A nurse is teaching a parent about normal infant growth and development. Which statement by the parent indicates they can apply developmental principles correctly to their own child?

A. Grunting is an expiratory sound produced when a newborn partially closes the glottis during exhalation. This helps maintain positive airway pressure, keeps alveoli open, and improves oxygenation. Persistent grunting indicates the newborn is working hard to breathe and is a classic early sign of respiratory distress.

B. Increased appetite is not a symptom of respiratory distress. In fact, newborns experiencing distress often have difficulty feeding or show poor coordination of sucking and swallowing because breathing requires increased effort. Feeding difficulties, rather than increased appetite, may accompany respiratory compromise.

C. Stridor is a high-pitched sound heard during inspiration, typically caused by upper airway obstruction. It may result from conditions such as laryngomalacia, vocal cord paralysis, or airway edema. Stridor is a red flag for respiratory compromise and requires prompt assessment and monitoring.

D. Retractions occur when a newborn uses accessory muscles to breathe, pulling the skin inward around the sternum, ribs, or clavicles. This indicates increased work of breathing and reduced lung compliance. Retractions are a reliable physical sign of significant respiratory distress.

E. Nasal flaring occurs when the nostrils widen during inspiration to increase airflow. It is one of the earliest visible signs of respiratory distress and signals that the newborn is compensating for hypoxia or increased airway resistance.

A. The client shows signs of magnesium sulfate toxicity: oliguria (urine output <30 mL/hr) and absent deep-tendon reflexes. These are potentially life-threatening signs that require immediate intervention, including preparing for emergent delivery if maternal or fetal status is unstable. Stopping the magnesium infusion and preparing for emergency interventions is critical.

B. Administering Vitamin K is not indicated in this scenario. Vitamin K is used to treat or prevent coagulopathy, such as in newborns or clients on certain anticoagulants, but it does not counteract magnesium toxicity.

C. Increasing the magnesium sulfate infusion would worsen toxicity. The correct action is to stop the infusion immediately and prepare to administer calcium gluconate as an antidote if prescribed.

D. Assessing maternal glucose levels is unrelated to the immediate concern of magnesium toxicity. While glucose monitoring may be part of overall prenatal care, it is not a priority in this emergent situation.

E. Placing the client in Trendelenburg position is not indicated. Positioning does not treat magnesium toxicity and could worsen respiratory compromise in a client with severe preeclampsia. The priority is stopping magnesium, assessing maternal and fetal status, and preparing for emergency delivery if necessary.