A nurse is assessing a newborn who is 48 hr old and is experiencing opioid withdrawals. Which of the following findings should the nurse expect?

Hypotonicity

Moderate tremors of the extremities

Axillary temperature 36.1° C (96.9° F)

Excessive sleeping

Answer and Explanation

The Correct Answer is B

A. Hypotonicity.: Incorrect. Opioid withdrawal in newborns typically presents with hypertonicity (increased muscle tone) rather than hypotonicity.

B. Moderate tremors of the extremities.: Correct. Newborns experiencing opioid withdrawal often exhibit tremors or jitteriness in the extremities as part of the withdrawal symptoms.

C. Axillary temperature 36.1° C (96.9° F).: Incorrect. Opioid withdrawal does not usually cause hypothermia. Newborns with withdrawal may have a normal or slightly elevated temperature.

D. Excessive sleeping.: Incorrect. Excessive sleeping is not a typical symptom of opioid withdrawal; rather, newborns with withdrawal might experience irritability and difficulty sleeping.

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Correct Answer is C

Explanation

A. Elevate the client's legs to a 30° angle: Incorrect. Elevating the legs is supportive but does not address the immediate cause of postpartum bleeding.

B. Insert an indwelling urinary catheter: Incorrect. While monitoring urine output is important, this action does not directly address the cause of excessive vaginal bleeding.

C. Massage the client's fundus: Correct. If the fundus is soft or boggy, massaging it can help stimulate uterine contraction and reduce bleeding. This is the most immediate action to manage postpartum hemorrhage.

D. Initiate an infusion of oxytocin: Incorrect. Administering oxytocin can be necessary if fundal massage alone is insufficient, but assessing and massaging the fundus should be the first step in the management of postpartum bleeding.

A. Prepare the necessary equipment to initiate an amnioinfusion. B. Assist with performing a vaginal/speculum exam to check for a prolapsed umbilical cord. C. Discontinue the infusion of oxytocin. D. Provide instructions for the client about potential preparation for birth.

Correct Answer is C

Explanation

A. Prepare the necessary equipment to initiate an amnioinfusion: Incorrect. While amnioinfusion may be considered for recurrent variable decelerations caused by umbilical cord compression, the priority is to address the immediate cause of the decelerations, which may be due to excessive oxytocin.

B. Assist with performing a vaginal/speculum exam to check for a prolapsed umbilical cord: Incorrect. Although checking for umbilical cord prolapse is important, the first action should be to address any potential causative factors like oxytocin use before performing an examination.

C. Discontinue the infusion of oxytocin: Correct. Recurrent variable decelerations can be a sign of umbilical cord compression, often exacerbated by excessive uterine contractions induced by oxytocin. Discontinuing the infusion is a critical first step to alleviate the pressure on the umbilical cord and improve fetal heart rate patterns.

D. Provide instructions for the client about potential preparation for birth: Incorrect. Providing instructions about preparation for birth is important but does not address the immediate issue of recurrent variable decelerations and their potential cause.

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A nurse is assessing a newborn who is 48 hr old and is experiencing opioid withdrawals. Which of the following findings should the nurse expect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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