A nurse is providing teaching to a client who has a depressive disorder and a new prescription for amitriptyline. Which of the following statements by the client indicates an understanding of the teaching?

A. Hypoglycemia might be a concern if the baby had risk factors like maternal diabetes, but this information is not provided.
B. Tachycardia is not mentioned as a concern in the scenario, and the heart rate is within normal limits for a newborn
C. Bronchopulmonary Dysplasia (BPD): The newborn's respiratory rate is increasing over time, along with the presence of grunting and retractions. These are signs of respiratory distress. Bronchopulmonary dysplasia (BPD) is a chronic lung disease that primarily affects premature infants who require mechanical ventilation and oxygen therapy for an extended period. The symptoms align with the respiratory distress and could suggest a risk for BPD.
D. Transient Tachypnea of the Newborn (TTN): The newborn's respiratory rate is increasing over time, along with grunting and retractions. These signs are consistent with transient tachypnea of the newborn, which is a self-limiting condition characterized by rapid breathing shortly after birth. It is more common in infants born via cesarean delivery and may result from delayed clearance of lung fluid.

Choice A rationale:

Changing the inner cannula on a tracheostomy is within the legal scope of practice for registered nurses. Nurses are trained to perform tracheostomy care, including changing the inner cannula. This procedure is within the nursing scope of practice and does not require a physician's intervention.

Choice B rationale:

Inserting a tunneled central venous catheter (such as a Hickman line) is a specialized procedure that generally falls under the scope of practice for advanced practice nurses (such as nurse practitioners or clinical nurse specialists) or physicians. RNs typically do not have the required training or authority to perform this invasive procedure.

Choice C rationale:

Irrigation of an external ear canal is within the legal scope of practice for registered nurses. Ear irrigation is a common nursing procedure used to remove impacted cerumen (earwax) and foreign bodies from the ear canal. Nurses are trained to perform this procedure safely and effectively.

Choice D rationale:

Administering blood products, including platelet transfusions, is within the legal scope of practice for an RN. RNs are responsible for preparing, verifying, and administering blood products according to institutional policies and procedures. This includes monitoring the patient during and after the transfusion for any adverse reactions.