A nurse is reviewing a newborn's laboratory results. Which of the following findings is the nurse's priority?
Platelets 200,000/mm3
Bilirubin 19 mg/dL
Blood glucose 45 mg/dL
Hemoglobin 22 g/dL
The Correct Answer is B
- A) A platelet count of 200,000/mm3 is within the normal range for a newborn and does not require immediate intervention.
- B) A bilirubin level of 19 mg/dL is high and suggests the possibility of hyperbilirubinemia, which can lead to jaundice and, in severe cases, kernicterus, a form of brain damage. This is a critical value that requires immediate attention.
- C) A blood glucose level of 45 mg/dL is on the lower end of the normal range, but it is not as immediately concerning as the elevated bilirubin level. Monitoring and appropriate feeding should address this issue.
- D) A hemoglobin level of 22 g/dL is high, indicating polycythemia, which can be a risk factor for hyperviscosity syndrome. However, it is not as urgent as the bilirubin level of 19 mg/dL. Monitoring and partial exchange transfusion may be considered if symptoms develop.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
a. "Place the retainer clip across the newborn's abdomen":
- This statement is incorrect and potentially dangerous. The retainer clip should be positioned at the level of the armpits to secure the harness straps. Placing it across the abdomen could cause abdominal injury in the event of sudden braking or a crash.
b. "Keep the car seat rear-facing until the newborn can sit unsupported":
- While this is generally true and important safety advice, it is not directly related to the positioning of the newborn in the car seat. Instead, it addresses the orientation of the car seat itself. Rear-facing car seats are safer for infants as they provide better protection for the head, neck, and spine in the event of a crash.
c. "Position the newborn at a 45-degree angle in the car seat":
- This is the correct recommendation. Newborns should be positioned at a 45-degree angle in the car seat to prevent their head from falling forward and potentially obstructing their airway. Many car seats come with angle adjusters or indicators to help achieve this optimal positioning.
d. "Place the shoulder harness straps below the level of the newborn's armpits":
- Placing the shoulder harness straps below the level of the newborn's armpits is incorrect. The straps should be positioned at or slightly below the level of the shoulders to provide proper restraint. Placing them too low increases the risk of the baby slipping out of the harness in the event of a crash.
Correct Answer is B
Explanation
A. Pain following a cesarean birth is important to address, but it may not indicate an urgent need for assessment compared to other potential complications.
B. A client with preeclampsia requires close monitoring of blood pressure to prevent
complications such as eclampsia, which can lead to seizures and other serious consequences. An elevated blood pressure reading warrants immediate attention.
C. A client scheduled for discharge following a laparoscopic tubal ligation is stable and can likely wait for assessment until after higher-priority clients have been seen.
D. While it's important to monitor for bleeding after a vaginal birth, the absence of bleeding reported by a client 24 hours postpartum may not indicate an immediate need for assessment compared to the potential urgency of managing preeclampsia.
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