A nurse is caring for a client who is in active labor. The nurse notes early decelerations of the FHR on the fetal monitor tracing. The nurse should identify that which of the following conditions causes early decelerations in the FHR?

The correct answer is: A. Hemoglobin 12 g/dL.

Choice A reason:

Hemoglobin levels in newborns are expected to be significantly higher than in adults due to the physiological adaptation to life outside the womb. The normal range for a newborn’s hemoglobin is approximately 14 to 24 g/dL1234. A level of 12 g/dL is below the expected range and could indicate anemia or other underlying conditions that may require further investigation and intervention by the healthcare provider.

Choice B reason:

The glucose level in a newborn can vary, especially within the first few hours after birth. Normal blood glucose levels for a newborn 1 to 2 hours old can be as low as 25 mg/dL and can rise to adult levels (60-100 mg/dL) within the first few days5. A glucose level of 50 mg/dL in a 24-hour-old newborn falls within the acceptable range and would not typically require reporting to the provider unless accompanied by symptoms of hypoglycemia.

Choice C reason:

Bilirubin levels in newborns can be elevated due to the normal breakdown of fetal hemoglobin as the baby’s liver matures. Normal bilirubin levels for a newborn can range from 1.0 to 12.0 mg/dL6. A bilirubin level of 4 mg/dL is within the normal range for a 24-hour-old newborn and is not typically a cause for concern unless there are signs of jaundice or other symptoms.

Choice D reason:

The normal platelet count for a newborn ranges from 150,000 to 450,000/mm³7. A platelet count of 200,000/mm³ is well within the normal range for a newborn and would not need to be reported to the healthcare provider.

Choice A rationale:

Placing the newborn under a radiant heat warmer is used to prevent cold stress. Newborns are at risk of losing body heat rapidly, and cold stress can lead to various complications, including respiratory distress, hypoglycemia, and metabolic acidosis. The radiant heat warmer helps maintain the baby's body temperature within the normal range, promoting overall stability and reducing the risk of cold-related issues.

Choice B rationale:

The nurse should not choose choice B, "Respiratory depression,” as the action used to prevent. Placing the newborn under a radiant heat warmer does not specifically target respiratory depression. Respiratory depression in newborns may be related to various factors, such as anesthesia exposure during delivery or certain medications, and it requires appropriate monitoring and management rather than just heat regulation.

Choice C rationale:

The nurse should not choose choice C, "Thermogenesis,” as the action used to prevent. Thermogenesis refers to the generation of heat in the body, which is essential for maintaining body temperature. While the radiant heat warmer indirectly supports thermogenesis by preventing heat loss, the main purpose of using the warmer is to prevent cold stress, as stated in choice A.

Choice D rationale:

The nurse should not choose choice D, "Tachycardia,” as the action used to prevent. Tachycardia refers to an abnormally fast heart rate, and the use of a radiant heat warmer does not specifically target this condition. The purpose of the warmer, as explained earlier, is to maintain the baby's body temperature and prevent cold stress, not to address tachycardia.