A mother of a preterm baby is performing skin-to-skin contact in the neonatal nursery. Which of the following responses would the nurse evaluate as a positive neonatal outcome?

Choice A rationale

A respiratory rate of 75 breaths per minute exceeds the normal range of 30 to 60 breaths per minute in neonates. Tachypnea indicates distress, which necessitates immediate intervention to prevent complications.

Choice B rationale

A temperature of 96.5°F is below the normal neonatal range of 97.7°F to 99.5°F, suggesting hypothermia. This can impair enzyme activity, oxygen delivery, and thermoregulatory functions, requiring prompt warming measures.

Choice C rationale

Sucking or licking of the nipples reflects a positive response in kangaroo care, indicative of improved thermoregulation and bonding. This natural behavior also suggests a healthy neonate capable of initiating feeding.

Choice D rationale

Nasal flaring is a sign of respiratory distress, typically indicating increased effort to meet oxygen demands. This would not be considered a positive outcome and requires immediate evaluation and intervention.

Choice A rationale

Engorgement is caused by milk overproduction or improper drainage rather than cracked nipples. While related to breastfeeding issues, it is not directly linked to cracked or bleeding nipples.

Choice B rationale

Mastitis is an infection of breast tissue that occurs due to milk stasis or blocked ducts. Cracked nipples increase infection risks, but mastitis is secondary to these infections.

Choice C rationale

Decrease in milk production is influenced by hormonal imbalances or poor latch rather than by cracked or bleeding nipples. It does not directly result from nipple trauma.

Choice D rationale

Cracked nipples create an entry point for bacteria, significantly increasing infection risks such as cellulitis or abscess formation. Proper hygiene and wound care are essential to reduce complications.