HESI Premature Infant
Jamie Fargo is a 17 y/o student. Pregnant. She has not told her family about it and has not sought prenatal care. One evening she tells her mom she is feeling really bad with abdominal cramps, so her mom takes her to the ER. After an exam by the HCP, she is found to be 30 wks pregnant and in active labor.
Premature Infant Case Study Questions Scenario
Which approach should the nurse use in sharing this information with Jamie and her mother?
C – discuss the situation with Jamie first and then talk with her mother.
Which response should the RN give Jamie?
C – the premature infant’s lungs will function more prematurely
In anticipation of a premmie birth, what should the RN tell the student to do? (order)
1-pep equipment for resucitation
2-cover scales with warm blanket
3-draw up Vit. K –> phytonadione
4-have ophthalmic erythromycin ointment available
What is the rationale for the RN intervention? (RN places infant under warmer and dries him quick)
C-prevent further heat loss
APGAR Score @ 1 min of birth the RN should record in infant’s record?
-weak cry : 1
-grunting respirations of 56: 1
-HR of 152: 1
-Skin mottled with acrocyanosis: 1
-Flexion in extremities: 2
-Active movement when suctioned: 1
Infant’s skin becomes dusky. What should the RN implement next?
A- give O2 by hood
Jamie asks the RN what is causing her infant to have trouble breathing. What is the RN’s appropriate response?
C – lack of surfactant needed to keep alveoli open
What intervention should the RN anticipate being done next?
D – adjustment of the ET tube
Jamie asks the purpose of another tube on her son, what explanation should the RN provide to the mother?
C- Resp. Acidosis
Based on ABGs, which intervention should RN implement first?
B – change in vent rate
After the Gestational Age assessment, the RN recognizes which findings are consistent with 30 wk preemie?
D – pinna is flexible and folds fwd easily
E – clitoris and labia minora are larger than labia majora
Jamie and her mother visit NICU 12hr after delivery. They are upset and crying. How should the RN respond?
D- This must be difficult for you right now
What response by the RN would promote bonding between Jamie and her baby?
B-He likes you to talk to him and to touch his hand
What response should RN provide?
C – He is breathing on his own but this equip provides pressure to help his lungs work better
For which early manifestation should RN assess Jamie’s son?
C – auscultated pulmonary crackles
When monitoring for a murmur r/t patent ductus arteriosus, where should the RN auscultate?
C- upper left sternal border
To promote closure of a persistent patent ductus arteriosus, the RN anticipates a prescription for which medication?
B – indocin
What change in the infant’s labs indicates to the RN that the drug is effective?
D – increasing Hgb and Hct
What should the RN do next?
C- Direct student to change diaper w/o bending infant
Which RN assessment is focused on this risk factor (Necrotizing enterocolitis (NEC))
A- increasing gastric residuals
Prior to inserting a tube for OG feedings, what should RN take?
D – Measure from mouth to ear to xyphoid process
What action should nurse take? (while giving gavage feeding by gravity baby lamar’s HR goes from 134 to 96)
A-Pause feeding by lowering the syringe
Baby Lamar has several apnea episodes and caffeine is RX
What primary effect should the nurse observe with the admin. of coffee?
A-Decrease in apneic events
Which response should the nurse make?
B-premie babies often tire and stop nursing before they get enough. Let me show you how to help him.