Suggested Answers to Assignments, Chapter 20, The Newborn at Risk: Gestational and Acquired Disorders

Written Assignments / Learning Objective(s)
1. Students’ answers should include the following:
  • Respiratory disorders, hypothermia, hypoglycemia, patent ductus arteriosus, intracranial hemorrhage, necrotizing enterocolitis, jaundice, infection, retinopathy of prematurity (ROP).
  • See Figures 20-4 and 20-8.
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2. Students’ answers should include the following:
  • Discussion of Group B beta-hemolytic streptococcal infection, rubella virus, Chlamydia trachomatis or Neisseria gonorrhoeae (leading to ophthalmia neonatorum), hepatitis B, herpes virus types 1 and 2, Treponema pallidum (T. pallidum) that causes syphilis, human immunodeficiency virus (HIV). A newer infection concern is methicillin-resistant Staphylococcus aureus (MRSA).
  • See Table 20-2.
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Group Assignments / Learning Objective(s)
1. Students’ answers should include the following:
  • Classification by size: small for gestational age (SGA), appropriate for gestational age (AGA), large for gestational age (LGA).
  • Classification by weight: low birth weight (LBW), very low birth weight (VLBW), extremely low birth weight (ELBW).
  • Classifications by gestational age: preterm, post-term, term.
  • Gestational age assessment includes neuromuscular maturity and physical maturity.
  • See Figures 20-1 and 20-2; Table 20-1.
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2. Students’ answers should include the following:
  • SGA: intrauterine growth restriction (IUGR), lack of maternal nutrition, abnormality in the placenta or its function.
  • See Box 20-1.
  • LGA: maternal diabetes, parents who are large, multiparous women, male newborns, congenital disorders.
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3. Students’ answers should include the following:
  • RhoGAM reduces the incidence of erythroblastosis fetalis; it is effective only in women who do not have Rh antibodies and must be administered by injection within 72 hours after delivery of an Rh-positive infant or after abortion.
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Clinical Assignments / Learning Objective(s)
1. Students’ answers should include the following:
  • Discussion of observational experience in the NICU, including goals of nursing care for the preterm infant.
  • See Box 20-2.
  • Characteristics of the preterm newborn as compared to the term newborn.
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2. Students’ answers should include the following:
  • Meconium aspiration, hypoglycemia, polycythemia due to intrauterine hypoxia.
  • Polycythemia puts the infant at risk for cerebral ischemia, hypoglycemia, thrombus formation, and respiratory distress because of hyperviscosity of the blood.
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3 Students’ answers should include the following:
  • Assessment, nursing diagnoses, expected outcomes, nursing interventions and rationale, evaluation.
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Web Assignments / Learning Objective(s)
1. Students’ answers should include the following:
  • A summarization of an article addressing acquired respiratory disorders associated with newborns, such as transient tachypnea of the newborn (TTN), meconium aspiration syndrome (MAS), and sudden infant death syndrome (SIDS).
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2. Students’ answers should include the following:
  • A summarization of an article addressing clinical manifestations and nursing care of a newborn of a chemically dependent mother.
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