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 places the infant on the radiant warmer. You are the resuscitating nurse for the infant, and you observe the following: the infant is limp, pale, gasping, has poor tone, and the heart rate is 101. (Learning Objective 1)

1. What are your first actions to aid in this infant’s recovery?
2. What Apgar score would you assign at 1 minute with these results? Explain the score for each category.

2. Tammi is an 18-year-old single mother who delivered a full-term infant 3 days ago. The father is not involved, and Tammi’s aunt is her support person. The infant is very fussy in the nursery, with mild tremors noted. Tammi is having a hard time feeding her baby, the baby spits up a lot and he does not console easily. The physician has been called to assess the infant. (Learning Objective 7)

1. What is the probable cause of the infant’s symptoms, and what questions do you need to ask the mother?
2. What is the acronym of the tool used in assessing the infant’s condition, and what are the top three substances used that can cause this condition?
3. Name what measures are used to test for this condition and on whom you perform the test.

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