The nurse identifies that which infant is at the highest risk of infection?

Choice A rationale

While lithotomy positioning can increase pressure on perineal tissues, it does not directly correlate with an elevated risk of postpartum hemorrhage. Other factors have stronger evidence for causing hemorrhage.

Choice B rationale

Uterine massage is a preventative measure against postpartum hemorrhage. It stimulates uterine contractions, promoting tone, and reducing atony, which is a primary cause of excessive postpartum bleeding.

Choice C rationale

A third stage lasting less than 10 minutes is within normal limits, reducing the likelihood of placental retention and subsequent bleeding. Prolonged stages, rather than shortened ones, increase risk.

Choice D rationale

Macrosomia, defined as infant birth weight over 4000 grams, increases uterine atony risk due to overdistension, impairing effective contractions post-delivery. Overdistension complicates placental separation, raising postpartum hemorrhage risk.

Choice A rationale

Hypoxia may contribute to tachypnea and distress, but it is unlikely the primary cause, as baseline fetal heart rate of 180 BPM indicates infection-related stress rather than isolated oxygen deprivation.

Choice B rationale

Respiratory distress syndrome predominantly affects preterm infants due to surfactant deficiency. At 37 weeks’ gestation, surfactant levels should be adequate, making this an unlikely cause of the newborn’s tachypnea and pallor.

Choice C rationale

Prolonged rupture of membranes increases the risk of neonatal sepsis. Signs such as tachypnea, pallor, and elevated fetal heart rate with marked variability suggest systemic infection requiring immediate evaluation and treatment.

Choice D rationale

Phrenic nerve injury typically causes diaphragmatic paralysis, leading to asymmetric chest movement and respiratory distress. However, it does not explain the systemic signs like pallor or elevated heart rate, making it an unlikely cause.