The nurse assesses a 1-day-old newborn. Which finding indicates that the newborn's oxygenation needs are not being met?
Select one:

Choice A Reason: Preterm infant. This is an incorrect answer that confuses TTN with another respiratory condition called respiratory distress syndrome (RDS). RDS is a serious condition where the newborn's lungs are immature and lack sufficient surfactant, which is a substance that reduces surface tension and prevents alveolar collapse. RDS can cause respiratory distress, hypoxia, acidosis, and organ failure. It is more common in preterm infants, especially those born before 37 weeks' gestation.

Choice B Reason: Female infant. This is an incorrect answer that has no evidence or rationale to support it. TTN does not have a gender preference or difference in incidence or severity.

Choice C Reason: GBS status of mother. This is an incorrect answer that relates to another respiratory complication called early-onset neonatal sepsis (EONS). EONS is a bacterial infection that occurs within 72 hours after birth, which can affect multiple organs and systems in the newborn. EONS can be caused by group B streptococcus (GBS), which is a common bacterium that colonizes in some women's vagina or rectum. GBS can be transmited to the newborn during delivery and cause pneumonia, meningitis, or septic shock.

Choice D Reason: Cesarean section. This is because cesarean section is a risk factor for TTN, which is a mild respiratory problem that results from delayed clearance of fetal lung fluid after birth. TTN causes rapid breathing, nasal flaring, grunting, and mild cyanosis. It usually resolves within 24 to 48 hours after birth. Cesarean section can increase the risk of TTN because it bypasses the normal process of labor, which helps squeeze out some of the fluid from the fetal lungs.

Choice A Reason: Assisting with the delivery of the placenta and ensuring that the fundus is contracted afterward. This is an appropriate action for the nurse to perform during the third stage of labor, as it helps complete the process of labor and prevent complications.

Choice B Reason: Palpating the woman's fundus for position and firmness. This is an action that is done after the delivery of the placenta, not during. It is important to monitor the fundal height, location, and consistency to assess uterine involution and bleeding.

Choice C Reason: Encouraging the woman to push with her contractions. This is an action that is done during the second stage of labor, not the third. The second stage of labor is the period from full cervical dilation to the birth of the baby. The nurse's role is to support and coach the woman to push effectively with her contractions.

Choice D Reason: Alleviating perineal discomfort with the application of ice packs. This is an action that is done after the delivery of the placenta, not during. It is a comfort measure that can reduce swelling, pain, and inflammation in the perineal area.