A woman received 50 mcg of fentanyl intravenously 1 hour before delivery. What drug should the nurse have readily available?

Choice A reason:

Changing the patient's gown may be necessary for comfort and hygiene, but it is not the priority after an amniotomy. The main concern is the well-being of the fetus and the mother.

Choice B reason:

Assessing the fetal heart rate is the priority after an amniotomy. This procedure involves rupturing the amniotic sac, which may lead to changes in the fetal environment. Monitoring the fetal heart rate helps determine if the baby is tolerating the procedure well and if there are any signs of distress.

Choice C reason:

Estimating the amount of amniotic fluid is essential during an amniotomy, but it is not the top priority. The focus should be on evaluating the fetal well-being first.

Choice D reason:

Assessing the color of the amniotic fluid is significant, but it is not the primary concern immediately after an amniotomy. While changes in fluid color may indicate certain conditions, the fetal heart rate assessment takes precedence in this situation.

The correct answer is: c. The lungs of a baby delivered by cesarean section may sound moist for 24 hours after birth.

Choice A reason:

If this baby was born vaginally, it could indicate a pneumothorax.

A pneumothorax occurs when air leaks into the space between the lung and chest wall, causing the lung to collapse. This condition can happen in newborns, especially those with underlying lung issues or those who have undergone mechanical ventilation However, moist lung sounds in a newborn are not typically indicative of a pneumothorax. Pneumothorax is more likely to present with symptoms such as rapid breathing, grunting, and cyanosis.

Choice B reason:

The neonate must have aspirated surfactant.

Surfactant aspiration is not a common cause of moist lung sounds. Surfactant is a substance that helps keep the lungs’ air sacs open and is crucial for proper lung function. Aspiration of surfactant is not a typical diagnosis and would not usually result in moist lung sounds. Instead, surfactant deficiency or dysfunction can lead to respiratory distress syndrome, which presents differently.

Choice C reason:

The lungs of a baby delivered by cesarean section may sound moist for 24 hours after birth.

Babies born via cesarean section often have moist lung sounds because they do not experience the compression of the chest that occurs during vaginal delivery, which helps expel fluid from the lungs. This retained fluid can cause moist lung sounds, which typically resolve within the first 24 hours after birth. This is a normal finding and does not usually indicate a serious problem.

Choice D reason:

The nurse should notify the pediatrician stat for this emergency situation.

While it is always important to monitor newborns closely, moist lung sounds alone in a baby born via cesarean section are not typically an emergency. This finding is usually due to retained fluid in the lungs, which is expected to clear within the first day of life. Immediate notification of the pediatrician is not necessary unless the baby shows other signs of respiratory distress or other concerning symptoms.