HESI Case Study: Healthy Newborn - Questions & Answers

HESI Case Study: Healthy Newborn - Questions & Answers The nursery RN places the infant under a radiant warmer and starts to dry her quickly. What is the rationale for these actions? Convective heat loss from evaporation is reduced. [Drying the infant quickly and placing her under a radiant warmer reduces heat loss through evaporation and radiation.] Which action should the nurse take prior to drying the infant's back? Inspect the back for possible neurological defects. [To prevent harm while drying the newborn, the back should always be inspected for possible neurological defects, such as spinal bifida.] Apgar Score Heart Rate: absent = 0, slow (100) = 1, Over 100 = 2 Resp Rate: absent = 0, slow/irregular = 1, good/crying = 2 Muscle Tone: flaccid = 0, some flexion of the extremeties = 1, active motion = 2 Reflex Irritability: no response = 0, grimace = 1, cry = 2 Color: blue/pale = 0, body pink/extremeties blue = 1, completely pink = 2 Upon inspection o the umbilical cord, which finding should the nurse report to the healthcare provider? One artery and one vein are present. [Two arteries and one vein should be present.] The Carson's baby's head is molded from the vaginal delivery. Upon seeing the baby, Ms. Carson says, "Oh, she is so beautiful, but something is wrong with her head." How should the nurse respond? Her head has been molded from delivery through the birth canal, which is normal. [Molding commonly curs in babies delivered vaginally, and the head will become more symmetrical over time.] The nurse checks the identification bands for both the baby and the mother upon admission to the nursery. One ID number is incorrect. Which action should the nurse take to solve this problem? Redo the identification bands with another nurse witnessing the process. [Identification bands must be correct to ensure the safety and security of all hospitalized clients, especially newborns.] Upon admission to the transition care nursery, the Carson's baby's auxiliary temperature is 97.4 F. WHich action should the nurse take? Place the infant in a radiant warmer and monitor her temperature. [The baby's temperature is not within normal range (97.5-99F). The infant should remain in the radiant heat warmer until her temperature has stabilized.] While examining the infant's