A nurse is caring for a newborn who is 4 hours old. Which condition poses the greatest risk to the newborn?
Neonatal Syndrome (NAS).
Developmental Dysplasia of the Hip (DDH).
Subgaleal hemorrhage.
Congenital cardiac defect.
The Correct Answer is D
Choice A rationale
Neonatal Abstinence Syndrome (NAS) is a group of problems that occur in a newborn who was exposed to addictive opiate drugs while in the mother’s womb. While NAS can pose risks to a newborn, it is not considered the greatest risk.
Choice B rationale
Developmental Dysplasia of the Hip (DDH) is a condition where the “ball and socket” joint of the hip does not properly form in babies and young children. While DDH can pose risks to a newborn, it is not considered the greatest risk.
Choice C rationale
Subgaleal hemorrhage is a rare but potentially lethal condition in newborns, usually resulting from vacuum-assisted delivery. While it can pose risks to a newborn, it is not considered the greatest risk.
Choice D rationale
Congenital cardiac defects are the most common type of birth defect. They can alter the way blood flows through the heart and pose a significant risk to a newborn.
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Correct Answer is C
Explanation
Choice A rationale
Preparing for an emergency cesarean birth may be necessary in some cases of preeclampsia, particularly if there are signs of fetal distress or if the condition is not responding to treatment. However, in this scenario, the client’s symptoms are indicative of magnesium toxicity, not worsening preeclampsia.
Choice B rationale
Positioning the client in Trendelenburg (with the head lower than the feet) is not typically used in the management of preeclampsia or magnesium toxicity.
Choice C rationale
Discontinuing the medication infusion is the correct action in this scenario. The client’s symptoms (respiratory rate of 10/min and absent deep-tendon reflexes) are indicative of magnesium toxicity, a potential complication of magnesium sulfate therapy. Magnesium sulfate is used in the management of preeclampsia to prevent seizures, but it can cause toxicity if the levels become too high. If signs of toxicity occur, the infusion should be discontinued immediately.
Choice D rationale
Assessing maternal blood glucose may be necessary in some cases, particularly if the client has a history of diabetes. However, it is not the priority in this scenario, as the client’s symptoms are indicative of magnesium toxicity, not hyperglycemia.
Correct Answer is C
Explanation
Choice A rationale
The patient’s anti-A and anti-B antibodies crossing the placenta and causing the destruction of the fetal red blood cells is related to ABO incompatibility, not Rh incompatibility.
Choice B rationale
If the patient’s blood contains the Rh factor and the newborn’s does not, Rh incompatibility would not occur. Rh incompatibility happens when the mother’s blood does not contain the Rh factor (Rh-negative), but the baby’s blood does contain the Rh factor (Rh-positive).
Choice C rationale
The patient’s blood does not contain the Rh factor, so she produces anti-Rh antibodies that cross the placental barrier and cause hemolysis of red blood cells in newborns. This is the correct reason for hyperbilirubinemia occurring with Rh incompatibility.
Choice D rationale
The patient’s blood containing anti-Rh antibodies that attack the newborn’s red blood cells is a result of Rh incompatibility, but it does not explain why hyperbilirubinemia occurs.
Hyperbilirubinemia occurs due to the breakdown of the extra red blood cells, leading to an increase in bilirubin levels.
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