A nurse is conducting health promotion education regarding contraindications to combination oral contraceptive use to a group of women. Which of the following conditions should the nurse include in the teaching?

The client is at risk for developing transient tachypnea of the newborn andhypoglycemia.

Rationale

Target 1: Transient Tachypnea of the Newborn (TTN)

• Transient tachypnea of the newborn (TTN) is a condition characterized by rapid breathing (tachypnea) in the first few hours after birth, typically caused by delayed clearance of fetal lung fluid. It often resolves within 24-48 hours.
• The newborn in the exhibit has a respiratory rate that is increasing: at 64 minutes, the rate is 68/min, and it increases to 76/min by 0700. This is significantly higher than the normal respiratory rate for a newborn (30-60/min) and is a key sign of tachypnea.
• Given the increased respiratory rate and the newborn’s age, transient tachypnea of the newborn is a likely concern. This condition is particularly common in late preterm and full-term infants who experience some delay in clearing fetal lung fluid after birth.

Target 2: Hypoglycemia

• Hypoglycemia in newborns can occur due to several factors, such as increased metabolic demand (which could be indicated by the tachycardia and respiratory rate), poor feeding, or stress during delivery.
• Tachycardia is one of the early signs of hypoglycemia in newborns, as the body responds to low blood sugar by increasing the heart rate to compensate for the lack of energy.
• The heart rate is consistently high, with values of 154/min and 156/min during the assessment. This tachycardia could be indicative of hypoglycemia, as the body works harder to compensate for low glucose levels.

Rationale for other conditions;

Bronchopulmonary Syndrome:

This condition refers to lung diseases like bronchopulmonary dysplasia (BPD), which typically occurs in premature infants who have had prolonged mechanical ventilation. There are no signs of this condition in the current assessment, such as the need for respiratory support or signs of chronic lung disease.

The newborn's respiratory rate and tachycardia are more consistent with transient tachypnea rather than a chronic condition like bronchopulmonary syndrome.

Tachycardia:

Tachycardia itself is a symptom, not a diagnosis. The infant's tachycardia could be a response to hypoxia or hypoglycemia, so the condition causing the tachycardia needs to be addressed (which is hypoglycemia and transient tachypnea of the newborn).

Hypercapnia (elevated PaCO2)

Malignant hyperthermia: Yes. Malignant hyperthermia (MH) is a life-threatening condition triggered by certain anesthetic agents, and it leads to hypermetabolism, muscle rigidity, and hypercapnia (elevated carbon dioxide levels.
Latex allergy: No. Hypercapnia is not associated with latex allergy.
Hypovolemic shock: Yes. In hypovolemic shock, hypercapnia can occur as a compensatory response due to tissue hypoxia and poor perfusion. However, it is less directly characteristic of hypovolemic shock than of malignant hyperthermia.
2. Wheezes
Malignant hyperthermia: No. Wheezing is not a typical feature of malignant hyperthermia. Instead, it is primarily characterized by muscle rigidity, hypercapnia, and tachycardia.
Latex allergy: Yes. A latex allergy can cause respiratory symptoms, including wheezing, shortness of breath, or bronchospasm. This can occur when an allergic reaction triggers an asthma-like response in the airways.
Hypovolemic shock: No. Wheezing is not characteristic of hypovolemic shock. Hypovolemic shock primarily involves signs of decreased blood volume and perfusion, such as tachycardia, hypotension, and altered mental status.
3. Urticaria (hives)

Malignant hyperthermia: No. Urticaria is not a feature of malignant hyperthermia. MH is characterized by hyperthermia, muscle rigidity, and tachycardia, not an allergic skin reaction.
Latex allergy: Yes. Urticaria (hives) is a common sign of a latex allergy. An allergic reaction to latex can lead to skin reactions, including hives, itching, or rash.

Hypovolemic shock: No. Urticaria is not a typical finding in hypovolemic shock. In hypovolemic shock, the primary concern is hypotension, tachycardia, cool, clammy skin, and poor perfusion, not skin reactions like hives.
4. Tachycardia

Malignant hyperthermia: Yes. Tachycardia is a prominent feature of malignant hyperthermia, often occurring alongside hyperthermia (high body temperature) and muscle rigidity. The elevated heart rate is a response to the increased metabolic demand and stress during MH.
Latex allergy: Yes. Tachycardia can be a response to an allergic reaction such as latex allergy. In more severe cases, anaphylaxis due to latex exposure can cause a rapid heart rate as part of the body's response to the allergic reaction.
Hypovolemic shock: Yes. Tachycardia is a compensatory mechanism in hypovolemic shock. As the body tries to compensate for fluid loss or reduced blood volume, the heart rate increases to maintain perfusion.
5. Muscle rigidity
Malignant hyperthermia: Yes. Muscle rigidity is a classic sign of malignant hyperthermia. It occurs as a result of abnormal muscle contraction, leading to increased metabolic activity, hyperthermia, and hypercapnia.
Latex allergy: No. Muscle rigidity is not a typical feature of latex allergy.
Hypovolemic shock: No. Muscle rigidity is not characteristic of hypovolemic shock, which is primarily marked by reduced blood volume, hypotension, and poor perfusion.