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.
Hemoglobin
Hematocrit
Heart rate
Serum glucose
White blood cells
Respiratory assessment
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A Physiological jaundice is a common condition in newborns characterized by yellow discoloration of the skin and sclerae due to elevated levels of bilirubin in the blood. It typically appears within the first few days of life, often peaking around 2 to 4 days after birth. B Jaundice within 24 hours of birth is pathological and may indicate the presence of maternal/newborn blood group incompatibility.
C Maternal cocaine abuse and D absence of vitamin K are not directly associated with the development of jaundice in newborns.
Correct Answer is D
Explanation
If the mother is Rh-negative and the fetus is Rh-positive, the mother may produce anti-Rh antibodies, which can cross the placenta and cause hemolysis of the fetal red blood cells, leading to hyperbilirubinemia in the newborn.
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