A nurse is caring for a newborn who is 72 hr old.

Physical Examination

1100:

Neonatal Abstinence Scoring System (NAS)

Excessive high-pitched cry-2 Sleeps <2 hr 2
Hyperactive Moro reflex=2 Moderate-severe tremors disturbed=2 Increased muscle tone=2
Fever <37.2 to 38.2° C (99 to 100.8° F)=1

Excessive sucking=1 Frequent sneezing=1

Frequent yawning-1 Loose stools=2 Poor feeding=2
Respiratory rate > 60/min=1 Mottling-1
NAS score 20

The nurse is planning to contact the provider regarding the newborn's status. Which of the following prescriptions should the nurse anticipate? Select the 3 interventions the nurse should anticipate.

Swaddle the newborn.

Administer naloxone for NAS scores greater than 24.

Continue NAS scoring as prescribed.

Encourage the birthing parent to breastfeed.

Administer oral morphine.

Answer and Explanation

Correct Answer : A,C,D,E

A.Swaddling can provide comfort to the newborn and may help reduce symptoms of NAS such as tremors and increased muscle tone.
B. Naloxone is not routinely used in the management of neonatal abstinence syndrome (NAS). Naloxone is an opioid antagonist and is not recommended for the treatment of NAS due to the risk of precipitating acute withdrawal in the newborn, which can be life-threatening.
C. Continuing NAS scoring as prescribed is an appropriate intervention. It helps assess the severity of withdrawal symptoms and guides the management plan.

D. Breastfeeding is often encouraged in newborns with NAS as it provides comfort, nutrition, and promotes bonding between the newborn and the birthing parent.
E. Administering oral morphine is one of the pharmacological treatments commonly used for moderate to severe cases of NAS. It helps to alleviate withdrawal symptoms in the newborn and is often titrated based on the severity of symptoms and NAS scoring.

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Correct Answer is ["A","B","C","D","F"]

Explanation

A, B Monitoring the newborn's hemoglobin and hematocrit levels are important due to the risk of anemia.

C. Monitoring the newborn's heart rate post-birth is crucial for assessing cardiac function and detecting any abnormalities.

F. Positive pressure ventilation was administered to the newborn for 1 minute after birth, indicating a need for respiratory support. The nurse should closely assess the newborn's respiratory status.

D. There may be concerns about the newborn's blood glucose levels, especially if there were any periods of hypoxia or stress during labor and delivery.

A. Monitor 1&0. B. Monitor axillary temperature. C. Monitor weight D. Monitor blood glucose levels.

Correct Answer is D

Explanation

Small for gestational age (SGA) newborns are at risk of hypoglycemia due to decreased glycogen stores and limited fat reserves. Therefore, monitoring blood glucose levels is essential to detect and promptly intervene in case of hypoglycemia.

A, B, C- monitoring other parameters such as vital signs, axillary temperature and weight are important aspects of newborn care but not specific to SGA newborns.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["A","B","C","D","F"]

Explanation

A nurse is planning care for a newborn who is small for gestational age (SGA). Which of the following is the priority intervention the nurse should include in the newborn's plan of care?

Correct Answer is D

Explanation

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