Price: Pediatric Nursing, 10th Edition

Open Book Quizzes Chapter 6: Disorders of the Newborn

1. The most common symptoms in infants include failure to thrive, chronic diarrhea, repeated respiratory infections, oral candidiasis, and enlargement of the liver and spleen. 2. The clinical signs of severe dehydration in an infant include the following: heart rate and respiratory rate are increased; blood pressure is normal or slightly decreased; behavior can be characterized as lethargic or comatose; turgor shows severe tenting; capillary refill time is greater than 3 seconds; skin is cold and clammy; cyanosis may be present; mucous membranes are extremely dry; anterior fontanel is severely shrunken; tears are absent; and severe oliguria is present. 3. Currently, the medication regimen given for tuberculosis is isoniazid (INH), given once a day, and rifampin, given twice a day for a 6-month period. Pyrazinamide, given once a day, will also be added for the first 2 months. 4. Patent ductus arteriosus is one of the most common cardiac anomalies. It results when the ductus arteriosus does not close shortly after birth. Blood continues to pass from the aorta into the pulmonary artery. This causes oxygenated blood to recycle through the lungs, overburdening the pulmonary circulation and making the heart pump harder. An atrial septal defect is a result of an abnormal opening between the right and the left atria. Blood that contains oxygen is forced from the left atrium to the right atrium. 5. The nursing goals in the care of the newborn infant with a heart defect are the following: (1) to reduce the work of the heart; (2) to improve respiration; (3) to maintain proper nutrition; (4) to prevent infection; (5) to reduce the anxiety of the patient; and (6) to support and instruct the parents. 6. Babies with cleft lip and/or cleft palate can be fed by bottle or by breast. Use of special nipples will assist meeting the babys sucking need and promote muscle development for speech. 7. Postoperative care involves care of a chest tube, a gastrostomy tube, and a nasogastric (NG) or gastric tube connected to low suction. The nurse needs to monitor respiratory status, thermoregulation, pain, and infection and assist in facilitating bonding between parent and infant. 8. Use two people to turn a child in a body cast. Lift the child and place him or her in the prone position. Do not use crossbars between the legs as handles. When the patient is in prone position, place a pillow under the chest and under each leg to prevent pressure on the toes. When a bedpan is used, support the upper back and the legs with pillows so that body alignment is maintained.

Copyright 2008 by Saunders, an imprint of Elsevier, Inc.

9. The treatment for spina bifida is surgical closure to prevent meningeal infection. 10. RhoGAM is administered to prevent erythroblastosis fetalis. An intramuscular injection can be given to the mother within 72 hours after delivery provided she has not previously been sensitized. RhoGAM can also be given to the pregnant woman who is Rh-negative at 28 weeks gestation if she is not sensitized. It is also administered in cases of abortion or miscarriage to women who are Rh-negative.