The nurse is assessing a child with acute epiglottitis.
Examining the child’s throat by using a tongue depressor might precipitate which symptom or condition?

Vernix caseosa is a cheese-like, whitish substance that fuses with the epidermis and serves as a protective coating for the newborn.

Some possible explanations for the other choices are:

• Choice B. Surfactant is a protein that lines the alveoli of the infant’s lungs and helps prevent them from collapsing.
• Choice C. Caput succedaneum is a swelling of the tissue over the presenting part of the fetal head caused by pressure during delivery.
• Choice D. Acrocyanosis is a bluish discoloration of the hands and feet due to reduced peripheral circulation.

Normal ranges for vernix caseosa are not applicable as it varies depending on the gestational age and skin maturity of the newborn. However, it is usually more abundant in preterm infants than in term or post-term infants.

This is because a patent ductus arteriosus is a congenital heart defect that involves a defect in which the fetal shunt between the aorta and the pulmonary artery fails to close. This causes a continuous machinery-like murmur that can be heard on auscultation.

Choice A is wrong because pulmonary stenosis is a narrowing of the pulmonary valve or artery that obstructs blood flow to the lungs. It causes a systolic ejection murmur that is best heard at the upper left sternal border.

Choice C is wrong because the ventricular septal defect is a hole in the wall between the ventricles that allows blood to flow from the left to the right side of the heart. It causes a loud, harsh holosystolic murmur that is best heard at the left lower sternal border.

Choice D is wrong because coarctation of the aorta is a narrowing of the aorta that reduces blood flow to the lower body. It causes a systolic murmur that radiates to the back and weak or absent femoral pulses.