Nurses' Notes 0800:
Newborn placed on radiate warmer. Color consistent with newborn's genetic background. Acrocyanosis present. Mild grunting, nasal flaring and intermittent retractions noted.
0830:
Grunting, nasal flaring, and sternal retractions noted. Color consistent with newborn's genetic background. Acrocyanosis present.
Select the 4 findings the nurse should report to the provider.
r.
Temperature
Respiratory assessment
Serum glucose level
WBC count
Hematocrit
Heart rate
Correct Answer : B,D,E,F
Grunting, nasal flaring, and sternal retractions are signs of respiratory distress in a newborn. These findings suggest that the newborn is having difficulty breathing and may require further evaluation and intervention by the provider.
Hematocrit levels may be indicative of polycythemia or other hematological abnormalities, which could impact the newborn's well-being and require further assessment and management. Changes in heart rate may indicate cardiac or circulatory issues in the newborn, which warrant further evaluation by the provider.
Respiratory distress in the neonatal period can also occur due to neonatal sepsis and hence, WBC count is important.
Temperature is important to assess in newborns, but it is not explicitly indicated as abnormal in the scenario provided. Newborn's serum glucose level is essential, it is not mentioned in the scenario and is not typically a priority in this context unless there are specific risk factors or symptoms of hypoglycemia.
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Related Questions
Correct Answer is B
Explanation
A. The client is experiencing postpartum depression. A prescription of antidepressants is important but should come after fully assessing the client's mental state
B. Asking the client if she has considered harming her newborn is important in further assessments to establish the mothers as it is a common feature of postpartum depression.
C. While reinforcing education on postpartum and newborn care is important for overall maternal and infant well-being, it may not directly address the client's current mental health concerns.
D. Exploring options on how to help the client is key but this should comer after a thorough examination has occurred.
Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A"}}
Explanation
-The client talks to her father and her best friend when she starts to feel sad. Effective: Seeking support from loved ones and communicating feelings is a positive coping mechanism for dealing with sadness.
-The client states she feels numb when thinking about the crash.
Ineffective: Feeling numb can indicate emotional detachment, which may suggest unresolved trauma and could be indicative of ineffective treatment.
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-The client states that she avoids driving altogether and takes the bus.
Effective: Avoiding triggering situations, such as driving, can be a healthy coping strategy to manage distress associated with traumatic events.
-The client reports sleeping 6 to 7 hours per night.
Effective: Sleeping adequately is essential for mental health and overall well-being. Reporting sufficient sleep suggests improvement.
-The client states she feels less jumpy and more relaxed.
Effective: Feeling less jumpy and more relaxed indicates a reduction in anxiety symptoms, suggesting that treatment has been effective in managing anxiety.
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