A nurse is assessing the fontanels of a crying newborn and notes that the posterior fontanel pulsates and briefly bulges. What do these findings indicate?

Increased intracranial pressure

Dehydration

Overhydration

These are normal findings

Answer and Explanation

The Correct Answer is D

A. Increased intracranial pressurE. Pulsation and bulging of the fontanel may be signs of

increased intracranial pressure in infants. However, it is important to differentiate between normal fontanel characteristics and abnormal signs of elevated intracranial pressure. In this case, the pulsation and bulging are likely normal responses to crying and changes in intracranial pressure during the newborn period.

B. Dehydration: Dehydration typically presents with sunken fontanels rather than pulsation and bulging. Dehydration is a serious condition that requires prompt assessment and intervention, but it is not indicated by the findings described in the scenario.

C. Overhydration: Overhydration is not typically associated with pulsation and bulging of the fontanel. Overhydration may lead to fluid overload and edema but does not directly affect fontanel characteristics.

D. These are normal findings: Pulsation and brief bulging of the fontanel in response to crying are considered normal findings in newborns. Fontanels allow for the flexibility of the skull bones during childbirth and provide space for brain growth during infancy. Pulsation and bulging may occur temporarily during crying or changes in intracranial pressure and are not necessarily

indicative of pathology.

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Correct Answer is B

Explanation

A. Wash the hands and breasts thoroughly prior to breastfeeding: While hand hygiene is

important, washing the breasts thoroughly before breastfeeding is not recommended as it can remove natural oils that protect the skin and may cause irritation.

B. Bring the baby's wide-open mouth to the breast to form a seal around all of the nipple and areolA. This is a recommended guideline for proper latching during breastfeeding. Ensuring that the baby's mouth covers both the nipple and the surrounding areola helps to facilitate effective milk transfer and prevents nipple pain or damage.

C. When finished, the mother can break the suction by firmly pulling the baby's mouth away from the nipplE. Breaking the suction by pulling the baby's mouth away can cause nipple

trauma. Instead, it's recommended to insert a clean finger into the corner of the baby's mouth to break the suction before removing the baby from the breast.

D. Stroke the nipple against the baby's chin to stimulate wide opening of the baby's mouth: This action may not effectively stimulate the baby to open wide and latch properly. It's better to use gentle pressure on the baby's chin or lower lip to encourage a wider latch

A. Epiglottitis B. Bronchiolitis C. Influenza D. Croup

Correct Answer is B

Explanation

A. Epiglottitis

Epiglottitis typically presents with rapid onset of severe sore throat, high fever, difficulty swallowing, and drooling due to inflammation and swelling of the epiglottis. It is a medical emergency requiring immediate intervention but is less likely to present with the described symptoms.

B. Bronchiolitis

Bronchiolitis commonly occurs in infants and young children, often during the winter months. It is characterized by symptoms such as coughing, wheezing, nasal congestion, fever, and

respiratory distress. The described symptoms, including coughing, nasal congestion, and intermittent fever, align with bronchiolitis.

C. Influenza

Influenza typically presents with symptoms such as fever, cough, sore throat, body aches, and fatigue. While coughing and fever are common symptoms of influenza, the presence of apneic spells is less typical of influenza and more indicative of lower respiratory tract infections like bronchiolitis.

D. Croup

Croup is characterized by a barking cough, hoarseness, and respiratory distress often accompanied by stridor. While croup shares some symptoms with bronchiolitis, such as coughing, the absence of stridor in the description suggests bronchiolitis as a more likely diagnosis.

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A nurse is assessing the fontanels of a crying newborn and notes that the posterior fontanel pulsates and briefly bulges. What do these findings indicate?

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