Chapter 54: Neonatal and Newborn

The nurse prepares to assist with beractant (Survanta) administration to an infant who

is intubated and mechanically ventilated. After removing the drug from the refrigerator,

the nursewill perform which action?

a. Heat the drug in a warmer.

b. Assemble supplies to administer IV.

c. Shake the vial and draw up the drug dose.

d. Warm the vial by hand for at least 8 min.

ANS: D

Beractant (Survanta) should be given at room temperature and should be out of the

refrigerator for 20 min to warm up at room temperature or warmed in the nurse's hand

for at least 8 min. Thedrug should not be artificially warmed. The drug should not be

shaken. Beractant is administeredIT.

A woman who has just delivered her infant observes the nurse administering

ophthalmic ointment into her infant's eyes, and she asks why this is being done. The

nurse will explain thatthis ointment is given for which purpose?

a. To prevent vitamin-K deficiency bleeding (VKDB)

b. To prevent infection

c. To provide moisture

d. To treat infection

ANS: B

To prevent the risk of infection, infants are treated with erythromycin ophthalmic

ointment. Phytonadione is given via injection to newborns to prevent VKDB.

Erythromycin ophthalmicointment is not used as a moisturizer. It is given as

prophylaxis, not treatment

The nurse is caring for a newborn infant whose mother is HBsAg-negative. The nurse

expects togive the infant which of the following?

a. Hepatitis B immune globulin

b. Hepatitis B immune globulin and hepatitis B vaccine 12 h later

c. No vaccines

d. Recombinant hepatitis B vaccine

ANS: D

Infants whose mothers are HBsAg-negative will need to receive recombinant hepatitis B

vaccine.Immune globulin is given to infants whose mother's status is unknown or who

are positive. All infants receive the hepatitis B vaccine.

The nurse is instructing a nursing student who will administer erythromycin ophthalmic

ointmentand phytonadione (vitamin K) injection to a newborn infant. The nurse will

instruct the student to perform which action?

a. Administer the ointment after giving the injection.

b. Apply a 1-cm ribbon of ointment to the infant's eyes.

c. Apply the ointment along the lower border of the upper eyelids.

d. Flush the infant's eyes after application.

ANS: B

Erythromycin ointment should be applied in a 1-cm ribbon in the lower conjunctival sac

of eacheye. The ointment should be administered first, since the injection may cause

the infant to cry. The infant's eyes should not be flushed after administration.

The nurse tells a woman postpartum that her baby will need hepatitis B vaccine. The

mother saysshe does not want her baby to have a shot and refuses to sign the consent.

The nurse will do which of the following?

a. Administer the vaccine without consent.

b. Note the refusal in the mother's and baby's chart.

c. Tell her she will harm her baby if she does not consent.

d. Tell the mother that it is required by law.

ANS: B

Although hepatitis B vaccine is recommended, patients have a right to refuse. The

refusal shouldbe documented in the mother's and baby's chart. The nurse should never

administer the vaccine without consent. Telling the mother that she will harm her baby if

she does not consent is coercive. The vaccine is recommended and is required for

admission to schools, but parents still have a right to refuse.