A nurse is collecting data from a newborn who is 4 hours old.
Which of the following findings should the nurse report to the provider?

Choice A rationale

The proper sequence for suctioning a newborn is the mouth first, then the nose, to prevent the newborn from aspirating secretions. Suctioning the nose first may cause the newborn to gasp, drawing pharyngeal secretions into the trachea and lungs, potentially leading to aspiration pneumonia or respiratory distress.

Choice B rationale

Depressing the bulb prior to insertion into the mouth or nose creates a negative pressure inside the bulb. Releasing the pressure after insertion will then effectively draw secretions into the bulb, achieving optimal suction. Inserting a non-depressed bulb will be ineffective for removing secretions.

Choice C rationale

The bulb syringe does not require lubrication with sterile water before use; it is intended for immediate use as a mechanical suction device. Lubrication could potentially introduce excess fluid into the newborn's airway or dilute secretions, which does not enhance the device's primary function of removing mucus.

Choice D rationale

The bulb should be placed gently into the sides of the newborn's mouth, rather than the center, to avoid stimulating the gag reflex. Placing it at the sides directs suction toward the cheeks and gums, facilitating the removal of secretions from the oral cavity without causing discomfort or vomiting.

Choice A rationale

Identifying that the newborn resembles oneself as a baby is a normal and positive aspect of maternal-infant attachment and bonding, representing the "taking-hold" phase of postpartum psychological adjustment, where the mother focuses on the infant and parental role. This demonstrates integration and is not considered a psychosocial concern warranting intervention, indicating healthy psychological adaptation.

Choice B rationale

Reporting fatigue and a desire to sleep is a physiological and expected finding in the immediate postpartum period, largely due to the physical exertion of labor, blood loss, and hormonal shifts. While rest is important, this is considered a normal physical adjustment and not a primary psychosocial concern indicative of maladaptation or mental health issues, unlike severe mood or attachment disturbances.

Choice C rationale

A lack of desire to feed the newborn can signify impaired maternal-infant bonding, emotional withdrawal, or a potential symptom of postpartum mood disorders, such as postpartum depression, which is a significant psychosocial concern. This finding deviates from the expected "taking-hold" phase where the mother is typically focused on caring for and interacting with the infant, necessitating further psychosocial assessment.

Choice D rationale

Discussing a desire to have more children is a normal expression of future family planning and generally indicates a positive, healthy adaptation to the current newborn and the role of motherhood. This thought process does not suggest any immediate psychosocial concern or distress and reflects forward-looking reproductive health considerations and positive family construction.