Name 3 nursing interventions that promote stabilization of the newborn immediately after birth:

A) "Babies usually breathe in and out through their noses so they can feed without choking.":
Newborns are obligate nasal breathers, meaning they primarily breathe through their noses rather than their mouths, which helps coordinate breathing with feeding. This nasal breathing mechanism helps prevent aspiration and ensures that babies can feed while still breathing. It is perfectly normal for a baby to primarily use their nose for breathing, especially in the early days of life, and no cause for concern should be raised about small nasal openings unless the baby is showing signs of respiratory distress.

B) "You are right. I will report the baby's small nasal openings to the pediatrician right away.":
A small nasal opening is common in newborns and is not usually a cause for alarm unless it interferes with breathing, feeding, or shows signs of a more significant anatomical issue. There is no immediate need to report it unless the baby is having trouble breathing or feeding. The nurse should offer reassurance instead.

C) "Everything about babies is small. It truly is amazing how everything works so well.":
While this response may seem comforting, it is not very informative. It dismisses the mother’s concern rather than providing a clear and educational explanation. Reassuring the mother with factual information about why babies breathe through their noses and how this works effectively for them would be more helpful.

D) "The baby does rarely open his mouth but you can see that he isn't in any distress.":
This response minimizes the importance of the mother’s question and doesn’t fully address her concern. While it’s true that babies rarely open their mouths to breathe, the explanation needs to focus on the physiological reasoning behind it. The nurse should also reassure the mother that nasal breathing is normal in newborns and not typically a concern unless signs of distress are present.

A) Massage the fundus:
The first priority in this situation is to massage the fundus to help control potential postpartum hemorrhage caused by uterine atony. A boggy fundus (soft and not firm) suggests that the uterus is not contracting effectively, which can lead to excessive bleeding. Massaging the fundus stimulates uterine contractions, which can help reduce bleeding by compressing the blood vessels that were supplying the placenta. The nurse should begin with this intervention immediately to address the most likely cause of the bleeding.

B) Take the patient's blood pressure:
While vital signs such as blood pressure are important for assessing shock or ongoing hemorrhage, massaging the fundus takes priority in this scenario to directly address the cause of the bleeding. Taking the blood pressure is not the most immediate intervention for this specific situation because the primary issue here is uterine atony, not hemodynamic instability (although it will need to be assessed shortly thereafter).

C) Start an IV:
Starting an IV may be important if there is significant blood loss, but it is not the first priority in this scenario. The nurse should first focus on stabilizing the uterus by massaging the fundus. IV access will become more critical if the bleeding is not controlled after the fundus is massaged and other interventions are required.

D) Have the patient empty her bladder:
While a full bladder can sometimes displace the uterus and cause it to be less effective at contracting, this is a secondary concern. The first priority is to address the uterine atony by massaging the fundus. Once the fundus is firm and bleeding is under control, the nurse can then consider having the patient empty her bladder to ensure it isn't interfering with the uterus' ability to contract.