A nurse is assessing a newborn following a forceps-assisted birth.
Which of the following clinical manifestations should the nurse identify as a complication of this birth method?
Bronchopulmonary dysplasia
Polycythemia
Facial palsy
Hypoglycemia
The Correct Answer is C
Choice A rationale
Bronchopulmonary dysplasia is a chronic lung disease that affects newborns and infants, but it is not a complication of forceps-assisted birth. It’s more common in premature babies who have been treated with oxygen and positive-pressure ventilation.
Choice B rationale
Polycythemia, a condition characterized by an increased number of red blood cells, is not a complication of forceps-assisted birth. It can occur due to various reasons, including high altitude and certain genetic disorders.
Choice C rationale
Facial palsy can occur as a complication of forceps-assisted birth. The pressure exerted by the forceps can cause damage to the facial nerve, leading to temporary or permanent facial weakness or paralysis.
Choice D rationale
Hypoglycemia, or low blood sugar, is not a complication of forceps-assisted birth. It’s more commonly seen in babies of mothers with diabetes, premature babies, and babies who are small for their gestational age.
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Correct Answer is D
Explanation
Choice A rationale
Expecting two to four wet diapers every 24 hours is not accurate for a newborn. Newborns typically have six or more wet diapers per day. This indicates that the baby is getting enough milk.
Choice B rationale
Feeding the newborn 5 to 10 minutes per breast is not sufficient. It is recommended that newborns be breastfed for 15 to 20 minutes on each breast during each feeding. This ensures that the baby gets both the foremilk, which quenches the baby’s thirst, and the hindmilk, which provides the necessary nutrients and helps the baby feel full.
Choice C rationale
Giving the newborn 30 ml (1 oz) of water between feedings is not recommended. Newborns do not need additional water - breast milk or formula provides all the hydration they need. Giving a newborn extra water can lead to water intoxication, which is a serious condition.
Choice D rationale
Allowing the baby to feed at least every 3 hours is correct. Newborns should be fed on demand, typically every 2 to 3 hours. This ensures that the baby gets enough nutrition for growth and development.
Correct Answer is D
Explanation
Choice A rationale
A temperature of 37.4°C (99.3°F) is within the normal range and does not indicate endometritis.
Choice B rationale
Scant lochia is not typically associated with endometritis. In fact, women with endometritis may experience heavy lochia or foul-smelling lochia.
Choice C rationale
A WBC count of 9,000/mm is within the normal range and does not indicate endometritis.
Choice D rationale
Uterine tenderness is a common symptom of endometritis. Other symptoms can include fever, malaise, and foul-smelling lochia.
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