A nursery nurse is performing a shift assessment on a baby who was born 8 hours ago via a vacuum-assisted vaginal birth and notices caput succedaneum. Which of the following statements regarding caput succedaneum is correct?
"Caput succedaneum is a concern and I need to call the pediatrician right away."
"Caput succedaneum is self-limiting and goes away on its own within 3-5 days.
Caput succedaneum is caused by the cranial bones changing shape to get through the maternal pelvis.
"Caput succedaneum is bleeding on the brain that does not cross the suture line."
The Correct Answer is B
Caput succedaneum is a common condition in newborns that causes swelling of the soft tissues of the scalp. It is usually caused by pressure on the baby's head during delivery and can be seen in both vaginal and instrumental births, such as vacuum-assisted deliveries. It generally crosses the suture lines, unlike a cephalohematoma.
Caput succedaneum is not a serious condition and generally resolves on its own within a few days without any treatment. However, the nurse should continue to monitor the newborn for signs of jaundice, which can occur due to the breakdown of red blood cells in the swelling.
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Correct Answer is C
Explanation
Health literacy is defined as the degree to which an individual can obtain, process, and
understand basic health information and services needed to make appropriate health decisions. Basic functional health literacy refers to an individual's ability to read and understand simple health information and instructions.
While all the clients mentioned may be demonstrating health literacy, the ability to read and understand discharge instructions after routine surgery is a basic functional health literacy skill. This client is able to comprehend written health information and follow simple instructions, which is an important aspect of managing their own health care.
The other clients mentioned may be displaying a higher level of health literacy, such as the client who is teaching a class about cancer survival or the client with Type II Diabetes who is using nutritional information to make a grocery list. These individuals may have a greater ability to understand and apply complex health information and navigate the healthcare system.
Correct Answer is D
Explanation
The question that the nurse would prioritize the least during the assessment is "Do you plan to have a vaginal or cesarean delivery?" This is because the priority at this point is to determine the urgency of the situation and assess the patient's current condition. The patient's delivery plan can be addressed later after the initial assessment is completed and the patient's stability has been established.
The other questions are all important in determining the cause and severity of the bleeding and the appropriate course of action. The question about the number of weeks is important to determine the gestational age and potential causes of bleeding, as some causes are more common in certain stages of pregnancy. The question about pain can help to determine the possible causes of bleeding and the patient's comfort level. The question about the last ultrasound is important to determine the location of the placenta and whether there are any abnormalities or potential complications.
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