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A nurse is caring for a newborn 1 hr following birth.

Medical History 1000:

39- week gestation

Emergency cesarean birth for abruptio placenta and non-reassuring fetal heart rate
Apgar 5 at 1 min 8 at 5 min

Positive pressure ventilation given for 1 min followed by free flow oxygen Select the 5 findings the nurse should report to the provider.

A.

Hemoglobin

B.

Hematocrit

C.

Heart rate

D.

Serum glucose

E.

White blood cells

F.

Respiratory assessment

Answer and Explanation

Correct Answer : A,B,C,D,F

A, B Monitoring the newborn's hemoglobin and hematocrit levels are important due to the risk of anemia.

C. Monitoring the newborn's heart rate post-birth is crucial for assessing cardiac function and detecting any abnormalities.

F. Positive pressure ventilation was administered to the newborn for 1 minute after birth, indicating a need for respiratory support. The nurse should closely assess the newborn's respiratory status.

D. There may be concerns about the newborn's blood glucose levels, especially if there were any periods of hypoxia or stress during labor and delivery.


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Related Questions

Correct Answer is C

Explanation


Allowing the baby to drain one breast at each feeding helps ensure effective milk removal, which can alleviate breast engorgement. Emptying the breast thoroughly promotes milk flow and prevents milk stasis, which contributes to engorgement.
A Cold compresses provide temporary relief from discomfort but does not address the underlying cause of engorgement.
B Drinking herbal tea, may have limited evidence supporting its efficacy in reducing engorgement. While hydration is important for breastfeeding, relying solely on herbal tea may not be as effective as other strategies.
D Feeding the baby every 2 hours, is important for maintaining milk supply and preventing engorgement. However, it's essential to ensure the breast is fully drained at each feeding, regardless of the time interval between feedings.

Correct Answer is A

Explanation


A Panting helps the client manage the urge to push and prevents premature pushing, which can cause cervical swelling or injury. This technique helps delay pushing until full dilation is achieved, ensuring a safer delivery process.
B. Helping the client into a comfortable position can facilitate labor progress. However, it may not be the most urgent action given the potential imminent delivery.

C. Voiding is a common suggestion during labor, but if the client feels the urge to push, it may be an indication that the baby is descending and delivery is imminent.
D. The client's urge to push indicates that the baby is descending, and birth is imminent. It would not be safe to have the client walk to the bathroom at this stage, as she may deliver the baby during the process, increasing the risk of an unattended birth.

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