Chapter 26 Maternal and Child Health Nursing 7th Edition

Chapter 26  Maternal and Child Health Nursing 7th Edition

Complete Chapter Questions And Answers
 

Sample Questions

1.
The nurse is preparing formula for a preterm infant. Which type of formula will most likely be prescribed for this patient?
A)
Glucose water
B)
20 calories per ounce
C)
22 calories per ounce
D)
Iron supplemented
Ans:
C

Feedback:

The caloric concentration of formulas used for preterm infants is usually 22 calories per ounce compared with 20 calories per ounce for a term baby. Glucose water will not provide the infant with adequate calories. Iron supplementation will depend on laboratory values.

2.
The results of an amniocentesis conducted just prior to birth showed a fetus’s lecithin/sphingomyelin ratio as being 1:1. From this information, for which respiratory problem should the nurse anticipate providing care once the baby is delivered?
A)
Alveolar collapse on expiration
B)
Bronchial constriction from room air
C)
Wheezing from excess fluid accumulation
D)
Inspiratory constriction from air contaminants
Ans:
A

Feedback:

Respiratory distress syndrome (RDS) of the newborn most often occurs in preterm infants. Pulmonary surfactant is not present in preterm infant. Surfactant is needed to prevent alveolar collapse upon expiration. RDS rarely occurs in mature infants. Dating a pregnancy by sonogram and by documenting the level of lecithin in surfactant obtained from amniotic fluid exceeds that of sphingomyelin by a 2:1 ratio are both important ways to be certain that an infant is mature enough that RDS is not likely to occur. RDS does not present as bronchial constriction from room air, wheezing from excess fluid accumulation, or inspiratory constriction from air contaminants.

3.
Immediately after birth, a preterm infant is placed in a radiant heat warmer. For which nursing diagnosis is this intervention addressing?
A)
Ineffective thermoregulation related to immaturity
B)
Risk for imbalanced nutrition, less than body requirements
C)
Risk for deficient fluid volume related to insensible water loss
D)
Impaired gas exchange related to immature pulmonary functioning
Ans:
A

Feedback:

Placing the preterm infant in a radiant heat warmer is addressing the diagnosis of ineffective thermoregulation related to immaturity. Interventions regarding intake would be appropriate for the diagnosis of risk for imbalanced nutrition. Interventions related to intravenous fluids would be appropriate for the diagnosis of risk for deficient fluid volume. Interventions related to oxygenation would be appropriate for the diagnosis of impaired gas exchange.

4.
The nurse manager of a labor and delivery unit is reviewing the skill set needed for the nursing staff to meet the 2020 National Health Goals regarding preterm births. Which skills should the manager validate that the nursing staff has to meet these goals? (Select all that apply.)
A)
Resuscitation at birth
B)
Actions to prevent apnea
C)
Identify characteristics of preterm labor
D)
Actions to prevent maternal hypotension
E)
Interventions to prevent intraventricular hemorrhage
Ans:
A, B, C, E

Feedback:

Nurses can help the nation achieve the 2020 National Health Goals for preterm births by teaching women the symptoms of preterm labor so that birth can be delayed until infants reach term. Nurses also need to be prepared for resuscitation at birth of high-risk infants and to plan developmental care that can help prevent conditions such as apnea and intraventricular hemorrhage. Actions to prevent maternal hypotension would not help achieve the 2020 National Health Goals for preterm labor.

5.
The nurse is planning developmental care for a preterm infant in the neonatal intensive care unit. Which interventions should the nurse include in this patient’s plan of care? (Select all that apply.)
A)
Provide audio stimulation with the use of music.
B)
Stop procedures if the infant shows signs of distress.
C)
Provide a nest with blankets to provide a sense of security.
D)
Provide tactile stimulation by tickling the bottom of the feet.
E)
Provide care consistently so the infant develops sleep/wake cycles.
Ans:
A, B, C, E

Feedback:

Developmental care for a preterm infant in the neonatal intensive care unit should include audio stimulation, stop procedures at signs of distress, provide a nest of blankets for security, and provide consistent care so sleep/wake cycles develop. Tactile stimulation should be provided by gentle back rubbing or massage. Tickling the feet would be too harsh for this young patient.