A nurse is assessing a newborn 2 hr following birth. Which of the following findings should the nurse expect?

A. "I have headaches in the evening.": Headaches associated with sleep apnea typically occur in the morning due to nocturnal hypoxia and carbon dioxide retention, not in the evening. Evening headaches are not a common presenting symptom.

B. "I feel rested upon wakening.": Clients with sleep apnea often experience non-restorative sleep and wake feeling tired or unrefreshed. Feeling rested upon waking would not be expected in untreated sleep apnea.

C. "I feel alert during the day.": Daytime sleepiness is a hallmark symptom of sleep apnea due to fragmented sleep and oxygen desaturation. Feeling alert would not align with the typical presentation.

D. "My spouse says I snore.": Loud, habitual snoring is a common and expected symptom of obstructive sleep apnea. It is often reported by bed partners and is an important clinical clue for diagnosis.

A. Start another IV line in another extremity: Establishing a new IV line is necessary to continue therapy, but it is not the first action. Immediate steps must focus on preventing further tissue damage from the infiltrated vesicant.

B. Apply a warm, moist compress: Warm or cold compresses may be applied depending on the type of vesicant and institutional protocol, but this is a secondary intervention after stopping the infusion and protecting the tissue.

C. Disconnect IV tubing and aspirate medication from the IV catheter: Aspirating the remaining medication may help reduce tissue exposure, but it is performed after the infusion is stopped to prevent further infiltration.

D. Stop the infusion: Stopping the infusion immediately is the first and most critical action to prevent further tissue damage. Halting the delivery of the vesicant stops the source of injury and allows subsequent interventions to minimize local tissue necrosis.