The nurse is performing a newborn assessment on a 37-week-gestation newborn at 2 hours of life. The nurse notes a small tuft of hair on the lumbosacral area of the spine. Which neural tube defect will the nurse associate with this assessment finding?

Choice A reason: The designation T3 indicates that the patient has had three full-term births, defined as births that occurred between 37 and 42 weeks of gestation. This is part of the standard obstetric history notation.

Choice B reason: The notation P1 means the patient has had one preterm birth, which is defined as a birth that occurred between 20 weeks and 36 weeks 6 days of gestation. This is an important part of understanding the patient's pregnancy history.

Choice C reason: A2 denotes that the patient has had two pregnancy losses before 20 weeks of gestation, which can include miscarriages or stillbirths. This is crucial for assessing the patient's reproductive health history.

Choice D reason: There is no indication from the notation G6, T3, P1, A2, L4 that the patient has had three elective abortions. Elective abortions would be noted differently in the patient's chart if they were part of the obstetric history.

Choice E reason: The notation L4 indicates that the patient currently has four living children. This is an important part of the patient's obstetric history as it gives insight into their childbearing outcomes.

Choice A reason: Preparing to hang hypotonic fluids is not the immediate priority in this situation. While hydration is important for managing sickle cell anaemia, the infant's respiratory distress and low oxygen saturation levels indicate that addressing oxygenation should be the first step. Hypotonic fluids may be considered after stabilizing the patient's breathing and oxygen levels.

Choice B reason: Administering oxygen via nasal cannula is the priority intervention given the infant's symptoms. The infant has increased work of breathing, a fever, coarse crackles upon auscultation, and low oxygen saturation (89%). Providing supplemental oxygen is crucial to improve oxygenation and alleviate respiratory distress. Prompt intervention is necessary to prevent further complications and stabilize the patient's condition.

Choice C reason: Providing patient education on acute chest syndrome is important, but it is not the immediate priority in this emergency situation. Education can be given once the infant's acute symptoms are managed and stabilized. The focus should be on addressing the critical needs first, such as oxygenation and respiratory support.

Choice D reason: Giving a dose of morphine sulphate may help manage pain, but it is not the first priority in this scenario. The infant's respiratory status and oxygenation levels are more critical and require immediate attention. Pain management can be addressed after ensuring the infant's breathing and oxygen levels are stabilized.