Case Studies,
Chapter 17, Newborn Transitioning
1. Sarah works in the labor and delivery unit as a transition nurse. Her department has instituted a new bedside transition period where newborns make the transition to extrauterine life in their mother’s recovery room about an hour after birth. Sarah’s next assignment is a new baby boy with Apgar scores of 8 and 9, born by cesarean about 1 hour ago to Lindsay, a 28-year-old G1. Sarah’s assessment findings of the new baby boy are:
As Sarah is charting her findings, Lindsay asks Sarah if everything is OK with her baby. (Learning Objectives 1, 2, 3, and 4)
2. Baby girl Destiny was born by cesarean delivery 2 days ago. Destiny weighed 7 lb 3 oz, length 19 in, head circumference 34 cm, and chest circumference 34 cm. Her newborn course has been unremarkable. You observe that when held, Destiny appears alert and stares into her caregiver’s face. Destiny appears to be a content baby and cries only when she is hungry or when she needs a diaper change. When hungry, you observe that she brings her hand to her mouth and starts sucking on her fist and then begins to cry. Destiny falls asleep immediately after the feeding. The telephone, which is next to Destiny on her mother’s bed, rings loudly and Destiny does not appear to respond to the loud sound by moving her extremities or awakening briefly. (Learning Objectives 7 and 8)
Case Studies,
Chapter 18, Nursing Management of the Newborn
1. As a postpartum nurse your next client is an LGA baby boy who was born at 37 weeks’ gestation. He had Apgar scores of 8 and 9. He was circumcised. The mother is breast-feeding. Your unit requires a full assessment, screenings, discharge instructions, and documentation. (Learning Objectives 3, 6,7, and 9)
2. You are the newborn nursery nurse and have been called to the labor and delivery suite to attend the delivery of a G5P4 mother whose pregnancy was complicated by gestational diabetes. At 2032 a male infant weighing 8 lb 2 oz was delivered vaginally with the assistance of a vacuum extractor. You have assigned Apgar scores of 7 and 9. (Learning Objectives 1, 2, 4, 5, and 7)
Case Studies,
Chapter 23, Nursing Care of the Newborn With Special Needs
1. Brenda is a nurse in a special care nursery. A 16-year-old girl had been admitted to the emergency department earlier that morning with complaints of excruciating back pain and nausea. She was diagnosed as being in labor and transferred to the labor and delivery unit. She was apparently unaware of the pregnancy. She received no prenatal care and cannot remember the exact date of her last menstrual period. An ultrasound determined the infant to be approximately 5 lb. All attempts to stop labor are unsuccessful, and a baby girl is delivered. The newborn is placed on the open bed warmer for the team to assess.
They observe decreased muscle tone, spontaneous respirations, and heart rate 120. The infant is crying softly. The infant receives stimulation by drying with a warm blanket and oxygen blow-by via bag and mask by the respiratory therapist at just prior to 1 minute of age. The infant’s color is blue at 1 minute of age and her Apgar score is 7. The infant’s tone improves, and she begins to pull her arms and legs to midline. Her color improves quickly with blow-by oxygen and the respiratory therapist slowly backs off the oxygen. The infant receives an Apgar score of 9 at 5 minutes of age.
The baby’s physical appearance includes the following: head a little larger than body size, numerous veins visible under skin, plantar creases on half of foot sole, ears are formed and soft with little cartilage, nipples aren’t well defined, labia majora smaller than labia minora. (Learning Objectives 1, 2, 3, and 4)
2. Paula gave birth to a premature baby boy at 27 weeks’ gestation. Baby boy Matthew is 10 days old, weighs 2 lb 1 oz and has just been diagnosed with a grade IV cerebral bleed. He is intubated and on a ventilator. He has an oral gastric tube in his mouth and has an umbilical IV access. Paula has just been informed that the probability of Matthew surviving is very low. (Learning Objectives 2, 3, 4, and 5)
A. Discuss the effect of Matthew’s death on his parents. What can the nurse do to assist them during this time?
Case Studies,
Chapter 24, Nursing Management of the Newborn at Risk: Acquired and Congenital Newborn Conditions
1. On the evening shift in the special care nursery, you are paged to delivery room 5. When you arrive, the labor nurse says the baby has been stuck in the birth canal for a while, and the fetal heart tones are down. They use the vacuum suction to assist delivery. The doctor gets the baby out and places the infant on the radiant warmer. You are the resuscitating nurse for the infant, and you observe the following: the infant is limp, pale, gasping, has poor tone, and the heart rate is 101. (Learning Objective 1)
2. Tammi is an 18-year-old single mother who delivered a full-term infant 3 days ago. The father is not involved, and Tammi’s aunt is her support person. The infant is very fussy in the nursery, with mild tremors noted. Tammi is having a hard time feeding her baby, the baby spits up a lot and he does not console easily. The physician has been called to assess the infant. (Learning Objective 6)
Please write the answers underneath each question. Please also take your time and do a good job.
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