A newborn in the nursery is exhibiting signs of intrauterine drug exposure. Which of the following signs/symptoms is the nurse observing? (Select all that apply)
Calm, easy to comfort
Tremors
Persistent shrill cry
Difficult to console
Correct Answer : B,C,D
Choice A) Calm, easy to comfort is incorrect because this is not a sign of intrauterine drug exposure, but rather a sign of normal or healthy newborn behavior. Newborns who are calm and easy to comfort are usually well-adjusted and have a good temperament. They respond positively to soothing techniques such as holding, rocking, or singing.
They do not show signs of distress or withdrawal, which are common in newborns who are exposed to drugs in utero. Therefore, this response is irrelevant and inaccurate.
Choice B) Tremors is correct because this is a sign of intrauterine drug exposure that can indicate neurological damage or withdrawal syndrome. Tremors are involuntary shaking or quivering movements of the body or limbs that occur due to abnormal electrical activity in the brain or nervous system. Newborns who are exposed to drugs such as opioids, cocaine, or alcohol in utero may develop tremors as a result of brain injury, hypoxia, hypoglycemia, or seizures. They may also experience tremors as a symptom of neonatal abstinence syndrome (NAS), which is a condition that occurs when the newborn stops receiving the drug from the mother and goes through withdrawal. NAS can cause various physical and behavioral problems in the newborn, such as irritability, poor feeding, vomiting, diarrhea, sweating, fever, or seizures. Therefore, this response is clear and accurate.
Choice C) Persistent shrill cry is correct because this is a sign of intrauterine drug exposure that can indicate pain or discomfort in the newborn. Crying is a normal and natural way for newborns to communicate their needs and feelings. However, some newborns who are exposed to drugs such as opioids, cocaine, or alcohol in utero may cry more often, louder, or longer than usual. They may have a high-pitched or piercing cry that is difficult to soothe or stop. This may be due to various factors such as hunger, colic, infection, injury, or withdrawal. A persistent shrill cry can also affect the bonding and attachment between the newborn and the parents or caregivers. Therefore, this response is clear and accurate.
Choice D) Difficult to console is correct because this is a sign of intrauterine drug exposure that can indicate emotional or behavioral problems in the newborn. Newborns who are difficult to console are usually unhappy and restless. They do not respond well to soothing techniques such as holding, rocking, or singing. They may have trouble sleeping, feeding, or interacting with others. They may also show signs of agitation, anxiety, or depression. These problems may be caused by exposure to drugs such as opioids, cocaine, or alcohol in utero, which can affect the development and function of the brain and nervous system. They may also be influenced by the environment and relationship of the newborn with the parents or caregivers. Therefore, this response is clear and accurate.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice a) Placenta previa is incorrect because this is a condition where the placenta partially or completely covers the cervix, which can cause painless vaginal bleeding in the third trimester. It is not related to trauma and does not require hospitalization unless bleeding occurs.
Choice b) Dehydration is incorrect because this is a condition where the body loses more fluid than it takes in, which can cause symptoms such as thirst, dry mouth, headache, fatigue, and dizziness. It is not a complication of pregnancy and can be prevented by drinking enough water and avoiding caffeine and alcohol.
Choice c) Gestational hypertension is incorrect because this is a condition where the blood pressure rises above 140/90 mmHg after 20 weeks of pregnancy, which can cause complications such as preeclampsia, eclampsia, and fetal growth restriction. It is not caused by trauma and can be managed by regular antenatal care and medication if needed.
Choice d) Abruptio placentae is correct because this is a condition where the placenta separates from the uterine wall before delivery, which can cause severe vaginal bleeding, abdominal pain, uterine contractions, and fetal distress. It is a life-threatening emergency that can be triggered by trauma and requires immediate delivery of the baby and treatment of shock and blood loss. Therefore, a woman who is 8 months pregnant and involved in a serious motor vehicle crash should be admitted to the hospital for observation for this complication.
Correct Answer is D
Explanation
Choice a) We are protecting the infant from our bacteria is incorrect because this is not the main reason why gloves are needed when handling a newborn. While it is true that newborns have immature immune systems and are susceptible to infections, gloves are not only used to protect the infant from our bacteria but also to protect ourselves from the infant's body fluids and secretions, which may contain pathogens or blood-borne diseases.
Therefore, this response is incomplete and misleading.
Choice b) Amniotic fluid and maternal blood pose risks to us is incorrect because this is also not the primary reason why gloves are needed when handling a newborn. While it is true that amniotic fluid and maternal blood may contain harmful microorganisms or viruses that can infect us, gloves are not only used to protect ourselves from these substances but also to protect the infant from our skin flora and potential contaminants, which may cause skin irritation or infection. Therefore, this response is also incomplete and misleading.
Choice c) It is hospital policy is incorrect because this is not a sufficient or satisfactory reason why gloves are needed when handling a newborn. While it is true that wearing gloves may be a hospital policy or protocol, this response does not explain the rationale or evidence behind this policy and may imply that the nurse does not understand or agree with it. Therefore, this response is vague and unprofessional.
Choice d) It is part of standard precautions is correct because this is the best and most accurate reason why gloves are needed when handling a newborn. Standard precautions are a set of guidelines and practices that aim to prevent the transmission of infections in healthcare settings. They include wearing gloves, gowns, masks, and eye protection when there is a risk of exposure to blood or body fluids, as well as washing hands before and after patient contact, cleaning and disinfecting equipment and surfaces, and disposing of waste properly. Standard precautions apply to all patients, regardless of their diagnosis or infection status, and are based on the principle that all blood and body fluids are potentially infectious. Therefore, this response is clear and appropriate.
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