A nurse is assisting in the care of a newborn who is 72 hr old and is receiving treatment for neonatal abstinence syndrome.
Which of the following data collection findings should the nurse identify as requiring immediate follow- up? (Select all that apply.).
Blood pressure.
Gastrointestinal disturbances.
Skin color.
NAS score.
Temperature.
Oxygen saturation.
Central nervous system disturbances.
Correct Answer : B,D,F,H
Choice A reason
Blood pressure is not a priority finding for a newborn with neonatal abstinence syndrome (NAS). Blood pressure is usually normal or slightly elevated in NAS, and it is not a reliable indicator of the severity of withdrawal symptoms.
Choice B reason
Gastrointestinal disturbances are a common and serious finding for a newborn with NAS. Vomiting and diarrhea can lead to dehydration, electrolyte imbalance, and poor weight gain. Projectile vomiting can also increase the risk of aspiration. This finding requires immediate follow-up and intervention.
Choice C reason
Skin color is not a priority finding for a newborn with NAS. Acrocyanosis (bluish color of the hands and feet) is a normal finding in newborns and does not indicate hypoxia or poor circulation. It usually resolves within the first few days of life.
Choice D reason
NAS score is not a priority finding for a newborn with NAS. NAS score is a tool used to assess the severity of withdrawal symptoms and the need for pharmacological treatment. It is based on a set of clinical signs and symptoms that are scored at regular intervals. However, it is not a substitute for clinical judgment and individualized care. The NAS score alone does not determine the urgency of follow-up.
Choice E reason
Temperature is not a priority finding for a newborn with NAS. Temperature may be slightly elevated or normal in NAS, and it is not a specific sign of infection or withdrawal. Temperature regulation is important for newborns, but it is not an immediate concern in this case.
Choice F reason
Oxygen saturation is a priority finding for a newborn with NAS. Tachypnea (rapid breathing) and retractions (inward movement of the chest wall) are signs of respiratory distress, which can compromise oxygen delivery to the tissues and organs. Hypoxia (low oxygen level) can cause brain damage, organ failure, and death if not corrected promptly. This finding requires immediate follow-up and intervention.
Choice G reason
Central nervous system disturbances are a priority finding for a newborn with NAS. Increased muscle tone, tremors, high-pitched cry, and seizures are signs of neurological dysfunction,which can indicate brain injury, bleeding, or infection. Seizures can also worsen hypoxia and metabolic acidosis. This finding requires immediate follow-up and intervention.
Choice H reason
Respiratory rate is not a priority finding for a newborn with NAS. Respiratory rate may be increased or normal in NAS, and it is not a specific sign of respiratory distress or infection. Respiratory rate should be monitored along with other vital signs.
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Related Questions
Correct Answer is ["C","D","F"]
Explanation
Choice A:
Temperature is not a finding that needs to be reported to the provider unless it is abnormally high or low. The normal temperature range for a newborn is 36.5°C to 37.5°C (97.7°F to 99.5°F).
Choice B:
Respiratory findings are not a finding that needs to be reported to the provider unless they indicate respiratory distress or infection. The normal respiratory rate for a newborn is 30 to 60 breaths per minute.
Choice C:
Serum glucose is a finding that needs to be reported to the provider, as it is higher than the normal range for a newborn. The normal serum glucose level for a newborn is usually just under 2 mmol/L (or 25 mg/dL) at birth, and it will rise to over 3 mmol/L (or 60 to 100 mg/dL) within two to three days. A serum glucose level of 130 mg/dL indicates hyperglycemia, which can have various causes and complications.
Choice D:
Hematocrit is a finding that needs to be reported to the provider, as it is lower than the normal range for a newborn. The normal hematocrit level for a newborn is 44% to 64%. A hematocrit level of 35% indicates anemia, which can have various causes and complications.
Choice E:
White blood cell count is not a finding that needs to be reported to the provider, as it is within the normal range for a newborn. The normal white blood cell count for a newborn is 9,000 to 30,000/mm³.
Choice F:
Hemoglobin is a finding that needs to be reported to the provider, as it is lower than the normal range for a newborn. The normal hemoglobin level for a newborn is 14 to 24 g/dL. A hemoglobin level of 9 g/dL indicates anemia, which can have various causes and complications.
Correct Answer is ["A","C","D"]
Explanation
Choice A reason:
Swimming is one of the best exercises for pregnant women because it provides moderate aerobic conditioning with minimal stress on your joints. It also supports your increased weight and helps you stay cool and comfortable.
Choice B reason:
Scuba diving is not a safe exercise for pregnant women because it poses a high risk of injury to the baby. The baby has no protection against decompression sickness and gas embolism, which are caused by changes in pressure underwater.
Choice C reason:
Walking is a great exercise for beginners and can be done throughout pregnancy. It improves your cardiovascular fitness, strengthens your muscles and bones, and helps prevent excessive weight gain and gestational diabetes.
Choice D reason:
Yoga can be beneficial for pregnant women as it can improve flexibility, balance, posture, breathing and relaxation. It can also reduce stress, anxiety and back pain. However, some yoga poses may not be suitable for pregnancy, so it is advisable to join a prenatal yoga class or consult a qualified instructor.
Choice E reason:
Snow skiing is not recommended for pregnant women because it involves a high risk of falling and affecting your balance. Falls can cause damage to your baby or placenta, especially in the second and third trimesters.
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