Maryland Next Gen NCLEX Test Bank Project

Maryland Next Gen NCLEX Test Bank Project September 1, 2022

Case Study Topic:

(& stand-alone -bowtie) Neonatal Respiratory Distress Syndrome

Author:Deborah Miller MSN, RNC, C-EFM, CNE

Community College of Baltimore County Case Summary A late preterm newborn, born at home attended by a certified nurse midwife, is brought to the emergency room at 12 hours of life in respiratory distress. The learner must recognize symptoms of respiratory distress; decide what interventions to include in the plan of care, the care priority, and determine what client findings would indicate interventions have been effective.Objectives

• Recognize the signs/symptoms of respiratory distress syndrome.
• Utilize the nursing process to develop an evidence-based, patient centered plan of care for newborns

experiencing a complication related to gas exchange.

• Identify nursing interventions that are consistent with current patient care standards in the care of the

newborn experiencing a complication related to gas exchange.

• Demonstrate caring behaviors and professional communication in the nursing care of the reproductive

family experiencing a complication related to gas exchange.Case Study LinkCase Study QR Code

https://umaryland.az1.qualtrics.com/jfe/

form/SV_bjROnSBym2IXpj0 Bow-tie QR CodeBow-tie Link

https://umaryland.az1.qualtrics.com/jfe/

form/SV_af3vDHcvZ7SSxtc Case References Ricci,S.S, Kyle, T. & Carmen,S. (2021) Maternity & Pediatric Nursing (4 th ed) Philadelphia, Wolters Kluwer 1 / 2

Case Study Question 1 of 6 The nurse cares for a 12- hour- old late-preterm male with respiratory distress following a home birth.Nurses’ Notes 1300: Parents of a 12-hour-old male newborn, born vaginally at home, brought the newborn into the emergency department in respiratory distress. Neonate was born at 37-weeks gestation in a birth attended by certified nurse midwife. Parents provided records that showed APGARs were 8/8 and the birth weight was 3235 grams. The newborn has fast and shallow breathing, grunting, nasal flaring, chest retracting, a heart murmur, and skin color gray. Parents report the baby breastfed right after birth, but has has not voided since birth. Provider at bedside.Vital Signs Time1300 Temp36.1 C/ 97F HR166 RR76

B/PN/A

Pulse oximeter 91% on RA Pain0 Which 3 findings require immediate follow-up?□Urine output □Temperature* □Birth weight □Respiratory status* □Pain □Heart rate □Oxygen saturation*

Scoring Rule: 0/1

Rationale: The newborn has respiratory distress as evidenced by the low oxygen saturation, elevated respiratory rate >60 and increased work of breathing (grunting, retracting, nasal flaring). The newborn also has a low temperature which could be causing cold stress. The resting heart rate is slightly elevated (normal resting rate 110-160). The infant is large for gestational age and a blood glucose should be obtained. There is no mention of pain. Urine output is irrelevant at this time, since the newborn is only 12 hours old. Excepted urinary output for the first day of life is once in 24 hours.

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