A nurse is assessing a pre-term newborn who was born at 28 weeks of gestation.

Which of the following findings indicates a possible diagnosis of respiratory distress syndrome (RDS)?

Tachypnea and grunting

Bradycardia and cyanosis

Apnea and nasal flaring

All of the above

Answer and Explanation

The Correct Answer is D

All of the above.

Respiratory distress syndrome (RDS) is a condition that affects preterm newborns who have immature lungs and lack sufficient surfactant.

Surfactant is a substance that helps keep the alveoli open and prevents them from collapsing.

Without enough surfactant, the newborn has difficulty breathing and may develop hypoxia and acidosis.

Choice A is wrong because tachypnea and grunting are signs of respiratory distress, but they are not specific to RDS.

They can also be caused by other conditions such as transient tachypnea of the newborn, pneumonia, or congenital heart defects.

Choice B is wrong because bradycardia and cyanosis are also signs of respiratory distress, but they are not specific to RDS.

They can also be caused by other conditions such as hypothermia, hypoglycemia, or sepsis.

Choice C is wrong because apnea and nasal flaring are also signs of respiratory distress, but they are not specific to RDS.

They can also be caused by other conditions such as intracranial ...

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Correct Answer is B

Explanation

Pre-term newborns are at risk of apnea of prematurity, which is a pause in breathing for more than 20 seconds or less than 20 seconds with bradycardia or cyanosis.An apnea monitor can detect and alert the parents of any episodes of apnea and help them intervene promptly.

Choice A is wrong because breastfeeding is beneficial for pre-term newborns and can provide them with antibodies, nutrients, and bonding with the mother.Breastfeeding should be encouraged as soon as the newborn is medically stable and able to suck and swallow.

Choice C is wrong because keeping the newborn in a warm environment at all times can lead to overheating, dehydration, and increased metabolic rate.Pre-term newborns have difficulty regulating their body temperature and need to be dressed appropriately for the ambient temperature.They should also be monitored for signs of cold stress or heat stress.

Choice D is wrong because delaying immunizations until the newborn reaches term gestation can expose the newborn to preventable infections that ...

A. Administer tocolytic medication to stop contractions B. Instruct the client to empty her bladder C. Obtain informed consent from the client D. Monitor fetal heart rate and activity

Correct Answer is B

Explanation

Instruct the client to empty her bladder.This is because a full bladder can interfere with the insertion of the needle and increase the risk of injury to the bladder or the uterus.Emptying the bladder also reduces discomfort during the procedure.

Choice A is wrong because administering tocolytic medication to stop contractions is not necessary before amniocentesis.Tocolytic medication can have side effects and should only be used when there is a clear indication of preterm labor.

Choice C is wrong because obtaining informed consent from the client is not a nursing action, but a medical one.The nurse can assist in providing information and answering questions, but the final consent should be obtained by the doctor who will perform the procedure.

Choice D is wrong because monitoring fetal heart rate and activity is not a specific action before amniocentesis, but a routine part of prenatal care.Fetal heart rate and activity can be affected by many factors, such as maternal position, fetal sleep cycle, or maternal blood sugar level.

Monitoring them before amniocentesis does not provide any useful information for the procedure.

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A nurse is assessing a pre-term newborn who was born at 28 weeks of gestation. Which of the following findings indicates a possible diagnosis of respiratory distress syndrome (RDS)?

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A nurse is assessing a pre-term newborn who was born at 28 weeks of gestation.

Which of the following findings indicates a possible diagnosis of respiratory distress syndrome (RDS)?