Inquire through: | Professional | Confidential Support
Chapter 34: Nursing Care of the High Risk
Newborn Lowdermilk: Maternity & Women's
Health Care, 12th Edition Verified and
Updated Questions and Answers (100%
Correct Answers)
1. 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.
2. 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
, Inquire through: | Professional | Confidential Support
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.
3. 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.
4. An infant is to receive gastrostomy feedings. Which intervention should the nurse
institute to prevent bloating, gastrointestinal reflux into the esophagus, vomiting,
and respiratory compromise?
a. Rapid bolusing of the entire amount in 15 minutes
b. Warm cloths to the abdomen for the first 10 minutes
c. Slow, small, warm bolus feedings over 30 minutes
Chapter 34: Nursing Care of the High Risk
Newborn Lowdermilk: Maternity & Women's
Health Care, 12th Edition Verified and
Updated Questions and Answers (100%
Correct Answers)
1. 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.
2. 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
, Inquire through: | Professional | Confidential Support
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.
3. 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.
4. An infant is to receive gastrostomy feedings. Which intervention should the nurse
institute to prevent bloating, gastrointestinal reflux into the esophagus, vomiting,
and respiratory compromise?
a. Rapid bolusing of the entire amount in 15 minutes
b. Warm cloths to the abdomen for the first 10 minutes
c. Slow, small, warm bolus feedings over 30 minutes
