Decreased surfactant production in the preterm lung is a problem because surfactant

Choice A) Report of absent breast pain is incorrect because this is not a finding that indicates that the medication was effective, but rather a finding that indicates that the client does not have mastitis or engorgement. Mastitis is an infection of the breast tissue that causes pain, swelling, redness, and fever. Engorgement is a condition where the breasts become overfilled with milk, causing pain, hardness, and leakage. Both conditions are common in postpartum women who are breastfeeding, but they are not related to methylergonovine or uterine bleeding. Therefore, this response is irrelevant and inaccurate.

Choice B) Increase in lochia is incorrect because this is not a finding that indicates that the medication was effective, but rather a finding that indicates that the medication was ineffective or that the client has a complication. Lochia is the vaginal discharge that consists of blood, mucus, and tissue from the uterus after childbirth. It usually lasts for about 4 to 6 weeks and gradually decreases in amount and color. Methylergonovine is a medication that helps to control uterine bleeding by improving the tone and contractions of the uterus. An increase in lochia may mean that methylergonovine did not work well or that the client has a problem such as retained placenta, infection, or subinvolution. Therefore, this response is opposite and inaccurate.

Choice C) Increase in blood pressure is incorrect because this is not a finding that indicates that the medication was effective, but rather a finding that indicates that the client has a side effect or a risk factor. Blood pressure is the force of blood against the walls of the arteries. It is measured by two numbers: systolic (the pressure when the heart beats) and diastolic (the pressure when the heart rests). The normal range for blood pressure is 120/80 mm Hg or lower. Methylergonovine is a medication that can cause vasoconstriction, which means narrowing of the blood vessels and increasing of the blood pressure. This can lead to complications such as hypertension, stroke, or heart attack. Therefore, this response is adverse and inaccurate.

Choice D) Fundus firm to palpation is correct because this is a finding that indicates that the medication was effective and that the client has a good outcome. The fundus is the upper part of the uterus that can be felt through the abdomen after childbirth. It should be firm, midline, and at or below the level of the navel. A firm fundus means that the uterus has contracted well and stopped bleeding. Methylergonovine is a medication that helps to achieve this by improving the tone and contractions of the uterus. Therefore, this response is positive and accurate.

Choice a) They are born before 38 weeks of gestation is incorrect because this is not the definition of SGA. SGA refers to newborns who have a birth weight or length that is significantly lower than expected for their gestational age, regardless of when they are born. Therefore, a newborn can be SGA even if they are born at term or post-term.

Choice b) Placental malfunction is the only recognized cause of this condition is incorrect because this is not the only factor that can contribute to SGA. Placental malfunction can cause fetal growth restriction due to insufficient blood supply and nutrients to the fetus, but there are other possible causes such as maternal factors (e.g.,

hypertension, diabetes, smoking, malnutrition), fetal factors (e.g., chromosomal abnormalities, infections, congenital anomalies), and environmental factors (e.g., altitude, pollution, stress).

Choice c) They weigh less than 2500 g is incorrect because this is not the criterion for SGA. SGA is based on the comparison of the newborn's weight or length with the expected values for their gestational age, not on an absolute cutoff. Therefore, a newborn can be SGA even if they weigh more than 2500 g, as long as they are below the 10th percentile for their gestational age.

Choice d) They are below the 10th percentile on gestational growth charts is correct because this is the most commonly used definition of SGA. Gestational growth charts are tools that plot the expected weight or length of a fetus or newborn according to their gestational age and sex. They are based on population data and can vary

depending on the ethnicity and region of origin of the mother and the baby. A newborn who falls below the 10th percentile on these charts is considered SGA, meaning that they have grown less than 90% of their peers .