Neonatal Evaluation & Monitoring Flashcards
7 cards from real RNC-NIC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Neonatal Evaluation & Monitoring flashcards as text
A neonate with suspected sepsis has a C-reactive protein (CRP) of 0.4 mg/dL at 12 hours of life. The nurse understands that:
Answer: CRP peaks 24-48 hours after the onset of infection, so an early normal value does not exclude sepsis
CRP is an acute-phase reactant that rises 24-48 hours after infection onset, so a normal early value should not be used to exclude sepsis.
During skin assessment of a 24-week neonate on day of life 1, the nurse observes gelatinous, red, transparent skin with visible veins. Using the NSRAS or Braden Q tool, this finding indicates:
Answer: Extremely high skin breakdown risk requiring protective measures
Extremely immature skin in micro-preemies is a primary pressure injury and TEWL risk, warranting immediate protective skin care interventions.
A term infant at 12 hours of life has a hematocrit of 68%. The infant appears plethoric with mild respiratory distress. The most appropriate next step is:
Answer: Obtain a central venous hematocrit to confirm polycythemia
Capillary hematocrits can be falsely elevated; a central venous sample is required to confirm polycythemia before considering partial exchange transfusion.
Which parameter is the MOST reliable indicator of adequate fluid balance in a VLBW neonate in the first week of life?
Answer: Daily weight trend correlated with fluid intake and output
Daily weight trend combined with fluid intake and output provides the most comprehensive picture of fluid balance in VLBW neonates.
A 29-week neonate's cranial ultrasound on day 7 reveals periventricular leukomalacia (PVL). The nurse counsels the family that this finding is most associated with an increased risk of:
Answer: Cerebral palsy and cognitive impairment
PVL involves white matter injury adjacent to the ventricles and is strongly associated with spastic diplegia (cerebral palsy) and neurodevelopmental impairment.
A neonate on day 3 of life has urine output of 0.5 mL/kg/hr despite adequate fluid intake. Serum creatinine is rising. Which condition is the most likely cause of oliguria?
Answer: Intrinsic renal failure from hypoxic-ischemic injury
Rising creatinine with oliguria unresponsive to fluid administration on day 3 suggests intrinsic renal parenchymal injury, most commonly from perinatal hypoxia-ischemia.
When monitoring a neonate receiving phototherapy for hyperbilirubinemia, which assessment finding requires the nurse to immediately pause therapy and notify the physician?
Answer: Bronze discoloration of the skin
Bronze baby syndrome — bronze skin discoloration during phototherapy — occurs in neonates with direct hyperbilirubinemia and signals that phototherapy may be contraindicated.