A nurse is assessing a newborn who is 48 hr old and has a maternal history of methadone use during pregnancy. Which of the following manifestations should the nurse identify as an indication of neonatal abstinence syndrome?

Choice A rationale:

An axillary temperature of 36.5°C (97.7°F) is within the normal range for a newborn. Normal axillary temperature for a newborn is typically between 36.5°C to 37.5°C (97.7°F to 99.5°F).

Choice B rationale:

This is the correct choice. Nasal flaring in a newborn is a concerning sign and may indicate respiratory distress. It suggests that the baby is having difficulty breathing and should be reported to the provider for further evaluation.

Choice C rationale:

A heart rate of 158/min is within the normal range for a newborn. The normal heart rate for a newborn can range from 100 to 160 beats per minute.

Choice D rationale:

Having one void since birth is not a concerning finding for a 10-hour-old newborn. In the early hours of life, the frequency of voids may vary, but the baby should have an increasing number of wet diapers in the following days.

Choice A rationale:

The nurse should ask the client if they are taking over-the-counter medications because ibuprofen is also available over-the-counter. It is important to know if the client is already taking ibuprofen or any other non-prescription pain relievers to avoid potential drug interactions or overdosing.

Choice B rationale:

The nurse should inquire about the client's history of gastric problems because ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can cause gastrointestinal irritation and bleeding. If the client has a history of gastric ulcers or other gastric issues, the nurse may need to consider an alternative pain relief option.

Choice C rationale:

The question about contraception is not directly related to administering ibuprofen for postpartum cramping. It is essential to provide adequate pain relief, but the method of contraception the client plans to use is not relevant to the administration of the medication.

Choice D rationale:

This question is pertinent because NSAIDs like ibuprofen can cause fluid retention and potentially worsen hypertension.

Choice E rationale:

The presence of cataracts is not relevant to the administration of ibuprofen for postpartum cramping. Cataracts are a concern with eye health and are not associated with taking this pain medication.