A nurse is caring for a newborn 1 hour following birth in the emergency unit.

Exhibits

Select the 5 findings the nurse should report to the provider.

Choice A rationale

Umbilical cord compression typically results in variable decelerations in the fetal heart rate, not moderate variability or regular accelerations. It can lead to changes in fetal heart rate patterns, but not regular mild contractions.

Choice B rationale

Dysfunctional labor refers to an abnormal labor pattern, including irregular uterine contractions. The described symptoms fit this condition, as they can cause mild pain and be managed by ambulation, showers, and rest.

Choice C rationale

Chorioamnionitis is an infection of the fetal membranes and amniotic fluid, leading to fever, uterine tenderness, and foul-smelling amniotic fluid, not mild contractions and moderate variability in FHR.

Choice D rationale

Iron deficiency anemia in pregnancy can cause fatigue, pallor, and shortness of breath but does not affect uterine contractions or fetal heart rate.

Given the provided information, here is the completion of the sentence using the options:

The newborn most likely has Brachial plexus injury as evidenced by Asymmetrical Moro reflex.

This conclusion is drawn from the observation that the newborn does not move the left arm during the Moro reflex, which is indicative of a possible brachial plexus injury. This type of injury can occur during childbirth, especially in cases involving shoulder dystocia and vacuum-assisted delivery.

The reason for diagnosing the newborn with a brachial plexus injury is based on the observation that the newborn does not move the left arm during the Moro reflex. The Moro reflex, also known as the startle reflex, is a normal response in newborns where they spread out their arms and then bring them back towards the body when they feel a sudden loss of support. In this case, the newborn is only moving one arm, which suggests that there might be an injury to the nerves that control movement in the affected arm.

Brachial plexus injuries often occur during difficult births, such as those involving shoulder dystocia and vacuum-assisted deliveries. These types of injuries can lead to weakness or paralysis of the affected arm. Given the details of the newborn's birth and the absence of movement in the left arm during the Moro reflex, a brachial plexus injury is the most likely condition.