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)
A. What equipment would Brenda check to ensure that it was present and working properly for the delivery? Why might she need this equipment?
B. Based on the physical assessment and response to resuscitation, what would you determine this infant to be: preterm, term, or postterm? Why?
C. Once the infant is stable, what course of action should Brenda take next? Why? What problems should she anticipate?
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?
A. The equipment the Nurse should ready are delivery kit, forceps if required to deliver and verbose machine. It can be checked and kept ready to use if required.
B. The infant seems to be preterm as there is little cartilage in the ears and are soft, labia majora is smaller than labia minora,plantar creases half of foot sole, nipples are not well defined these are the characteristics of preterm baby.
C. Once the infant is stable. The infant should be given Injection Vitamin K to prevent bleeding. The infant should be started with feeding to prevent hypoglycemia which can lead to respiratory distress. Care of the skin, Maintaining thermoregulation is important to prevent hypothermia.
2 A. Matthews' death can lead to grief of their parents. Nurse should
Case Studies, Chapter 23, Nursing Care of the Newborn With Special Needs 1. Brenda is a...
Essentials of Maternity, Newborn, and Women's Health Nursing 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...
Essentials of Maternity, Newborn, and Women's Health Nursing 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...
Case Studies Essentials of Maternity, Newborn, and Women's Health Nursing Chapter 16: Nursing Management During the Postpartum Period 1. You are caring for Bonnie, age 42, who has just undergone a cesarean birth for her first baby. You are responsible for monitoring her condition during recovery and for teaching her how to take care of herself and her baby. (Learning Objectives 2, 3, 4, 5, and 7) 1A. You note that Bonnie has a positive Homans’ sign in the left...
Newborn Assessment: 1. An infant boy boy was born @ 3:13 pm vaginal delivery the 1 minute APGAR is 6 & the 5 minute APGAR is 7. The infant is transferred into nursery and has jittery, cyanosis (face, hand, and feet), shaking when he’s stimulated. Upon auscultation, the lungs are moist. 1. What action would you take with this infant? 2. What nursing interventions would you do for this patient by 4:15 pm? 3. At 24 hours of age the...
Case Studies Essentials of Maternity, Newborn, and Women's Health Nursing Chapter 22: Nursing Management of the Postpartum Woman at Risk 1. Amy calls the office 3 days after delivering a healthy baby girl and tells you she is passing small clots and feels like her bleeding is heavier than it should be. You advise Amy to come into the clinic to be checked. (Learning Objectives 1, 2, 3, and 6) What are the “four T's” that need to be assessed...
Essentials of Maternity, Newborn, and Women's Health Nursing 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...
Case Studies Essentials of Maternity, Newborn, and Women's Health Nursing Chapter 21: Nursing Management of Labor and Birth at Risk . These not answered. 2. Carol, age 17, is pregnant with her first child. Her menstrual dates are accurate and her date of conception is limited to one possible day. Her physician gives her an EDC of March 28th. Carol has gone past her due date and refuses to have her labor induced. Carol states, “My grandmother says that the...
Newborn Transiting, chapter 17 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: •...
Case Studies Essentials of Maternity, Newborn, and Women's Health Nursing Chapter 13: Labor and Birth Process 1. Emily, age 32, has an obstetrical history of G1, T0, P0, A0, L0. Emily’s week of gestation is 39.1. Emily telephones the health care provider’s office and tells the nurse she believes she is in labor. Based on her assessment, the nurse advises her to have her husband bring her to the labor and birth unit. Emily arrives and is admitted. She is...
Nursing care plan for Chapter 41: Nursing Care of the Child With a Cardiovascular Disorder 1. Baby boy Ellis, 2 hours old, is being evaluated in the newborn nursery by the nursing staff. Findings include T 37°C; apical heart rate 140 bpm; respirations 58 breaths per minute; BP (arms) 70/47, (calves) 62/39; head circumference 34 cm; chest circumference 31 cm; length 48 cm; weight 2,700 g. The infant is crying. (Learning Objectives 1, 2, 3, 4, and 8)