A nurse is assessing a preterm infant who has necrotizing enterocolitis (NEC).

Which of the following findings should alert the nurse to a possible bowel perforation?

All of these findings can indicate a possible bowel perforation in a preterm infant with necrotizing enterocolitis (NEC).NEC is a serious condition that causes inflammation and necrosis of the intestinal tissue, and can lead to a hole (perforation) in the bowel wall.Bacteria can leak through this hole and cause infection and sepsis.NEC usually develops within two to six weeks after birth, and mostly affects premature babies.

Choice A is wrong because bloody stools are not specific for bowel perforation.They can also be seen in mild cases of NEC or other causes of gastrointestinal bleeding.

Choice B is wrong because abdominal distension is a common sign of NEC, but not necessarily of bowel perforation.It can be caused by gas accumulation, fluid retention, or inflammation of the bowel wall.

Choice C is wrong because bilious vomitus is also a non-specific sign of NEC or other causes of bowel obstruction.It can indicate a problem with the passage of food or bile through the intestines.

This is the recommended method for measuring the head circumference of a preterm infant.

It ensures accuracy by capturing the largest dimension of the head, which reflects the growth of the brain.

Choice B is wrong because it does not measure the widest part of the head, which may be above or below the occiput.

Choice C is wrong because it does not measure the widest part of the head, which may be above or below the ears.

Choice D is wrong because it does not measure the widest part of the head, which may be above or below the chin.

The normal range for head circumference at birth for preterm infants born between 32 and 42 weeks gestation is about 25 to 36 cm.Head circumference should be measured and plotted regularly until two years of age for preterm infants.