A nurse is caring for a neonate in the neonatal intensive care unit. Q122

Exhibits

Which findings in the client's electronic medical record (EMR) are risk factors for the client developing a complication? Select all that apply.

Abdominal circumference

Gestational age

Respiratory distress

UAC

Feeding method

5-minute Apgar score

Answer and Explanation

Correct Answer : A,B,C,D

A. Abdominal circumference: The increase in abdominal circumference by 1 cm (0.4 in) since the prior assessment is concerning and may indicate a complication such as abdominal distension, which could be a sign of necrotizing enterocolitis (NEC) or other gastrointestinal issues. NEC is a serious condition that is common in preterm infants, especially those receiving enteral feedings.

B. Gestational age: Being born at 34 weeks gestation is a significant risk factor. Prematurity increases the risk for complications like respiratory distress syndrome (RDS), infections, and feeding difficulties. Preterm infants are also at risk for problems with thermoregulation, which is why the neonate is on a radiant warmer.

C. Respiratory distress: The presence of substernal retractions, nasal flaring, and an elevated respiratory rate (70/min) indicates respiratory distress. Preterm neonates, especially those born at 34 weeks, are at risk for RDS due to insufficient surfactant production, which can lead to difficulty breathing and hypoxemia.

D. UAC: The umbilical arterial catheter (UAC) is commonly used for monitoring blood pressure and obtaining blood samples in neonates. However, it carries a risk for complications such as infection, thrombosis, and injury to blood vessels. This is an invasive device that could contribute to complications.

E. Feeding method (Continuous breast milk feedings via OG tube): Although feeding via an orogastric tube is a standard method for preterm neonates, it does not pose an immediate risk factor in this case. The method of feeding itself is not a complication risk. However, complications like feeding intolerance or aspiration can arise, which would require further monitoring.

G. 5-minute Apgar score: A 5-minute Apgar score of 7 is considered an acceptable score for a neonate. Although it indicates some initial difficulty, this score does not present a significant risk factor for complications by itself. A lower score would be more concerning, but a score of 7 typically suggests the neonate is transitioning well.

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Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}

Explanation

Answers: Hypoxemia; Oxygen saturation

Rationale:

Hypoxemia: The client’s oxygen saturation is 88% on room air, which is below the normal range (≥ 95%). Hypoxemia is the most immediate and life-threatening concern as it affects oxygen delivery to vital organs.

Oxygen saturation: Low oxygen saturation is a direct indicator of impaired gas exchange, commonly seen in conditions like pneumonia. The priority intervention is to improve oxygenation, as outlined in the provider's prescription to administer oxygen at 2 L/min via nasal cannula.

A. A 25-gauge needle B. An angiocatheter C. A butterfly needle D. A noncoring needle

Correct Answer is D

Explanation

A. A 25-gauge needle is too small and inappropriate for accessing a port.

B. An angiocatheter is used for peripheral IV access, not for implanted ports.

C. A butterfly needle is used for venipuncture, not for accessing ports.

D. A noncoring needle (e.g., Huber needle) is specifically designed to access an implanted venous port without causing damage to the septum, preserving the integrity of the port.

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A nurse is caring for a neonate in the neonatal intensive care unit. Q122 Exhibits Which findings in the client's electronic medical record (EMR) are risk factors for the client developing a complication? Select all that apply.

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A nurse is caring for a neonate in the neonatal intensive care unit. Q122

Exhibits

Which findings in the client's electronic medical record (EMR) are risk factors for the client developing a complication? Select all that apply.