What is the most likely cause of early decelerations in the fetal heart rate (FHR) pattern?

D. Meconium, which is the baby's first stool, is typically passed within the first 24-48 hours after birth. Delayed passage of meconium beyond 48 hours can be indicative of meconium ileus, Hirschsprung's disease, or other bowel obstruction issues. Therefore, a newborn who has not passed meconium by 24 hours post-delivery requires prompt evaluation and intervention to rule out potential bowel obstruction or other underlying conditions.

A. Acrocyanosis, which is blueness of the hands and feet, is a common finding in newborns and usually resolves on its own without intervention. It occurs due to immature circulation in the peripheral areas and is considered a normal variant in the early hours to days after birth

B. A temperature of 37.5°C (99.5°F) in a newborn is within the normal range. Newborns can have slight variations in temperature, and 37.5°C is not considered feverish or indicative of significant pathology.

C. Delayed passage of urine beyond 24 hours can indicate dehydration, renal issues, or other conditions that require assessment and intervention. Therefore, a newborn who has not voided by 24 hours post- delivery should be assessed promptly by the nurse to evaluate for signs of dehydration and to ensure adequate renal function. However, delay in meconium is more urgent.

A. This is the correct and recommended approach for newborns born to HBsAg-positive mothers. The newborn should receive hepatitis B immune globulin (HBIG) within 12 hours of birth, ideally along with the first dose of hepatitis B vaccine. HBIG provides passive immunity against HBV infection, while the vaccine stimulates active immunity by producing antibodies against the virus.

B. This schedule is not recommended because delaying HBIG administration increases the risk of HBV transmission to the newborn during the critical early period. The monthly schedule for hepatitis B vaccine does not provide immediate protection when the risk of transmission is highest.

C. This approach is not appropriate because it does not include HBIG, which is necessary for immediate passive immunity. Monthly vaccination alone does not address the immediate risk of infection from the mother to the newborn.

D. This option is not recommended because the current guideline emphasizes the administration of HBIG within 12 hours of birth to maximize its effectiveness in preventing HBV transmission. Delaying HBIG beyond the first 12 hours increases the risk of infection.