OB Chapter 14
Terms in this set (58)
A sign that should make the nurse suspect hydrocephalus in the newborn is:
an enlarged fontanel or cranial sutures
Expected treatment for hydrocephalus is:
placement of a shunt
Vital sign changes when an infant has increased intracranial pressure include:
increased blood pressure, decreased pulse and respirations
Before surgical repair, the usual position of a newborn with a meningomyelocele is:
prone, maintaining abduction with a pad between the legs.
Which nursing measure is appropriate for a 2-week-old infant who has a new cleft lip repair?
Place in a car seat after each feeding.
A priority of postoperative nursing care for a 9-mont-old infant who has cleft palate repair is:
Appropriate care related to a new plaster cast for correction of clubfoot in the newborn is to:
observe the toes for pallor, cyanosis, reduced capillary refill, or cold temperature.
When checking range of motion of an infant, what sign suggests developmental hyp dysplasia?
Reduced thigh abduction
A 2-week-old infant will be fitted with a Pavlik harness as treatment for developmental hip dysplasia. The mother asks the nurse about the harness and how it will help her baby. To reinforce teh physical explanation, the nurse should teach the motehr that:
keeping the hip bone within the hip socket helps the socket to become deeper.
The nurse should suspect intracranial hemorrhage in a newborn because:
muscle tone has become poor since birth.
The child with PKU must be on a diet that is:
low in phenylalanine to limit buildup of the protein.
Early identification of galactosemia is required to prevent:
liver damage, cataracts, and mental retardation
Appropriate nursing care for parents immediately after the birth of a baby who has characteristics typical of Down syndrome should include:
spending time with them so they can best verbalize their concerns
Parent-infant bonding in an infant with a meningomyelocele prior to repari can be enhanced by:
encouraging the parents to talk to and touch the baby.
The mother of a 2-week-old infant who is going to have a cleft lip repair asks if she will able to hold her baby after surgery. The nurse should reply:
"Holding your baby helps to keep her content."
An Rh-negative woman who gives birth to an Rh-positive infant should receive Rh (D) immune globulin - RhoGAM - no later than ____ hours after birth.
Expected advice for the woman with PKU who is considering pregnancy is to eat a daily diet that:
has low quantitites of phenylalanine.
The infant with Down syndrome is at increased risk for developing:
What complication is more likely for an infant of a diabetic motehr within the first few hours after birth?
Low blood glucose levels
Why might an infant of a diabetic mother be small for gestational age (SGA)?
The placenta did not receive adequate perfusion during pregnancy.
Meconium aspiration syndrome may be prevented by:
reducing meconium in amniotic fluid before birth by amnionfusion.
Surgical repair of a cleft lip
Teaching a skill to a child who is handicapped from birth
Accumulation of cerebrospinal fluid within the brain's ventricles
Excess blood levels of bilirubin
Brain damage due to accumulation of bilirubin in the brain tissue
Large fetal or newborn body size
Form of spina bifida in which portions of the membranes and cerebrospinal fluid are contained in a cystic mass
Group of malformations of the spinal cord
Form of spina bifida that consists of protrusion of a saclike cyst containing meninges, spinal fluid, and a portion of the spinal cord with its nerves
Neonatal abstinence syndrome
Fetal exposure to maternal drugs that cause dependence
Suggests developmental hip dysplasia
Maintains hip abduction in the treatment of developmental hip dysplasia
Single transverse line across the palm
Partial displacement of the head of the femur from the acetabulum
Inspection of a cavity or organ by passing a light through its walls
Presence of one extra chromosome in a body cell
results from the obstruction of CSF flow from the ventricles of the brain to the subarachnoid space.
results when CSF is not obstructed in the ventricles but is inadequately reabsorbed in the subarachnoid space
make sure to support the head of the baby
If baby has a shunt and fontanelle is still bulging, what nursing action should be completed?
place the infant in semi-Fowler's position to facilitate drainage of the ventricles through the shunt
After feeding an infant with hydrocephalus, the infant should be placed in what position?
side-lying because at high risk for vomiting
Positioning of an infant with meningomyelocele
prone position to keep pressure off sac
Infant with cleft palate
1. at increased risk for ear infections.
2. May be ordered elbow restraints to prevent the infant from scratching the lip.
4. May be fed with a dropper to an infant or coming from the side with a spoon with older child.
5. Should be fixed by 3 months
Signs hip dysplasia
1. Limitiation of abduction
2. Asymmetry of skin folds
3. Shortening of femur
4.Butt cheek higher
used to treat hip dysplasia.
Screen for PKU
48-72 hours after birth then repeated in 2 weeks
low protein, most common used formula Lofenalac. May or may not be able to partially breastfeed at same time. Need to watch diet
cannot breastfeed with, doesn't go away, and have to watch diet for rest of life else brain and liver damage.
Down syndrome issues
cardiac and respiratory
When RhoGAM given
Mother is Rh negative and baby is Rh positive. If mother previously had RhoGAM will have antibodies to prevent any problems in subsequent pregnancies.
breakdown of bilirubin
Baby with gestational diabetes
watch for hypoglycemia
Down syndrome characteristics
1. close-set and upward-slanting eyes
2. small head
3. round face
4. flat nose
5. protruding tongue that interferes with sucking
6. mouth breathing
7. simian crease
8. short and thick hands
9. little finger curved
10. wide space between first and second toes
11. ability to assume unusual positions
Intracranial hemorrhage interventions
1. observation of increased intracranial pressure
2. head is elevated
3. feed slowly
Club foot cast care
1. kept uncovered and dry
2. check toes for capillary refill, poor circulation, palor, cyanosis, swelling, coldness, numbness, pain, or burning
3. check for irritation around cast
4. If discolored area appears on cast, circled and time recorded. Further bleeding can be estimated.
Neonatal abstinence syndrome principal signs
body tremors and hyperirritability
also have excess sneezing
Intracranial hemorrage signs
1. poor muscle tone
3. poor sucking reflex
4. respiratory distress
7. forceful vomiting
8. high-pitched shrill cry
10. possible opisthotonic posturing