A nurse is caring for a newborn who is 30 minutes old in the newborn nursery.
The condition that poses the greatest risk to the newborn is
The Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"B"}
The condition that poses the greatest risk to the newborn is meconium aspiration syndrome due to amniotic fluid.
Rationale for correct answers
Meconium aspiration syndrome (MAS) occurs when a newborn inhales meconium-stained amniotic fluid, leading to airway obstruction, chemical pneumonitis, and surfactant dysfunction. The presence of dark brown-greenish amniotic fluid, along with mild respiratory distress (nasal flaring, increased respiratory rate of 60/min), raises concern for MAS. Close monitoring for worsening respiratory symptoms is essential.
Amniotic fluid contamination with meconium increases the risk of lung inflammation and infection. The newborn’s vigorous condition suggests mild aspiration, but continuous observation is needed.
Rationale for incorrect Response 1 options
- Jaundice: While term newborns may develop physiological jaundice, there are no indications of hyperbilirubinemia or hemolysis in this case.
- Hypoglycemia: No jitteriness or poor feeding, and birth weight is within normal range; hypoglycemia more commonly affects preterm or low birth weight infants.
- Cold stress: The newborn is under a radiant warmer, and temperature is within normal range (36.5°C).
Rationale for incorrect Response 2 options
- Birth weight: No signs of growth restriction or macrosomia-associated complications.
- Acrocyanosis: Normal in newborns due to immature circulation, not an indicator of respiratory compromise.
- Apgar scores: Strong Apgar scores (8 and 9) suggest good adaptation to extrauterine life.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Placenta previa is a condition where the placenta partially or totally covers the cervix. While it poses risks for hemorrhage during labor and delivery, it does not directly increase the risk of postpartum infection. The primary risks associated with placenta previa are related to bleeding, not infection.
Choice B rationale
Meconium aspiration occurs when a fetus inhales meconium-stained amniotic fluid. This primarily affects the newborn's respiratory system and does not directly increase the postpartum client's risk of infection. The complications of meconium aspiration are focused on the neonate.
Choice C rationale
A midline episiotomy is a surgical incision made in the perineum during childbirth to enlarge the vaginal opening. This incision creates a break in the skin and mucous membranes, providing a potential portal of entry for bacteria. Therefore, a midline episiotomy places the postpartum client at an increased risk for local infection at the incision site.
Choice D rationale
Gestational hypertension is high blood pressure that develops during pregnancy and typically resolves after delivery. While it poses risks to both the mother and the fetus, it does not directly increase the postpartum client's risk of infection. The primary concerns with gestational hypertension are related to blood pressure control and potential end-organ damage.
Correct Answer is B
Explanation
Choice A rationale
Thoroughly cooking meat to an internal temperature of 160°F (71°C) kills the Toxoplasma gondii parasite, thus preventing transmission. This is a recommended measure to prevent toxoplasmosis during pregnancy.
Choice B rationale
Drinking unpasteurized milk poses a risk of exposure to various pathogens, including Toxoplasma gondii, as pasteurization is a process that kills harmful microorganisms. Pregnant women should avoid unpasteurized dairy products to reduce the risk of infection. This statement indicates a need for further instruction as it suggests an unsafe practice.
Choice C rationale
Cat feces can contain oocysts of Toxoplasma gondii. Avoiding contact with materials potentially contaminated with cat feces, such as litter boxes or garden soil, is a crucial measure to prevent toxoplasmosis.
Choice D rationale
Raw meat can be contaminated with Toxoplasma gondii. Avoiding touching mucous membranes of the mouth or eyes while handling raw meat and washing hands thoroughly afterwards prevents the parasite from entering the body. This is a recommended preventive measure.
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