A newborn is delivered by vaginal birth at 40 weeks of gestation.
Which of the following findings should the nurse report to the provider?

Choice A rationale

While hearing loss can occur in some individuals with spina bifida due to associated anomalies or complications like meningitis, it is not as universally expected as other neurological impairments. The primary impact of hydrocephalus and neurological damage often manifests in areas directly related to brain development and function, making hearing loss a less common direct consequence.

Choice B rationale

Neurological damage associated with hydrocephalus and spina bifida frequently affects brain regions responsible for speech production and language processing. This can lead to various speech problems, including dysarthria or apraxia of speech, due to impaired motor control or cognitive deficits impacting linguistic expression and comprehension.

Choice C rationale

Frequent seizures are a potential complication of hydrocephalus and neurological damage due to abnormal electrical activity in the brain caused by structural anomalies or increased intracranial pressure. However, while possible, they are not as universally present in all cases as other common motor and cognitive impairments, making them a less frequent expectation.

Choice D rationale

Spina bifida often involves malformations of the spinal cord, directly impacting nerve function to the lower extremities. Hydrocephalus, by causing increased intracranial pressure and brain damage, can further impair motor control pathways. This combination frequently leads to motor deficits, resulting in varying degrees of difficulty walking or complete paralysis.

Choice E rationale

Hydrocephalus, especially when associated with neurological damage, can significantly impair cognitive development due to increased intracranial pressure and damage to brain tissue. This can manifest as delays in various cognitive domains, including learning, memory, problem-solving, and executive functions, impacting overall intellectual functioning.

Choice A rationale

Detergent pods are highly concentrated and can cause severe chemical burns to the esophagus and respiratory tract if ingested. Their bright colors and soft, squeezable nature can attract young children, making them a significant aspiration and poisoning risk due to their caustic properties. Normal esophageal tissue is delicate and easily damaged by corrosives.

Choice B rationale

Television remote controls, while a common household item, are typically too large and irregularly shaped to be easily aspirated into a toddler's airway. The primary concern with remote controls is choking on small, removable parts like batteries, not aspiration of the entire object into the trachea. Normal airway diameter in toddlers is small.

Choice C rationale

A tennis ball, due to its size and spherical shape, can perfectly occlude a toddler's airway, leading to complete obstruction and potential asphyxiation. Its smooth surface makes it difficult to dislodge once aspirated, posing a significant and immediate life-threatening choking hazard for young children. Normal tracheal lumen can be fully occluded by objects of similar diameter.

Choice D rationale

Hairbrushes are generally too large and awkwardly shaped to be aspirated by a toddler. While bristles or small decorative elements could potentially break off and be ingested, the primary concern with a hairbrush itself is not airway obstruction through aspiration of the entire object. Normal pharyngeal reflexes would typically prevent aspiration of such large objects. .