A nurse is inspecting a newborn’s oral cavity.

The nurse should identify that which of the following findings is a normal variation?

Epstein’s pearls on the gums or palate are small, white cysts that are common and harmless in newborns.

They usually disappear within a few weeks without treatment.

Choice B is wrong because thrush on the tongue or gums is a fungal infection that causes white patches and soreness in the oral cavity.

It is not a normal variation and may require antifungal medication.

Choice C is wrong because petechiae on the hard palate are tiny red spots that indicate bleeding under the skin.

They are not a normal variation and may be caused by trauma, infection, or clotting disorders.

Choice D is wrong because yellowing of the hard palate is a sign of jaundice, which is a condition where the skin and mucous membranes turn yellow due to high levels of bilirubin in the blood.

It is not a normal variation and may indicate liver problems or hemolytic disease.

Normal ranges for oral cavity findings in newborns are:

• Gums: pink and moist, no inflammation or bleeding

• Teeth: none or natal teeth (present at birth), which may need to be removed if loose or interfering with feeding

• Tongue: pink and moist, no lesions or coating

The correct answer is choice A, D, and E.The nurse should instruct the mother to clean the newborn’s eyes with warm water and cotton balls from the inner to the outer canthus to prevent infection and remove any discharge.The nurse should also advise the mother to avoid using cotton-tipped applicators to clean the newborn’s ears because they can damage the eardrum or push cerumen deeper into the ear canal.Additionally, the nurse should tell the mother to report any signs of eye infection, such as redness, swelling, or discharge, to the provider as soon as possible.

Choice B is wrong because using a bulb syringe to suction any drainage from the newborn’s ears can cause trauma or infection