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Newborn Assessment and Care Exam Study Guide, Exams of Nursing

Galen Health Institute - San AntonioNursing

A study guide for the nur230 newborn assessment and care 1 exam. It covers a wide range of topics related to newborn physiology, assessment, and care, including respiratory function, skin and color assessment, reflexes, measurements, and common newborn conditions and interventions. The guide provides detailed information on the correct answers to various multiple-choice questions, covering topics such as the triggers for the first breath, normal newborn respiratory patterns, signs of respiratory distress, airway management techniques, and the treatment of respiratory distress syndrome (rds). Additionally, the document addresses newborn skin, head, and extremity assessments, as well as common congenital abnormalities. This comprehensive study guide could be a valuable resource for nursing students preparing for an exam on newborn assessment and care.

Typology: Exams

2024/2025

Available from 10/21/2024

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NUR230 NEWBORN ASSESSMENT AND
CARE 1 EXAM STUDYGUIDE
QUESTIONS AND ANSWERS| A+ GRADE
chemical stimuli of newborn Correct Answer -first breath grasp;
triggered by Pco2 and decreased pH and Po2
-trigger of brains respiratory center
-natural result of a normal vaginal birth
thermal stimuli Correct Answer -decrease in environmental temp
after birth
-newborn responds w increase in respirations
-avoid prolonged exposure to cold = cold stress/apnea
sensory stimuli Correct Answer Light
Sounds
Gravity
Touch
normal newborn respirations first 2 hours Correct Answer 60-70
breaths per min
newborn respirations after first 2 hours Correct Answer 30-60
breaths per min
periodic breathing Correct Answer holds breath up to 20 seconds
apneic breathing Correct Answer hold breath for more than 20
seconds
signs of newborn resp distress Correct Answer -nasal flaring
-intercostal or xiphoid retractions
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NUR230 NEWBORN ASSESSMENT AND

CARE 1 EXAM STUDYGUIDE

QUESTIONS AND ANSWERS| A+ GRADE

chemical stimuli of newborn Correct Answer - first breath grasp; triggered by Pco2 and decreased pH and Po

  • trigger of brains respiratory center
  • natural result of a normal vaginal birth thermal stimuli Correct Answer - decrease in environmental temp after birth
  • newborn responds w increase in respirations
  • avoid prolonged exposure to cold = cold stress/apnea sensory stimuli Correct Answer Light Sounds Gravity Touch normal newborn respirations first 2 hours Correct Answer 60 - 70 breaths per min newborn respirations after first 2 hours Correct Answer 30 - 60 breaths per min periodic breathing Correct Answer holds breath up to 20 seconds apneic breathing Correct Answer hold breath for more than 20 seconds signs of newborn resp distress Correct Answer - nasal flaring
  • intercostal or xiphoid retractions
  • expiratory grunting or sighing
  • seesaw respirations
  • tachypnea interventions for clearing newborn airway Correct Answer bulb suctioning chest percussion (mallet) transient tachypnea of newborn Correct Answer progressive respiratory distress noted by at least 6 hours of age until 72 hours causes of transient tachypnea of newborn Correct Answer LGA, late preterm infants, maternal over sedation, maternal bleeding, prolapsed cord, breech birth, maternal diabetes, cesarean birth more prevalent bulb suction is used for Correct Answer non-meconium babies suction catheter is used for Correct Answer meconium babies stabilization at delivery Correct Answer - replace w dry blankets; replace w warm blankets
  • warm (kangaroo care/warmer); warm blankets/hat how many baby bracelets do parents/baby get? Correct Answer - 2 for mom/sig other
  • 2 bracelets for baby apgar scores are given at Correct Answer 1 and 5 minutes apgar scoring criteria Correct Answer - heart rate
  • respiratory effort
  • muscle tone
  • reflex irritability
  • color

how much fluid remains in the lungs of full-term infant Correct Answer 80 - 100 what happens to the fetal chest during the birth process Correct Answer the fetal chest is compressed and squeezes fluid out mechanical changes of labor Correct Answer - at time of delivery, 80 - 100 mL of fluid remains in lungs of full-term infant

  • decreased production of lung fluid 2-4 days prior to delivery
  • during birth processes, the fetal chest is compressed and squeezes fluid out first breath grasp is triggered by Correct Answer increased Pco and decreased pH and Po transient tachypnea of newborn treatment Correct Answer - chest xray: hyper-expanded lungs, clear by 72 hours
  • oxyhood: less than 40%, O2 cannula 2 liters
  • possible IV fluids or tube feedings; due to elevated resp rate to prevent aspiration the __ are the terminal air sacs at the very ends of each lung branch Correct Answer alveoli what are the last to form during development of the lung? Correct Answer alveoli what is critical to extra-uterine life as this is where gas exchange occurs? Correct Answer alveoli the younger the baby, the fewer the ____ and the more severe the RDS is likely to be Correct Answer alveoli surfactant development in the alveoli can be stimulated by Correct Answer - giving the mother Betamethasone
  • rupture of membranes RDS is treated with Correct Answer - oxygen therapy
  • surfactant administration
  • thermoregulation
  • ECMO oxygen therapy to treat RDS Correct Answer continuous positive airway pressure therapy (CPAP) mechanical ventilation high frequency ventilation surfactant administration to treat RDS Correct Answer beractant/survanta poractant alpha/curosurf calfactant/infrasurf lucinactant/suraxin colfosceril/Exosurf thermoregulation to treat RDS Correct Answer incubator ECMO to treat RDS Correct Answer for severely ill babies a modified heart/lung machine that allows the baby's lungs to rest/heal oxygen therapy to newborns Correct Answer nasal cannula oxyhood assess newborn's HR apically when Correct Answer infant is at rest heart rate may drop to ___ while infant is sleeping Correct Answer 80 to 100 when crying, infant HR may increase to Correct Answer 180 BPM

Normal axillary temperature range Correct Answer 97.7-99. normal rectal temp Correct Answer 97.8-99. causes of heat loss Correct Answer - a large surface area to body mass ratio

  • subcutaneous fat
  • body water content
  • immature skin leading to evaporative water and heat losses
  • poorly developed metabolic mechanism for responding to thermal stress (no shivering)
  • altered skin blood flow (peripheral cyanosis) ___ babies are at even greater risk because they usually Correct Answer - lack a flexed posture for preserving heat
  • very thin skin w capillaries close to the surface signs/symptoms of hypothermia Correct Answer acrocyanosis and cool, mottled, or pale skin hypoglycemia transient hyperglycemia bradycardia tachypnea/restlessness/shallow and irregular resps RESP DISTRESS, APNEA, HYPOXEMIA, METABOLIC ACIDOSIS decreased activity, lethargy, hypotonia feeble cry, poor feeding decreased weight gain hyperthermia causes Correct Answer - overheating from incubators, radiant warmers, or ambient environmental temp
  • maternal fever
  • maternal epidural anesthesia
  • phototherapy lights, sunlight
  • excessive bundling or swaddling
  • infection
  • CNS disorders
  • dehydration hyperthermia symptoms Correct Answer tachycardia/tachypnea/apnea warm extremities, flushing, perspiration (term newborns) dehydration lethargic/hypotonia/poor feeding irritability weak cry hyperthermia consequences Correct Answer - hypotension and dehydration (as a result of increased insensible water loss)
  • seizures and apnea (as a result of high core temp)
  • hypernatremia
  • respiratory distress hyperthermia management Correct Answer *adjust environmental conditions
  • move newborn away from source of heat, undress partially or fully if necessary
  • if in incubator, air temp should be lowered
  • newborn must be breastfed frequently to replace fluids kangaroo care is used for ____ infants Correct Answer stable radiant warmer is used for ____ Correct Answer c/s infants unstable infants close assement average weight of infant at term Correct Answer 3405g infant weight loss: term infants Correct Answer 5 - 10% of birth wt

approximately 1/4 of body size newborn fontanelles Correct Answer anterior: 2.1 cm (diamond shape) posterior: < 0.5 cm (triangle shape) molding Correct Answer Shaping of the fetal head during movement through the birth canal. Cephalohematoma Correct Answer hemorrhage between skull- periosteum

  • bleeding from ruptured membrances
  • does not cross suture lines caput succedaneum Correct Answer soft tissue swelling; does cross suture lines eye variations in newborn Correct Answer subconjunctival hemorrhage transient strabismus doll's eye subjunctival hemorrhage Correct Answer blood in the white part of the eye
  • caused by trauma/pressure transient strabismus Correct Answer cross-eyed doll's eyes Correct Answer When the head is turned to one side, the eyes should move conjugately to the opposite direction if the brainstem is intact placement of newborns ears Correct Answer low set

ear form and cartilage distribution: preterm infant Correct Answer relatively shapeless and flat, no recoil ear form and cartilage distribution: term infant Correct Answer some cartilage and slight incurving of upper pinna, good recoil newborn mouth assessment Correct Answer assess suck cleft lip and palette precocious teeth epstein's pearlds newborn;s ears must intersect with Correct Answer part of ear (pinna) what is the greatest immediate risk to newborn and what causes it? Correct Answer aspiration of feedings; cleft lip/cleft palette Epsteins pearls are? Correct Answer Small,white epithelial cysts on babys gums. what decreases as gestational age increases Correct Answer lanugo breast bud term: Correct Answer the tissue will measure between 0.5 and 1 cm 3 vessels of umbilical cord Correct Answer 2 arteries and 1 vein *observe for umbilical hernia sacral dimple Correct Answer indention or "pit" at the base of spine (sometimes accompanied by tuffs of hair)if if sacral dimple is not closed, you need to do a ... Correct Answer ultrasound

nevus flammeus (port wine stain) nevus vasculosus (strawberry mark) vernix caseosa Correct Answer cheesy substance covering the skin of the fetus Milia Correct Answer Benign, keratin-filled cysts that can appear just under the epidermis and have no visible opening. Telangiectatic nevi Correct Answer blanchable pink "stork bites" Mongolian spots Correct Answer bluish purple spots of pigmentation nevus flammeus Correct Answer a port wine stain on face or neck that is permanent birthmark of newborn strawberry mark Correct Answer capillary hemangioma; raised, bright red doesn't blanch; immature capillaries present at birth; disappear by 5-7 years; no treatment needed newborn extremities deformities Correct Answer fractured clavicle erbs palsy simian crease syndactyly or polydactyly clubfoot sole (plantar) creases hip dislocation erbs palsy Correct Answer a paralysis of the arm that most often occurs as an infant's head and neck are pulled toward the side at the same time as the shoulders pass through the birth canal simian crease Correct Answer a single straight palmar crease; an abnormal finding that is associated with Down Syndrome.

syndactyly Correct Answer webbed fingers or toes Polydactyly Correct Answer extra digits clubfoot Correct Answer feet arent turned the correct way left dysplasia of hip Correct Answer disaligned, extra creases to determine presence of clubfoot.. Correct Answer nurse moves foot to midline *resistance indicates true clubfoot Barlow maneuver Correct Answer newborn hip evaluation - adduction of hip - evaluates for congenital dislocation *will feel femur move out of acetabulum ortolanis maneuver Correct Answer A manual procedure performed to rule out the possibility of developmental dysplastic hip *positive sign will hear hip "clunk"

  • puts downward pressure on hip and then inward rotation