Exhibits

A nurse is reviewing the medical record of a client who has schizophrenia. Which of the following findings should the nurse report to the provider? (Click on the exhibit tabs for additional information about the client. There are three tabs that contain separate categories of data.)

Rationale for correct choices

• Hypoglycemia: The newborn’s birth weight is 4200 g (9 lb 4 oz), indicating macrosomia. Infants of this size, especially after cesarean delivery, are at increased risk for hypoglycemia due to potential neonatal hyperinsulinemia. Early identification and monitoring of blood glucose are essential to prevent neurodevelopmental complications.

• Tachypnea of the newborn: The newborn demonstrates increasing respiratory rates (68 → 76/min) with grunting and mild intercostal retractions. These signs indicate transient tachypnea of the newborn, commonly seen after cesarean birth due to delayed clearance of fetal lung fluid. Continuous respiratory monitoring and supportive care are required to prevent hypoxemia or respiratory distress.

Rationale for incorrect choices

• Tachycardia: Although the newborn’s heart rate is slightly on the higher end of normal (154–156/min), it remains within the normal range for a newborn (120–160/min). This is not currently indicative of a pathologic condition or immediate risk.

• Bronchopulmonary dysplasia: Bronchopulmonary dysplasia typically occurs in premature infants who require prolonged mechanical ventilation or oxygen therapy. This term does not apply to a full-term newborn with transient tachypnea following cesarean birth.

Rationale:

A. Respite care: Respite care provides temporary relief for caregivers, but it does not directly assist clients with limited financial resources in obtaining home IV therapy or covering medical costs. This resource may be helpful later but is not a primary financial support option.

B. Food stamps: Supplemental Nutrition Assistance Program (SNAP), or food stamps, helps low-income clients access adequate nutrition. Proper nutrition is important for healing and overall health, making this a relevant resource for a client below the poverty level.

C. Medicaid: Medicaid provides health coverage for low-income individuals and can help cover costs associated with home IV therapy, medications, and other healthcare needs. It is an appropriate recommendation for a client who meets income eligibility criteria.

D. Medicare Part A: Medicare primarily covers inpatient hospital care, skilled nursing facilities, hospice, and some home health services for clients over 65 or with certain disabilities. A young adult below the poverty level may not qualify, making this less appropriate for the scenario.

E. Adult day care: Adult day care provides socialization and supervision during the day, mainly for older adults or those with cognitive impairments. It does not address financial assistance or coverage for home IV therapy, so it is not a primary resource in this case.