Part of the health assessment of a newborn includes observation of the neonate's breathing pattern. A full-term newborn's breathing pattern is predominantly:

Abdominal with synchronous chest movements.

Chest breathing with nasal flaring.

Diaphragmatic with chest retraction.

Deep with a regular rhythm.

Answer and Explanation

The Correct Answer is A

A) Abdominal with synchronous chest movements:
Newborns primarily exhibit abdominal breathing, meaning that the diaphragm does most of the work while the chest movements are less pronounced. This is normal for full-term neonates, and the chest and abdomen move in a synchronous manner as the baby breathes. This pattern is indicative of an immature respiratory system that is still developing, but it is completely normal in the early stages of life.

B) Chest breathing with nasal flaring:
While some chest movement is observed in newborns, the primary pattern of breathing is abdominal. Nasal flaring is generally an abnormal sign in newborns and may indicate respiratory distress, such as when there is an obstruction in the airway or a need for increased oxygen intake. It is not considered a normal, healthy breathing pattern in newborns.

C) Diaphragmatic with chest retraction:
Diaphragmatic breathing is normal, but chest retraction is not. Retractions occur when there is increased effort to breathe, and they typically indicate respiratory distress or obstruction. In a healthy, full-term newborn, retractions should not be present. This type of breathing would require further investigation to rule out conditions like respiratory distress syndrome or infection.

D) Deep with a regular rhythm:
Newborns may have irregular breathing patterns, including periods of apnea (a few seconds without breathing) and slight irregularity in rhythm, especially during sleep. Deep, regular breathing without any irregularities is not typical in a newborn, and any consistent deep breathing would require further observation to rule out any potential underlying issues.

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Correct Answer is B

Explanation

A) Pauses in respiration lasting 30 seconds:
Pauses lasting longer than 20 seconds or accompanied by other signs of distress would warrant further evaluation. A 30-second pause by itself, without additional concerning symptoms, is generally not a reason for immediate action.

B) Respiratory rate 36, crackles present bilaterally:
The presence of bilateral crackles is concerning. Crackles can indicate fluid in the lungs, possibly from retained amniotic fluid or respiratory distress syndrome (RDS). In a term newborn, bilateral crackles at this time, especially if accompanied by tachypnea or other signs of respiratory distress, may indicate a serious respiratory issue, such as aspiration pneumonia or RDS. Immediate assessment and intervention are necessary to ensure the infant is breathing adequately and that there are no underlying complications.

C) Apical heart rate of 160 with mild systolic murmur heard:
An apical heart rate of 160 is within the normal range for a newborn (typically 120-160 bpm). A mild systolic murmur is also not uncommon in newborns and may be benign, especially in the first few days of life. Murmurs are often transient and can be caused by normal circulatory changes as the newborn's cardiovascular system adjusts after birth. Although a heart murmur should be monitored, it is not typically an urgent concern unless associated with signs of poor perfusion or other cardiac symptoms.

D) Small white papules on nose and chin:
These small white papules are likely milia, which are common and harmless in newborns. Milia are keratin-filled cysts that typically appear on the face, especially around the nose and chin. They are a normal finding and resolve on their own without treatment. These papules do not require immediate action.

A. Protect the fetal skin from amniotic fluid. B. Promote normal peripheral nervous system development. C. Allow transport of oxygen and nutrients across the amnion. D. Regulate fetal temperature.

Correct Answer is A

Explanation

A) Protect the fetal skin from amniotic fluid:
Vernix caseosa is a whitish, cheese-like substance that covers the skin of the fetus during the second and third trimesters of pregnancy. It plays an essential role in protecting the fetal skin from prolonged exposure to amniotic fluid, which can be irritating. Vernix also serves as a barrier that helps prevent water loss and protects against potential infections.

B) Promote normal peripheral nervous system development:
While the development of the peripheral nervous system is vital to fetal development, the presence of vernix caseosa is not directly related to promoting nervous system development. The vernix's primary function is to protect the skin, not influence neural development. Neural development occurs due to other factors, such as adequate nutrition and hormonal regulation during pregnancy.

C) Allow transport of oxygen and nutrients across the amnion:
Vernix caseosa does not play a role in transporting oxygen or nutrients across the amnion. Oxygen and nutrients are transferred to the fetus through the placenta and the umbilical cord. The amniotic sac, which contains amniotic fluid, provides a cushioning effect for the fetus, but the vernix itself does not participate in nutrient or oxygen exchange.

D) Regulate fetal temperature:
Vernix caseosa does not directly regulate fetal temperature. Fetal temperature regulation is mainly managed by the mother's body through thermoregulation and the umbilical blood flow. The vernix may provide some protection against temperature fluctuations after birth, but its primary function is to protect the skin, not to regulate temperature.

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Part of the health assessment of a newborn includes observation of the neonate's breathing pattern. A full-term newborn's breathing pattern is predominantly:

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

A new mother asks the nurse about the white substance" covering her infant. The nurse explains that the purpose of vernix caseosa is to:

Correct Answer is A

Explanation

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