A client expresses concern that her 2-hour-old newborn is sleepy and difficult to awaken. The nurse explains that this behavior indicates:
normal progression of behavior.
probable hypoglycemia.
physiological abnormality.
inadequate oxygenation.
The Correct Answer is A
A. Newborns typically go through predictable behavioral states after birth. During the first period of reactivity, which lasts about 30–60 minutes after birth, the newborn is awake, alert, and active. This is followed by a period of sleep or decreased activity, which can last 2 to 4 hours. It is normal for the baby to be sleepy and difficult to awaken during this phase, especially around 2 hours of age.
B. Probable hypoglycemia could cause lethargy in a newborn, but it would typically be accompanied by other symptoms such as jitteriness, poor feeding, or abnormal vital signs. In a healthy 2-hour-old baby, sleepiness alone is not enough to suggest hypoglycemia.
C. Physiological abnormality is incorrect. There is no evidence of abnormality in a sleepy 2-hour-old newborn, as this is an expected part of the normal behavioral cycle after birth.
D. Inadequate oxygenation would likely present with signs such as cyanosis, abnormal respiratory rate, or poor perfusion, not just sleepiness.
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Related Questions
Correct Answer is D
Explanation
A. 25mg/hr is incorrect. The question asks for the volume in mL/hr, not the dose in milligrams per hour.
B. 25g/hr is incorrect. The ordered dose is 1g/hr, not 25g/hr.
C. 250mL/hr would provide a much higher dose than ordered, based on the concentration.
D. 25mL/hr is correct. This is the calculated volume to deliver the 1g/hr maintenance dose based on the supplied concentration. Volume= Ordered dose/ Concentration
Determine the concentration of the solution: The supplied concentration is 20g/500mL, which simplifies to 0.04g/mL (since 20g = 20,000mg and 500mL = 500mL).
Determine the ordered dose: The order is for a maintenance dose of 1g/hr.
Calculate the volume to be infused: 1/0.04= 25mL/hr
Correct Answer is B
Explanation
A. Short duration of labor is not typically associated with subinvolution. In fact, prolonged labor (not short) can be a risk factor due to increased uterine fatigue.
B. Use of anesthetics is correct. The use of certain anesthetics during labor, especially those that affect uterine tone (like general anesthesia or high doses of regional anesthesia), can contribute to uterine atony, which may lead to subinvolution—a condition where the uterus does not return to its normal size after childbirth.
C. Early ambulation actually promotes uterine involution and prevents complications like thrombophlebitis, making it a protective factor, not a contributing one.
D. Breastfeeding stimulates the release of oxytocin, which causes uterine contractions and promotes involution, making it a helpful factor in preventing subinvolution.
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