 3.0 @ CLOSE Module: RN Maternal Newborn Teaching Prenatal and Newborn Care Nurse Toni is teaching Claire and Kyle about umbilical cord care. Which of the following information should Nurse Toni include? The parent should cleanse the skin at the base of the cord with plain water if soiled. The parent should then dry the site thoroughly. Place antibiotic ointment on the cord twice each day. Remove the clamp 6 to 12 hr after birth using the specified tool. Ensure the cord remains covered by the diaper. @ Wash the area at the base of the cord with plain water if soiled. sk _ Simulation: Real Life 3.0 @ CLOSE Co ve ati Module: RN Maternal Newborn Teaching Prenatal and Newborn Care Nurse Toni is teaching Claire and Kyle about safe sleeping. Which of the following information should Nurse Toni include in the teaching? To ensure the newborn's safety and decrease the risk for SIDS, the newborn should sleep on a firm mattress. Cover the newborn with a light, cotton blanket during sleep. 7] The newborn should be placed on a firm mattress for sleep. Bed sharing is encouraged during the first few weeks of life. Tie bumper pads securely to the rails of the crib. a _ Simulation: Real Life 3.0 @ CLos aA = ati, Module: RN Maternal Newborn Teaching Prenatal and Newborn Care Nurse Toni is teaching Claire and Kyle about circumcision care. Which of the following instructions should Nurse Toni include? Gentle pressure should be applied to the circumcision site using a gauze pad if bleeding occurs. If bleeding does not stop, the provider should be notified. Gently wipe the penis with an alcohol swab after each soiled diaper. Make sure the diaper fits snugly over the area. Wash the area with warm, soapy water with each diaper change. @ Apply gentle pressure to the area with gauze if bleeding occurs. 
