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A nurse is caring for a newborn immediately following birth.

Exhibits

A nurse is assessing the newborn 24 hours later. Based on the exhibits provided, which findings indicate that the newborn’s condition is improving, worsening, or unrelated to the diagnosis?

A.

WBC count 18,000/mm³

B.

Hgb 18 g/dL

C.

Hct 55%

D.

Blood glucose 50 mg/dL

E.

Axillary temperature 36.8°C

F.

Heart rate 130/min

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"C"},"C":{"answers":"C"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"A"}}

•    WBC count 18,000/mm³: This is within the noímal íange foí a newboín (9,000 to 30,000/mm³). The incíease fíom the initial count could be a íesponse to biíth stíess oí infection, but it’s still within the noímal íange, indicating impíovement.
•    Hgb 18 g/dL and Hct 55%: These values aíe slightly decíeased but still within the noímal íange foí a newboín (Hgb: 15 to 24 g/dL, Hct: 44 to 70%). These changes aíe likely uníelated to the newboín’s condition.
•    Blood glucose 50 mg/dL: This is an impíovement as it’s within the noímal íange foí a newboín (40 to 60 mg/dL).
•    Axillaíy tempeíatuíe 36.8°C: This is closeí to the noímal íange (36.5 to 37.5°C) compaíed to the initial tempeíatuíe, indicating impíovement.
•    Heart rate 130/min: This is within the noímal íange foí a newborn (120 to 160/min), indicating impíovement.
 


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Related Questions

Correct Answer is []

Explanation

  • Endometritis: The client’s symptoms such as general malaise, chills, decreased appetite, elevated white blood cell count, fever, a boggy and tender uterus, and foul-smelling lochia suggest that she is most likely experiencing endometritis, an inflammation of the inner lining of the uterus, typically due to infection.
  • Actions to take: The nurse should administer the prescribed antibiotics to treat the infection. The nurse should also educate the client on proper perineal hygiene to prevent further infection.
  • Parameters to monitor: The nurse should monitor the client’s temperature to assess for fever, which can be a sign of infection. The nurse should also monitor the amount and odor of the client’s lochia, as changes can indicate worsening infection.

Correct Answer is B

Explanation

Choice A rationale: Ensuring the call button is within the client's reach is important for general patient safety and communication, but it is not the highest priority for seizure precautions.

Choice B rationale: Placing suction equipment at the client's bedside is crucial for managing airway secretions during a seizure. Having suction equipment readily available ensures that the client's airway can be cleared promptly, which is vital for maintaining breathing and preventing aspiration.

Choice C rationale: Dimming the lights in the client's room can help reduce stimuli that may trigger seizures, but it is not the most urgent action to take when implementing seizure precautions.

Choice D rationale: Padding the side rails of the client's bed is important to prevent injury during a seizure, but ensuring that suction equipment is available takes priority to maintain airway patency and prevent complications.

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