The nurse is caring for a child who is diagnosed with severe dehydration and is being treated with intravenous fluids. The nurse notes bilateral crackles on lung auscultation. Which actions will the nurse prioritize?

Choice A reason: A newborn at 41 weeks and 5 days gestation is past full term and, while being older in gestational age, does not typically present increased risk for feeding difficulties as compared to preterm infants. At 6 hours old, this infant would still be adapting, but no additional risk is posed by the gestational age.

Choice B reason: An infant born at 36 weeks and 6 days gestation is considered late preterm. Late preterm infants often have immature suck and swallow reflexes and may experience difficulties with feeding, coordinating breathing with feeding, and maintaining body temperature. These issues place them at a higher risk for feeding difficulties compared to full-term infants.

Choice C reason: A newborn at 37 weeks and 3 days gestation is considered early term and generally faces fewer risks compared to preterm infants. At 34 hours old, feeding patterns are still being established, but there are no significant additional risks related to their gestational age.

Choice D reason: An infant born at 38 weeks gestation is considered full term. At 27 hours old, the baby would still be in the early stages of adapting to feeding, but being full term generally implies a lower risk for feeding difficulties compared to preterm infants.

Choice A reason: Having the patient sit on the side of the bed before standing is crucial to prevent dizziness or fainting, especially after giving birth. This intervention allows the patient to stabilize and ensures that they do not experience sudden drops in blood pressure, which can lead to falls.

Choice B reason: Walking alongside the patient to the bathroom is important to provide support and ensure their safety. The patient may still be weak or unsteady after giving birth, and having the nurse nearby can help prevent falls and provide assistance if needed.

Choice C reason: Obtaining an oral temperature is not immediately necessary when assisting a patient to the bathroom post-vaginal birth. While monitoring vital signs is important, this intervention does not directly contribute to the immediate need for safe ambulation.

Choice D reason: Assessing for sensation in the lower extremities is essential to ensure that the patient has regained feeling and control in their legs. This assessment helps to determine if there are any residual effects from epidural anaesthesia or other factors that may affect mobility and safety.

Choice E reason: Assessing bowel sounds and passing flatus is important for overall postpartum care but is not directly related to assisting the patient to the bathroom. This intervention is more relevant to monitoring gastrointestinal recovery and function after childbirth.