A nurse is examining a newborn’s head and observes a diffuse edema over the scalp that crosses the suture lines.
The nurse recognizes this as a caput succedaneum.
What should the nurse do next?
Notify the physician immediately.
Document the finding and monitor for resolution.
Apply ice packs to reduce swelling.
Perform a neurological assessment.
The Correct Answer is B
Document the finding and monitor for resolution. Caput succedaneum is a harmless condition that causes swelling of the scalp due to pressure during delivery. It does not indicate any damage to the brain or the skull and usually resolves on its own within a few days.
Therefore, the nurse should document the finding and monitor for resolution.
Choice A is wrong because there is no need to notify the physician immediately. Caput succedaneum is not a medical emergency and does not require any intervention.
Choice C is wrong because applying ice packs to reduce swelling is not recommended. Ice packs can cause skin irritation, infection, or hypothermia in newborns.
Choice D is wrong because performing a neurological assessment is not necessary. Caput succedaneum does not affect the brain or the nervous system and does not cause any neurological symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The mother should avoid touching the fontanelles because they are very sensitive.
This statement indicates a need for further teaching because it is a misconception.The fontanelles are not sensitive and can be gently touched and washed without causing any harm to the infant.
Choice A is correct because the fontanelles should be gently washed and dried when bathing the baby to prevent infection.
Choice B is correct because signs of bulging or sunken fontanelles can indicate increased or decreased intracranial pressure, which requires medical attention.
Choice D is correct because the fontanelles usually close by 18 months of age, but some variation is normal.
Correct Answer is A
Explanation
Birth trauma.A cephalohematoma is a collection of blood under the scalp of a newborn that forms a bulge.It is caused by rupture of blood vessels crossing the periosteum due to pressure or trauma on the fetal head during birth.This pressure or trauma may result from a prolonged second stage of labor, instrumental delivery, particularly forceps delivery, ventouse application, or the baby’s head squeezing through the birth canal.
Choice B is wrong because infection is not a cause of cephalohematoma, but a potential complication that may occur in some cases.
Choice C is wrong because dehydration is not a cause of cephalohematoma, but a possible consequence of anemia, which may result from blood loss.
Choice D is wrong because hemorrhage is not a cause of cephalohematoma, but a synonym for bleeding, which is what happens when the blood vessels rupture.
Normal ranges for newborn cephalohematoma are not applicable, as it is an abnormal condition that varies in size and severity.However, most cephalohematomas resolve on their own without intervention within weeks or months.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.