Maternity Nursing: Postpartum Q 51
All of the following are important in the immediate care of the premature neonate. Which nursing activity should have the highest priority?
A. Neurological assessment to determine gestational age.
B. Placement in a warm environment.
C. Identification by bracelet and footprints.
D. Instillation of antibiotics in the eyes.
Correct Answer: B. Placement in a warm environment.
Babies can’t adjust to temperature changes as well as adults. Babies can lose heat rapidly, nearly 4 times faster than an adult. Premature and low-birthweight babies don’t have much body fat. Their bodies may not be ready to control their own temperature, even in a warm environment. Even full-term and healthy newborns may not be able to keep their body warm if the environment is too cold. Wet skin can cause the baby to lose heat quickly by evaporation. He or she can quickly lose 2° to 3°F. It is important to warm and dry the baby right away using warm blankets and skin-to-skin contact. Another source of warmth such as a heat lamp or over-bed warmer may also be used.
Option A: Health assessments of the new baby start right away. One of the first checks is the Apgar test. The Apgar test is a scoring system to evaluate the condition of the newborn at 1 minute and 5 minutes after birth. The healthcare provider or midwife and nurses will evaluate these signs and give a point value. A score of 7 to 10 is considered normal. A score of 4 to 6 may mean that the baby needs some rescue breathing measures (oxygen) and careful monitoring. A score of 3 or below means that the baby needs rescue breathing and lifesaving techniques.
Option C: Footprints are often taken and recorded in the medical record. Before a baby leaves the delivery area, ID bracelets with matching numbers are placed on the baby and on you. Babies often have 2, on the wrist and ankle. These should be checked each time the baby comes or goes from your room.
Option D: The baby’s eyes start to grow around 16 weeks. The most rapid growth happens in the last 12 weeks of pregnancy. Experts think premature birth interrupts this later growth, leading to ROP. Other risk factors include anemia, breathing problems, blood transfusions, and poor health. ROP causes blood vessels in the eye to grow abnormally and spread through the retina. These new blood vessels are fragile, and they leak blood into the eye. Scar tissue can form and pull the retina away from the back of the eye, causing vision loss.