Question 1

Providing care for the neonate born to a mother who abuses substances can present a challenge for the health care team.Nursing care for this infant requires a multisystem approach.The first step in the provision of this care is

Accepted Answer

Various scoring systems exist to determine the number,frequency,and severity of behaviors that indicate neonatal abstinence syndrome.The score is helpful in determining the necessity of drug therapy to alleviate withdrawal.Pharmacologic treatment is based on the severity of withdrawal symptoms.Swaddling,holding,and reducing environmental stimuli are essential in providing care to the infant who is experiencing withdrawal.However,the scoring helps provide definitive care.Fluids and electrolyte balance are appropriate for any infant.

Question 2

A woman who has had no prenatal care enters the labor and delivery unit in advanced labor.She has chickenpox.What action by the nurse is best?

Accepted Answer

Women with varicella infections (chickenpox or shingles)need to be in isolation (airborne and contact per the CDC).There might not be enough time to administer immune globulin to the mother before delivery,but it could be given to the baby.Acyclovir is the drug of choice for treatment,but the staff needs to be protected from this infection through isolation precautions.Antibiotics are not used for this disease.

Question 3

A primigravida has just delivered a healthy infant girl.The nurse is about to administer erythromycin ointment in the infant's eyes when the mother asks,"What is that medicine for?" The nurse responds

Accepted Answer

With the prophylactic use of erythromycin,the incidence of gonococcal conjunctivitis has declined to less than 0.5%.Eye prophylaxis is administered at or shortly after birth to prevent ophthalmia neonatorum.Erythromycin has no bearing on enhancing vision and is not used for herpes infections or lubrication.

Question 4

A woman who has a history of frequent substance abuse is close to delivering.What action by the nurse is best?

Accepted Answer

When anticipating the delivery of a baby whose mother is addicted to opioids,the nurse prepares to give the newborn naloxone for respiratory depression.To administer the drug in the fastest way possible,the nurse prepares a syringe with the medication.Then when the baby's weight is known,the nurse discards the excess drug and administers the correct dose to the baby.Social services will need to be involved but not at this point; the medication is the priority.The naloxone may cause signs of withdrawal in the infant.The baby gets the naloxone,not the mother.

Question 5

Near the end of the first week of life,an infant who has not been treated for any infection develops a copper-colored,maculopapular rash on the palms and around the mouth and anus.The newborn is showing signs of

Accepted Answer

This rash is indicative of congenital syphilis.The lesions may extend over the trunk and extremities.This is not characteristic of gonorrhea,herpes,or HIV.

Question 6

Newborns whose mothers are substance abusers frequently have what behaviors? (Select all that apply.)

Accepted Answer

The infant exposed to drugs in utero often has poor sleeping patterns,hyperactive reflexes,and uncoordinated sucking and swallowing behavior.They do not have circumoral cyanosis and will have a high-pitched cry.

Question 7

The nursing student learns that transmission of HIV from mother to baby occurs in which fashion?

Accepted Answer

Postnatal trAnswermission of HIV through breastfeeding may occur.TrAnswerplacental trAnswermission can occur at any time during pregnancy.Unsterile instruments are possible sources of trAnswermission but highly unlikely.TrAnswermission of HIV may also occur during birth from blood or secretions.TrAnswermission of HIV from the mother to the infant may occur trAnswerplacentally at various gestational ages.This is highly unlikely as most health care facilities must meet sterility standards for all instrumentation.

Question 8

Some infants develop hypoxic-ischemic encephalopathy after asphyxia.Therapeutic hypothermia has been used to improve neurologic outcomes for these infants.Criteria for the use of this modality include (Select all that apply.)

Accepted Answer

The infant must be at least 36 weeks of gestation to meet the criteria for therapeutic hypothermia.Treatment should be initiated within the first 6 hours of life,ideally at a tertiary care center.The infant must have evidence of perinatal hypoxic-ischemic episodes.

Question 9

The nurse is preparing a dose of naloxone for a newborn who weighs 6.9 pounds.How much naloxone does the nurse administer? ______ mg

Accepted Answer

The answer of The nurse is preparing a dose of...

Question 10

What action does the nurse add to the plan of care for an infant experiencing symptoms of drug withdrawal?

Accepted Answer

The infant should be wrapped snugly to reduce self-stimulation behaviors and protect the skin from abrasions.The baby is not kept sedated.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.

Quiz 30: The High-Risk Newborn: Acquired and Congenital Conditions