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Chapter 34: Nursing Care of the High-Risk Newborn Questions and Answers with Complete Solutions
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Chapter 34: Nursing Care of the High-Risk Newborn Questions and Answers with Complete Solutions
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Chapter 34: Nursing Care of the High-RiskNewborn Questions and Answers with
Complete Solutions
An infant at 36 weeks of gestation has increasing respirations (80 to 100 breaths
per minute with significant substernal retractions). The infant is given oxygen by
continuous nasal positive airway pressure (CPAP). What level of partial pressure of
arterial oxygen (PaO2) indicates hypoxia?
a.67 mm Hg
b.89 mm Hg
c.45 mm Hg
d.73 mm Hg - ANSWER ANS: C
The laboratory value of PaO2 of 45 mm Hg is below the range for a normal
neonate and indicates hypoxia in this infant. The normal range for PaO2 is 60 to 80
mm Hg; therefore, PaO2 levels of 67 and 73 mm Hg fall within the normal range,
and a PaO2 of 89 mm Hg is higher than the normal range.
,On day 3 of life, a newborn continues to require 100% oxygen by nasal cannula.
The parents ask if they may hold their infant during his next gavage feeding.
Considering that this newborn is physiologically stable, what response should the
nurse provide?
a."Parents are not allowed to hold their infants who are dependent on oxygen."
b."You may only hold your baby's hand during the feeding."
c."Feedings cause more physiologic stress; therefore, the baby must be closely
monitored. I don't think you should hold the baby."
d."You may hold your baby during the feeding." - ANSWER ANS: D
Physical contact with the infant is important to establish early bonding. The nurse
as the support person and teacher is responsible for shaping the environment and
making the caregiving responsive to the needs of both the parents and the infant.
Allowing the parents to hold their baby is the most appropriate response by the
nurse. Parental interaction by holding should be encouraged during gavage
feedings; nasal cannula oxygen therapy allows for easy feedings and psychosocial
interactions. The parent can swaddle the infant or provide kangaroo care while
gavage feeding their infant. Both swaddling and kangaroo care during feedings
provide positive interactions for the infant and help the infant associate feedings
with positive interactions.
, A premature infant with respiratory distress syndrome (RDS) receives artificial
surfactant. How does the nurse explain surfactant therapy to the parents?
a."Surfactant improves the ability of your baby's lungs to exchange oxygen and
carbon dioxide."
b."The drug keeps your baby from requiring too much sedation."
c."Surfactant is used to reduce episodes of periodic apnea."
d."Your baby needs this medication to fight a possible respiratory tract infection."
- ANSWER ANS: A
Surfactant can be administered as an adjunct to oxygen and ventilation therapy.
With the administration of an artificial surfactant, respiratory compliance is
improved until the infant can generate enough surfactant on his or her own.
Surfactant has no bearing on the sedation needs of the infant. Surfactant is used
to improve respiratory compliance, including the exchange of oxygen and carbon
dioxide. The goal of surfactant therapy in an infant with RDS is to stimulate the
production of surfactant in the type 2 cells of the alveoli. The clinical presentation
of RDS and neonatal pneumonia may be similar. The infant may be started on
broad-spectrum antibiotics to treat infection.
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