Special Care Nursery Clinical Questions

3.

1.

What are normal vital signs in a neonate?

a. Respiration: 30-60/minute
b. Blood pressure: 60-80/40-50
c. Pulse: 110-160
d. Temperature: 97.7-99.5

2.

What are signs of cold stress in a premature infant? What are appropriate
nursing measures to treat this?
a. S&S: tachycardia, tachypnea, hypoglycemia, poor muscle tone, poor
feeding ability, lethargic, brown fat metabolism
b. Treatment: skin to skin, warmer, dry
Respiratory Distress Syndrome:
a.

What are symptoms of (RDS) in a premature infant?

a. Rapid breathing, cyanosis, intercostal and subcostal retractions,
grunting, nasal flaring, apnea
c. What are common treatments?
i. Manual ventilation, ETT, PPV, CPAP
ii. Surfactant
d. What is neonatal lung surfactant, and how is it administered?
i. Helps to open the alveoli thus increasing lung expansion and
increasing gas exchange at the capillary. Administered as a
bolus either given within a single time frame, divided into
multiple doses, continuous infusion, or nebulization

4.

Jaundice in the newborn:

a.

What are some risk factors for jaundice in the newborn?

a. Prematurity-might not be able to process bilirubin as quickly as a
full-term baby. Also feeding less and have fewer bowel movements
b. Hemolysis or RBC
c. Decreased fluid intake/dehydration
d. ABO incompatibilities
e. Maternal infections
f. Hepatic cell damage
g. Neonatal polycythemia
h. Biliary atresia
i. Acute bilirubin encephalopathy

b.

Why is the passage of stool important for the baby with an elevated
bilirubin level?
a. Bilirubin is excreted in the stool and if not excreted, it can be
reabsorbed back into the bloodstream

e. Name 2 parts of the baby that must be protected during phototherapy.

i. Eyes
ii. Genitals
5.

6.

Digestion in the premature newborn:

a.

Review proper insertion technique for OG and NG tubes.

a. Measure the tube from the nostril to the bottom of the ear lobe.
Then, measure from the ear lobe to the umbilicus
b. Mark the spots that are measured
c. Make sure the baby lay down flat
d. Dip 2 to 4 inches of the tube in the water or a lubricant so it will go
in easier
e. Insert the tube till you reach the mark on the tube
f. Listen to the bowel sounds and secure

b.

Necrotizing enterocolitis is a complication of prematurity that is less

likely if the baby is given only breastmilk. What are clinical signs of
nec?
a. Abdominal bloating
b. Blood in the stool
c. Diarrhea
d. Feeding problems
e. Lack of energy
f. Unstable temperature
g. Unstable breathing, heart rate, BP
h. Vomiting

b.

The provider has ordered ranitidine 2mg/kg/day divided into 2 doses.

The babys weight is 1800 grams. How much ranitidine should the
baby receive in one dose?
a. 1.8 mg/dose

The provider orders caffeine citrate 5 mg/kg IV every 24 hours. The baby weighs
500 grams. What is the proper dose of caffeine that the nurse should administer?
Why is caffeine being given?
-2.5 mg of caffeine
-caffeine helps to maintain apnea and act as a stimulant to help the lungs
breathe