Newborn – tutoring
1.Describe the following reflexes: Babinski, Grasp, Moro, Rooting, Step, Sucking, Tonic neck
2. What is incorrect about the normal breathing patterns for these newborns
Baby A is breathing deeply, with a regular rhythm, at a rate of 40/min
Baby B is sleeping. His is breathing diaphragmatically and his sternum is
retracting. The rate is 70/min.
Baby C is breathing swallowing with 40 second periods of apnea and cyanosis.
3. A newborn (4 hours old) weights 8 lbs and is 20 inches long. Her head is 12 inches in
circumference and her chest is 14 inches in circumference. Her anterior fontanel is palpable and
the posterior fontanel is not. Bowel sounds are present and she has just passed meconium. She
has fine hair on her forehead and shoulders and vernix is the folds of her wrists, elbows and
ankles.
4. Apgar – One minute after birth an infants heart rate is 60/min. the baby has slow respirations
and a weak cry, slight flexion of extremities, grimaces when suctioned, and is pink except for
the hands and feet, which are blue.
5. Prioritize nursing activities in care of newborn at delivery
a. place the infant skin-to-skin with the mother or in a warmer
b. place the baby in Trendelenburg position and suction the nose and mouth
c. perform complete physical examination
d. bathe the infant
e. administer eye ointment
f. assess the baby’s respirations and heart rate
g. footprint the baby and thumbprint the mother applying matching ID bands
6. The following nursing interventions prevents which type of heat loss
a. keep hat on the newborns head
b. dry the infant
c. regulate the room temperature
d. warm hands and stethoscope before touching newborn
e. keep the infant well wrapped
f. use a warmed blanket to wrap the infant
7. If the average newborn needs 100-120 calories per kilogram per day and the infant weights 8
pounds (3.64 kg) how many calories is needed per day?
8. Describe the discharge teaching needed for the circumcised male.
9. A 32-week gestation male infant is born to a 30-year old mother. His birth weight is 1100
grams. The infant’s Apgar scores are 3 at one minute and 7 at five minutes. The infant is having
nasal flaring, grunting, substantial, and intercostal retractions. He is flaccid, lying in a frog-like
position. The baby is covered with a thick, cheesy substance and lanugo is widely distributed
over his body
- Baby P, one hour old, was born at 42 weeks and three days of gestation. He has loose skin with little subcutaneous fat. He has no lanugo and no vernix , but does have a great deal of hair on his head, as well as long fingernails. His skin is dry, cracked, and peeling. His skin, umbilical cord, and nails are stained. The baby weighed 7 pounds at birth. His Apgar scores were 6 and 7 at one minute and five minutes.
11 An obese, multiparous woman at 40 weeks of gestation has just given birth to a baby. After
prolonged pushing in second stage, a forcep-assisted birth was necessary. The baby weighs
9 lbs and 8 oz. The baby has marked caput and marked bruising about the face, head, and
shoulders.
12. Baby girl J.P. , was born less than one hour ago. Her gestational age is 38 weeks and she is
10 lbs 5 oz. J.P.’s mother was diagnosed with gestational diabetes at 26 weeks gestation.
The newborns first blood glucose reading is slightly under 40 mg/dL. J.P’s heart rate is
120, her respirations are 80, and she is not flexing her arms and legs as newborns usually
do. The mother intends to breastfeed J.P., but she has not tried yet.
13. E.M. is a one-day-old, full term newborn. She weighs 7 lbs 1 oz. She is receiving
phototherapy because of jaundice secondary to ABO incompatibility. E.M. is
breastfeeding, but has been sleepy and is feeding poorly. She has had several loose green
stools. Her skin and mucous membranes are slightly dry, skin turgor is good and the
anterior fontanel is flat. Her urine is slightly dark.
14. JB is a premature, AGA African American male infant, who weighed 4.4 lbs at birth. His
Apgar scores were 5 and 7. J.B. is in an incubator, receiving oxygen, attached to a cardiac
monitor and pulse oximeter. His respiratory rate is 68 per minute, heart rate is 150 beats
per minutes, and temperature is 97.4 rectally. He has sternal retractions, nasal flaring, and
expiratory grunting with his breathing. His mother wishes to breastfeed him, but he is
presently being gavage fed because he is too lethargic to latch on and suck effectively.
15 List risk factors for sepsis in newborns.
16Which of following is neonatal sepsis suspected (temps are all axillary)
- baby A – temp 100 F, dry mucous membranes, minimal urinary output
- baby B – temp 97 F, feeding poorly, lethargic, pate, and jittery
- baby C – temp 98.4, nasal flaring and grunting with respirations, mottled, with periods of apnea
- baby D – temp 96.8 , jaundiced, feeding poorly
- Baby E – temp 98.2, diarrhea, vomiting , rash
17. BJ is 72 hours old. He was born prematurely at 32 weeks gestation and was exposed to
cocaine and heroin in utero. He is SGA, not feeding well, but suck frantically on a pacifier. He
is being fed through a nasogastric tube and regurgitates much of his feedings. His temperature
is 100 F, pulse is 140, and respirations are 70 per minute. His in on an apnea monitor, B.J. has
had six watery stools in the past 24 hours and has lost 10% of his birth weight. He has mild
tremors when stimulated, and cries often with a high- pitched cry.