A nurse explains to new parents that their newborn has developed respiratory distress syndrome (RDS). Which of the following assessments that the nurse makes would support a diagnosis of RDS?
Select one:

Apical pulse of 148 beats per minute.

Respiratory rate of 40 during sleep.

Skin color jaundiced.

Chest retractions.

Answer and Explanation

The Correct Answer is D

Choice A Reason: Apical pulse of 148 beats per minute. This is not a finding that would support a diagnosis of RDS, but rather a normal finding for a newborn. A normal apical pulse for a newborn ranges from 120 to 160 beats per minute. A high pulse rate may indicate fever, infection, anemia, or dehydration. A low pulse rate may indicate hypothermia, hypoxia, or heart block.

Choice B Reason: Respiratory rate of 40 during sleep. This is not a finding that would support a diagnosis of RDS, but rather a normal finding for a newborn. A normal respiratory rate for a newborn ranges from 40 to 60 breaths per minute. A high respiratory rate may indicate respiratory distress, infection, or metabolic acidosis. A low respiratory rate may indicate respiratory depression, hypothermia, or narcotic exposure.

Choice C Reason: Skin color jaundiced. This is not a finding that would support a diagnosis of RDS, but rather a diﬀerent condition called jaundice. Jaundice is a yellowish discoloration of the skin and mucous membranes caused by elevated levels of bilirubin in the blood. Bilirubin is a breakdown product of hemoglobin that is normally excreted by the liver and kidneys. Jaundice can occur in newborns due to immature liver function, increased red blood cell breakdown, or blood group incompatibility. Jaundice does not aﬀect lung function or oxygenation.

Choice D Reason: Chest retractions. This is because chest retractions are a sign of respiratory distress that indicate increased work of breathing and reduced lung compliance. Chest retractions occur when the chest wall sinks in between the ribs or below the sternum during inhalation, creating a negative pressure that helps draw air into the lungs. RDS is a serious condition where the newborn's lungs are immature and lack sufficient surfactant, which is a substance that reduces surface tension and prevents alveolar collapse. RDS can cause respiratory distress, hypoxia, acidosis, and organ failure. It is more common in preterm infants, especially those born before 37 weeks' gestation.

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Correct Answer is A

Explanation

Choice A Reason: Macrosomic fetus is a fetus that weighs more than 4000 grams or 8 pounds 13 ounces at birth. It is not a common complication of teenage pregnancy, but rather of maternal diabetes, obesity, or a history of large babies.

Choice B Reason: Preeclampsia is a condition characterized by high blood pressure and proteinuria in pregnancy. It can cause serious complications for both the mother and the baby, such as seizures, organ damage, growth restriction, and placental abruption. Teenage pregnancy is a risk factor for preeclampsia, especially if the mother is younger than 15 years old.

Choice C Reason: Inadequate nutritional status of mother is a condition where the mother does not consume enough calories, protein, vitamins, minerals, or ﬂuids during pregnancy. It can aﬀect the growth and development of the baby and increase the risk of low birth weight, preterm birth, and birth defects. Teenage pregnancy is a risk factor for inadequate nutritional status of mother, as teenagers may have poor dietary habits, eating disorders, or limited access to food.

Choice D Reason: Cephalopelvic disproportion is a condition where the size or shape of the baby's head or body is too large to fit through the mother's pelvis. It can prevent normal vaginal delivery and require cesarean section. Teenage pregnancy is a risk factor for cephalopelvic disproportion, as teenagers may have smaller or immature pelvises that are not fully developed.

A. Provide compassionate and accurate information throughout the process and support them to make their own decisions. B. Inquire about the names they have chosen for their baby to get their mind oﬀ their stress. C. Express sympathy and provide directive advice to the couple about what they should do. D. Refer them to a marriage counselor in the same building to help them with the decisions.

Correct Answer is A

Explanation

Choice A Reason: Provide compassionate and accurate information throughout the process and support them to make their own decisions. This is a therapeutic strategy that demonstrates empathy, honesty, and advocacy for the couple. It also helps them understand their options, risks, benefits, and alternatives, and encourages them to participate in their care.

Choice B Reason: Inquire about the names they have chosen for their baby to get their mind oﬀ their stress. This is a non-therapeutic strategy that avoids addressing the couple's concerns, minimizes their feelings, and may create false hope or unrealistic expectations.

Choice C Reason: Express sympathy and provide directive advice to the couple about what they should do. This is a non-therapeutic strategy that shows pity, imposes personal values, and undermines the couple's self-determination.

Choice D Reason: Refer them to a marriage counselor in the same building to help them with the decisions. This is a non-therapeutic strategy that implies that the couple has marital problems, shifts responsibility, and may create resentment or resistance.

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A nurse explains to new parents that their newborn has developed respiratory distress syndrome (RDS). Which of the following assessments that the nurse makes would support a diagnosis of RDS?
Select one: