A nurse is teaching a client who is scheduled for an amniocentesis about the purpose of a lecithin/sphingomyelin ratio test.
Which of the following statements should the nurse make?

Choice A rationale

Dark and concentrated urine in an infant indicates inadequate hydration, which can be a sign of insufficient milk intake during breastfeeding. Well-hydrated infants, receiving adequate breast milk, typically produce urine that is pale yellow and dilute, not dark and concentrated. This reflects proper kidney function and fluid balance.

Choice B rationale

After effective breastfeeding, the breasts should feel softer and less engorged, not firm. The firmness before feeding is due to milk accumulation within the mammary glands. As the infant removes milk, the pressure decreases, leading to a softer breast texture, indicating successful milk transfer.

Choice C rationale

A tugging sensation during breastfeeding is a normal and expected physiological sign. This sensation results from the baby's effective latch and negative pressure creation, which draws milk from the milk ducts into the baby's mouth. It signifies proper milk ejection and efficient feeding.

Choice D rationale

Two to three wet diapers in a 24-hour period for a 5-day-old infant is indicative of insufficient fluid intake. A well-hydrated newborn at this age, receiving adequate breast milk, should typically have six to eight wet diapers per 24 hours, reflecting sufficient hydration and milk transfer.

Choice A rationale

Meconium aspiration syndrome is primarily associated with post-term gestation or fetal distress, where the fetus passes meconium in utero and subsequently aspirates it. While fetal distress can occur with PPROM, it is not the *most* direct or primary complication anticipated in the newborn due to preterm premature rupture of membranes itself.

Choice B rationale

Polycythemia, an abnormally high red blood cell count, is not a direct complication expected in a newborn specifically due to preterm premature rupture of membranes. It is more commonly associated with chronic hypoxia, maternal diabetes, or certain genetic conditions, and not a direct consequence of prolonged membrane rupture.

Choice C rationale

Sepsis is a significant and highly anticipated complication in a newborn following preterm premature rupture of the membranes (PPROM). The prolonged absence of the amniotic sac, which normally acts as a protective barrier, increases the risk of ascending infection from the maternal genital tract to the fetus, leading to neonatal sepsis.

Choice D rationale

Hyperbilirubinemia, or jaundice, is common in newborns, especially preterm infants, due to immature liver function. However, it is not a specific complication directly and primarily caused by preterm premature rupture of membranes. While prematurity itself is a risk factor for hyperbilirubinemia, PPROM does not directly induce elevated bilirubin levels. .