A woman is admitted for induction of labor at 43 weeks' ...

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A woman is admitted for induction of labor at 43 weeks' gestation. Upon artificial rupture of membranes, thick meconium-stained fluid is noted. The nurse caring for the neonate after birth should anticipate:
 
  a. Hyperglycemia, hyperthermia, alert wide-eyed appearance
  b. Meconium aspiration, hypoglycemia, dry cracked skin
  c. Excessive vernix caseosa covering the skin, closed sleepy eyes, respiratory distress syndrome
  d. Golden yellow to green stained skin and nails, absence of scalp hair, increased amount of subcutaneous fat

Question 2

The initial nursing management of newborns with neonatal abstinence syndrome includes:
 
  a. Minimizing stimulation
  b. Providing bright indirect lighting
  c. Removing all clothing and blankets
  d. Collecting a stool specimen for substance identification

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Answer to Question 1

ANS: B
Meconium aspiration syndrome primarily affects postterm newborns and those who have had prolonged labor and intrauterine asphyxia or hypoxia. Although the skin may be stained a greenish yellow color, postterm newborns have decreased subcutaneous fat (not increased) and may be hypoglycemic or hypothermic. Dry, cracked skin is a characteristic of a postterm infant. Excessive vernix caseosa and respiratory distress syndrome are related to preterm newborns.

Answer to Question 2

ANS: A
Symptoms of withdrawal affect the central nervous system. Stimulation must be minimal, with low lighting and swaddling to prevent startling. Vertical rocking and/or use of a pacifier may soothe an irritable infant and provide comfort. Urine or blood specimens are usually collected to identify the drug involved.