A nurse is caring for a client who is receiving an epidural block with an opioid analgesic. The nurse should identify which findings as an adverse effect of the medication?

Rationale:

A. When teaching parents about the Plastibell circumcision technique, it's important to explain that a yellow exudate (sometimes referred to as granulation tissue) will typically form at the surgical site within 24 hours after the procedure. This is a normal part of the healing process and should not be a cause for concern.

B. The end of the penis will likely get red, then develop a yellow discharge, and finally scab over, “like a skinned knee.” This is the normal healing process and will progress over the 7-14 days that the Plastibell Ring stays on. The correct size Plastibell Ring is secured with a string and the excess skin trimmed. The skin that overlaps the ring will turn dark “like the umbilical cord” before the ring falls off at 7-14 days.

C. The Plastibell is typically left in place for several days, not removed 4 hours after the procedure.

D. Ensuring the newborn's diaper is snug may help keep the Plastibell in place, but it is not the most crucial aspect of care related to the circumcision technique.

A.

Rationale:

A. Excessive crying:

Correct answer. Neonatal abstinence syndrome (NAS) often presents with irritability, inconsolable crying, and difficulty soothing.

B. Decreased muscle tone: NAS can cause hypertonia or increased muscle tone rather than decreased muscle tone.

C. Absent Moro reflex: NAS may cause hyperactive Moro reflex rather than absent.

D. Diminished deep tendon reflexes: NAS can cause hyperactive deep tendon reflexes rather than diminished.