A nurse is caring for several clients who are receiving well-child check-ups. The nurse should identify that the initial diphtheria, tetanus, and pertussis (DTaP) vaccine is indicated for which of the following clients?

c. Weak cry

Explanation: In the context of a newborn with shoulder dystocia, a weak cry can be an indication of pain. Newborns communicate their discomfort or pain through crying, and a weak cry may suggest that the newborn is experiencing pain or distress.

Option a, lip-smacking, is not necessarily a specific indication of pain in this situation. Lip-smacking can

occur due to various reasons and may not solely indicate pain.

Option b, a stiff posture, may be more indicative of muscle tension or rigidity rather than pain in this

scenario.

Option d, tongue-darting, is not a specific indicator of pain in this context. Tongue-darting is a common behavior in newborns and may not be directly related to pain.

By recognizing a weak cry as a potential indication of pain in the newborn with shoulder dystocia, the nurse

can provide appropriate interventions and support to manage the newborn's pain and discomfort.

c. "I will have a chest x-ray following the procedure."

Explanation:

The statement that indicates an understanding of the information provided is "I will have a chest x-ray following the procedure."

Explanation for the other options:

a. "I will have general anesthesia during the procedure":

This statement is incorrect. Thoracentesis is typically performed using local anesthesia, which numbs the area where the needle will be inserted. General anesthesia, which induces a state of unconsciousness, is not usually required for this procedure.

b. "I will lie flat for 6 hours following the procedure":

This statement is incorrect. While the client may be advised to lie still for a short period after the thoracentesis, it is not necessary for them to lie flat for a full 6 hours. The specific post-procedure instructions may vary depending on the client's condition and the healthcare provider's preferences.

d. "I will breathe deeply through my nose during the procedure":

This statement is incorrect. During a thoracentesis, the client is typically asked to sit upright and lean forward to allow beter access to the space between the lungs and chest wall. They may be instructed to take slow, deep breaths and hold their breath for short periods as needed during the procedure to help maintain proper positioning and reduce the risk of complications.

In summary, the statement that demonstrates an understanding of the thoracentesis procedure is "I will have a chest x-ray following the procedure." This indicates the client's awareness of the need for a post- procedure chest x-ray to evaluate the results and ensure the absence of any complications.