A nurse is assessing the newborn of a client who took a selective serotonin reuptake inhibitor (SSRI) during pregnancy. Which of the following manifestations should the nurse identify as an indication of withdrawal from an SSRI?

A. Decreased vaginal discharge is not typically associated with the onset of labor. In fact, an increase in vaginal discharge may be observed as the cervix begins to soften and efface.

B. Weight gain of 0.5 to 1.5 kg is not a specific sign that precedes labor. Weight gain during late pregnancy is more related to fluid retention, and it does not necessarily indicate imminent labor.

C. Urinary retention is not a common sign that precedes labor. However, increased pressure on the bladder from the descending fetus may lead to more frequent urination rather than retention.

D. A surge of energy is known as the "nesting instinct" and is a common sign that precedes labor. Some women experience a burst of energy and motivation to prepare for the upcoming birth.

Choice A Reason:

Hemoglobin (Hgb) of 20 g/dL is elevated, but this can be a normal finding in a newborn and does not necessarily require immediate intervention.

Choice B Reason:

Total bilirubin of 5 mg/dL is within the normal range for a 24-hour-old newborn.

Choice C Reason:

Blood glucose 30 mg/dL. A blood glucose level of 30 mg/dL is significantly lower than the normal range for a newborn. Hypoglycemia in a newborn can lead to neurologic complications, so it is important to report this result promptly for further evaluation and intervention.

Choice D Reason:

White blood cell (WBC) count of 20,000/mm³ is within the expected range for a newborn and is not a cause for immediate concern. Newborns often have higher WBC counts shortly after birth.