A nurse is transporting a newborn to their parents from the nursery.
Which of the following actions should the nurse perform to confirm the newborn's identity?

Choice A rationale:

At approximately 20 weeks of gestation, the fundus is typically located at the level of the umbilicus. By 32 weeks, the uterus has grown significantly beyond this point. Therefore, a fundal height at the umbilicus would be inconsistent with 32 weeks gestation and may suggest intrauterine growth restriction or incorrect dating if observed.

Choice B rationale:

At 32 weeks of gestation, the fundus is expected to be located about halfway between the umbilicus and the xiphoid process. Fundal height in centimeters generally correlates with gestational age between 20 and 36 weeks. Thus, a measurement of approximately 32 cm from the symphysis pubis to the top of the fundus is expected, placing it midway between these anatomical landmarks.

Choice C rationale:

The fundus typically reaches the xiphoid process around 36 to 40 weeks of gestation. At 32 weeks, it has not yet ascended to this level. A fundal height at the xiphoid process at 32 weeks may suggest polyhydramnios, macrosomia, or multiple gestation, and would require further evaluation.

Choice D rationale:

At 16 weeks of gestation, the fundus is generally located halfway between the symphysis pubis and the umbilicus. By 32 weeks, the uterus has expanded well beyond this point. A fundal height at this level would be abnormally low for 32 weeks and could indicate fetal growth restriction or oligohydramnios.

Choice A rationale

While vitamin K is important for coagulation and is often supplemented in newborns, increasing maternal intake of vitamin K during breastfeeding is not a primary nutritional recommendation for the mother. The focus for maternal nutrition during lactation is generally on overall caloric and fluid intake, and specific macronutrients and micronutrients that support milk production.

Choice B rationale

While potassium is an essential electrolyte, and maintaining appropriate levels is crucial for overall health, there isn't a specific recommendation to significantly increase potassium intake beyond general dietary guidelines for a breastfeeding mother. The emphasis is typically on adequate fluid and overall balanced nutrition rather than targeted potassium supplementation for lactation.

Choice C rationale

Breastfeeding significantly increases a mother's energy expenditure due to the metabolic demands of milk production. Therefore, maintaining the same caloric intake as during pregnancy would be insufficient to meet these increased energy needs, potentially leading to maternal fatigue and weight loss. An increase of approximately 330-400 additional calories per day is typically recommended.

Choice D rationale

Adequate fluid intake is crucial for successful lactation. Breast milk is approximately 87% water, and the process of milk synthesis requires a substantial fluid volume. Maintaining adequate hydration, guided by thirst, ensures sufficient substrate for milk production and prevents maternal dehydration, which can negatively impact milk supply and overall well-being. .