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A nurse is caring for a mother who delivered vaginally 2 hr ago. 38 week gestation.Vaginal delivery of a 9-pound 8-ounce baby girl.
Select the 4 findings the nurse should report to the provider.

A.

Respiratory assessment.

B.

Hemoglobin level.

C.

Heart rate.

D.

Constant trickle of blood at vagina.

Answer and Explanation

Correct Answer : A,B,C,D

Choice A rationale

Respiratory assessment is vital, especially following childbirth, to ensure the mother is not experiencing respiratory issues.

Choice B rationale

Monitoring hemoglobin levels can help identify significant blood loss during delivery, which can lead to anemia and other complications.

Choice C rationale

A heart rate that is elevated postpartum may indicate underlying issues such as infection or hemorrhage, which need to be reported.

Choice D rationale

Continuous blood trickling from the vagina is a warning sign of potential postpartum hemorrhage, which is a medical emergency.


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Related Questions

Correct Answer is B

Explanation

Choice A rationale

Cephalohematoma is a collection of blood between a newborn's scalp and the skull bone, often caused by birth trauma, but it's not specifically related to small for gestational age (SGA) assessment.

Choice B rationale

Hypoglycemia is a common concern in SGA newborns because they have less stored glucose and glycogen, making blood glucose level monitoring critical.

Choice C rationale

Necrotizing enterocolitis is a serious condition in premature newborns involving inflammation and damage to the intestines, but it is not specific to SGA newborns.

Choice D rationale

Immature reflexes are assessed in newborns, but hypoglycemia takes priority in SGA newborns due to their higher risk of low blood sugar.

Correct Answer is {"A":{"answers":"A,C"},"B":{"answers":"A,C"},"C":{"answers":"A,C"},"D":{"answers":"B"},"E":{"answers":"C"}}

Explanation

  1. Jitteriness: This can be a sign of hypoglycemia in a newborn, and it may also be seen in Neonatal Abstinence Syndrome (NAS) due to withdrawal symptoms.
  2. Lethargy: Lethargy is common in hypoglycemia (due to low energy reserves) and can also be seen in Neonatal Abstinence Syndrome due to withdrawal effects.
  3. Poor Feeding: Hypoglycemia may cause poor feeding due to the lack of energy, and Neonatal Abstinence Syndrome can cause feeding difficulties because of withdrawal symptoms.
  4. Jaundice: Jaundice is a hallmark sign of Neonatal Jaundice, typically due to elevated bilirubin levels.
  5. Loose Stool: Loose stool can be a sign of Neonatal Abstinence Syndrome, as gastrointestinal disturbances are common in withdrawal. It is not typically associated with hypoglycemia or neonatal jaundice.

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