A nurse is caring for a newborn who is 72 hr old.

Vital signs

0900:

• Heart rate 160/min
• Respiratory rate 80/min
• Temperature 38.1° C (100.6° F)
• Oxygen saturation 97%

1000:

• Heart rate 167/min
• Respiratory rate 72/min
• Temperature 38°C (100.4°F)
• Oxygen saturation 97%

Medical History

0900:

A term newborn 37 weeks of gestation is admitted to the newborn nursery following a precipitous vaginal birth. Birthing parent has a history of heroin use during pregnancy and prenatal care beginning at 34 weeks of gestation. Birthing parent and newborn drug screens positive for heroin.

The nurse is planning to contact the provider regarding the newborn's status. Which of the following prescriptions should the nurse anticipate? Select the 3 interventions the nurse should anticipate.

Rationale:

A. Headache can be a common side effect of magnesium sulfate but is usually not concerning unless severe or persistent.

B. A fetal heart rate of 158/min is within the normal range for a fetus and is not typically associated with magnesium sulfate administration.

C. Respirations of 16/min are within the normal range and are not typically associated with magnesium sulfate administration.

D. A urinary output of 40 mL in 2 hours is significantly reduced and may indicate magnesium toxicity or impaired renal function, which should be reported to the provider for further

evaluation and management.

A. Providing information on child development to the caregiver about when a child can use an inhaler without supervision is crucial. It ensures that the caregiver has realistic

expectations and understands the importance of supervision until the child is developmentally ready.

B. While providing a pamphlet is helpful, it does not ensure that the child will be able to use the inhaler correctly without supervision.

C. Providing the caregiver with resources in the community for support can help alleviate stress and provide additional assistance, which can indirectly benefit the child's management of their asthm

A.

D. Referring the caregiver to an asthma educator can provide them with specialized knowledge and skills to better support the child's asthma management.

E. Asking the caregiver about their worries is empathetic but does not directly contribute to the child's ability to use the inhaler safely.

F. Teaching the child how to use the inhaler is an essential step in ensuring they can manage their asthma effectively and safely, especially as they grow older and gain more

independence.