A nurse is reviewing the assessment findings of a paediatric patient. Which finding will the nurse prioritize?

Choice A reason: While a child with asthma exacerbation needs monitoring, they used their rescue inhaler 16 hours ago and are currently stable. This patient is not the highest priority.

Choice B reason: A 3-year-old who continues to cough with an oxygen saturation of 91% is at risk of respiratory distress or obstruction due to the swallowed sunflower seeds. The low oxygen saturation indicates impaired gas exchange and requires immediate attention.

Choice C reason: A 15-year-old recovering from a laparoscopic appendectomy who is stable and preparing for discharge can wait to be seen after more urgent cases.

Choice D reason: An 18-month-old admitted for dehydration who is producing a normal number of wet diapers and eating well indicates improved hydration status and can be seen after addressing the more critical situation.

Choice A reason: Lack of prenatal care is a significant risk factor for neural tube defects, including myelomeningocele, because it often means the mother did not receive important prenatal vitamins like folic acid, which are crucial for proper neural tube development. Prenatal care provides essential screenings and supplements to support a healthy pregnancy and fatal development. Without it, the risk of congenital anomalies, such as myelomeningocele, increases significantly. Additionally, prenatal care helps in identifying and managing other risk factors and conditions that may affect both maternal and fatal health.

Choice B reason: While active Labor with wounds requires medical attention and may pose risks to both mother and baby, it does not directly correlate with an increased risk of myelomeningocele. Myelomeningocele is a congenital condition related to neural tube development early in pregnancy. The presence of wounds in active Labor may indicate complications such as trauma or infection, but these are not associated with neural tube defects.

Choice C reason: Premature rupture of membranes (PROM) is a condition where the amniotic sac ruptures before Labor begins, potentially leading to preterm birth and infections. While PROM is a concern and requires appropriate medical intervention, it is not directly linked to the development of myelomeningocele. The causes of PROM and neural tube defects like myelomeningocele are different, with PROM often related to issues with the amniotic sac or maternal infections.

Choice D reason: Precipitous Labor, which is an unusually rapid Labor and delivery, can pose risks such as trauma to the birth canal and complications for the newborn, but it is not associated with an increased risk of myelomeningocele. The speed of Labor and delivery is not a contributing factor to neural tube defects. Instead, precipitous Labor is more concerning for potential delivery complications and the need for rapid medical response.