A nurse is examining the medical record of a client who gave birth vaginally two days ago and is experiencing constipation.
Which of the following conditions should the nurse recognize as a contraindication for the use of a suppository?

Choice A rationale: A positive Coombs test indicates that the newborn has antibodies against his own red blood cells, which can lead to hemolytic disease of the newborn. This condition can cause severe anemia and jaundice, which can lead to complications such as kernicterus if not treated promptly.

Choice B rationale: The newborn’s glucose level is within the normal range (40 to 60 mg/dL), so this finding does not require immediate follow-up.

Choice C rationale: The yellow color of the sclera indicates jaundice, which can be a sign of hyperbilirubinemia. This condition can lead to complications such as kernicterus if bilirubin levels become too high.

Choice D rationale: The absence of meconium stool in a 36-hour-old newborn is unusual, as most newborns pass meconium within the first 24 to 48 hours after birth. This could indicate a problem such as meconium ileus or Hirschsprung disease, which would require further evaluation.

Choice E rationale: The head assessment finding of caput succedaneum is a common and typically harmless condition in newborns caused by pressure on the head during delivery. It does not require immediate follow-up.

Choice F rationale: The newborn’s heart rate is slightly elevated (normal range for a newborn is 120-160 beats per minute). This could be a response to factors such as fever, pain, or distress, and should be reported to the provider.

Choice G rationale: The newborn’s respiratory rate is also elevated (normal range for a newborn is 30-60 breaths per minute). This could be a sign of respiratory distress and should be reported to the provider.

Choice H rationale: Dry mucous membranes can be a sign of dehydration, which can occur if the newborn is not feeding well or is losing too much fluid, for example, through excessive sweating due to fever. This should be reported to the provider.

Choice A rationale
A client who has gestational diabetes mellitus does not have a contraindication for a contraction stress test.
Choice B rationale
A client who had a previous stillbirth does not have a contraindication for a contraction stress test.
Choice C rationale

A client who had a nonreactive nonstress test does not have a contraindication for a contraction stress test. In fact, a nonreactive nonstress test is often an indication for further testing, such as a contraction stress test.
Choice D rationale
A client who has a previous classical incision is at risk for uterine rupture, which is a contraindication for a contraction stress test.