A nurse is assessing a newborn who was born 2 hr ago and was admitted to the neonatal intensive care unit with chest wall retractions and blue discoloration of the hands and feet. Which of the following findings indicates a decline in the newborn's status?

Rationale:

A. "Your provider will schedule a chorionic villus sampling to determine the sex of your baby." Chorionic villus sampling (CVS) is a different prenatal test that involves taking a sample of chorionic villi for genetic testing, not determining the sex of the fetus.

B. "This procedure determines if your baby has genetic or congenital disorders."

Correct answer.

Amniocentesis is a prenatal test used to diagnose genetic disorders or chromosomal abnormalities, not to determine the sex of the fetus.

C. "We can schedule the procedure for later today if you'd like." Amniocentesis is not typically scheduled on the same day as requested. It requires prior preparation and scheduling.

D. "You cannot have an amniocentesis until you are at least 35 years of age." There's no age restriction for amniocentesis based solely on maternal age. It's typically recommended for women at higher risk for genetic conditions, regardless of age.

Rationale:

A. An apneic episode less than 15 seconds may be considered within normal limits for a newborn and does not necessarily indicate a decline in status.

B. Fine crackles may indicate fluid in the lungs but are not specific to a decline in the newborn's status.

C. An oxygen saturation of 89% indicates hypoxemia, which is a significant concern and suggests respiratory compromise. It indicates a decline in the newborn's status and requires immediate intervention to improve oxygenation.

D. Nasal flaring is a sign of respiratory distress but may not be as concerning as a low oxygen saturation level in this context. It indicates increased work of breathing but does not provide direct information about oxygenation status.