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22, Anurse is caring for a 10-day-old neonate who was bom at 33 weeks’ gestation. Which of the following actions assist the nurse in assessing for signsof feeding tolerance? (Select all that apply.) a. Check for presence of bowel sounds b. Assess temperature Check gastric residual by aspirating stomach contents Assess stools ANS: a, ¢, d Feedback e e a. Feedings should be held and physician notified if bowel sounds are absent. s The neonate’s temperature has no direct effect on feeding tolerance. c. Aspirated stomach contents are assessed for amount, color, and consistency.This assists in the evaluation of the degree of digestion and absorption. d. Stools are assessed for consistency, amount, and frequency. This assists inthe evaluation of the degree of digestion and absorption. 23, Which of the following are common assessment findings of postmatureneonates? (Select all that apply.) a. Dry and peeling skin b. Abundant vernix caseosa c. Hypoglycemia d. Thin, wasted appearance ANS: a, b, ¢, d Feedback a. Vernix caseosa covers the fetus’s body around 17 to 20 weeks® gestation; aspregnancy advances, the amount of vernix decreases. Vemix prevents water loss from the skin to the amniotic fluid; as the amount of vernix decreases, anincreasing amount of water is lost from the skin. This contributes to the dry and peeling skin seen in postmature neonates. b. Vernix caseosa covers the fetus’s body around 17 to 20 weeks’ gestation; as pregnancy advances, the amount of vernix decreases. Maternal-Newbom Nursing: The Critical Components Of Nursing Care, 3rd Edition, Roberta Durham, Linda Chapman c. Placental insufficiency related to the aging of the placenta may result in postmaturity syndrome, in which the fetus begins to use its subcutaneous fatstores and glycemic stores. This results in the thin and wasted appearance ofthe neonate and risk for hypoglycemia during the first few hours post-birth. d. Placental insufficiency related to the aging of the placenta may result in postmaturity syndrome, in which the fetus begins to use its subcutaneous fatstores and glycemic stores. This results in the thin and wasted appearance ofthe neonate and risk for hypoglycemia during the first few hours post-birth. 24, Anurse is caring for a 40 weeks’ gestation neonate. The neonate is 12 hours post- birth and has been admitted to the NICU for meconium aspiration. The nurse recalls that the following are potential complications related to meconium aspiration (select all that apply): a. Obstructed airway b. Hyperinflation of the alveoli c. Hypoinflation of the alveoli d. Decreased surfactant proteins ANS: a, b, d Feedback a. The presence of meconium in the neonate’s lungs can cause a partial obstruction of the lower airway that leads to a trapping of air and a hyperinflation of the alveoli. b. The presence of meconium in the neonate’s lungs can cause a partial obstruction of the @ O 2