A nurse is caring for a client who is at 36 weeks of gestation.

Exhibits

For each day 2 finding, click to specify whether the finding indicates that the client's condition has improved, has not changed, or has declined.

Meconium aspiration syndrome (MAS) occurs when a newborn breathes in meconium present in the amniotic fluid before or during birth, which can cause respiratory problems. In this case, the presence of meconium-stained fluid, rapid and shallow respiration with occasional expiratory grunting, and fine crackles auscultated throughout lung fields are clinical indicators that suggest the newborn is at risk for MAS.

The newborn is at the greatest risk for meconium aspiration syndrome because meconium-stained fluid was noted during labor. This condition occurs when a newborn inhales a mixture of meconium and amniotic fluid into the lungs, which can lead to respiratory issues such as grunting and fine crackles, both of which were observed in the newborn. It is important for the healthcare team to monitor the baby closely and initiate appropriate interventions to support ventilation and oxygenation as needed.

A. Abundant lanugo is incorrect because postmature newborns typically lose their lanugo before birth.

B. Vernix in the folds and creases is incorrect as vernix caseosa, the white, cheese-like substance covering the skin of the fetus, is often absent in postmature newborns due to it being absorbed as the gestation period extends beyond the normal term.

C. Short, soft fingernails are not expected in postmature newborns; instead, they may have long, overgrown nails.

D. Cracked, peeling skin is a common finding in postmature newborns due to prolonged exposure to amniotic fluid and a decrease in the protective vernix caseos

A.

E. A positive Moro reflex is a normal finding in newborns, including those who are postmature, indicating a healthy neurological response.