Which of the following findings indicates the nurse should titrate the oxytocin infusion rate to 2 milliunits/min after the first 30 min for a client receiving 1 milliunit/min of oxytocin for labor induction?

Choice A reason: Applying petroleum gauze to an omphalocele is inappropriate, as it does not provide a sterile barrier and risks infection or adhesion to exposed viscera. Omphaloceles require protection from contamination and dehydration, which sterile plastic wrap achieves, preserving bowel integrity until surgical repair, per neonatal surgical protocols.

Choice B reason: Positioning a newborn with an omphalocele in a supine position risks pressure on exposed viscera, potentially causing trauma or ischemia. A side-lying position supports the defect, preventing bowel damage. Proper positioning minimizes complications before surgical correction, as supine posture does not protect the omphalocele’s delicate membrane.

Choice C reason: Placing the newborn under a radiant heat source without covering the omphalocele risks dehydration and injury to exposed viscera. While thermoregulation is important, uncovered viscera lose moisture and are prone to infection. Sterile wrapping takes priority to protect the defect, followed by controlled warming, per neonatal care standards.

Choice D reason: Using sterile plastic wrap to cover the omphalocele prevents infection and dehydration of exposed viscera, maintaining bowel integrity until surgical repair. The wrap creates a sterile barrier, reducing bacterial contamination and fluid loss, critical for stabilizing the newborn’s condition and supporting preoperative management, per congenital defect care protocols.

Choice A reason: A WBC count of 11,000/mm3 is slightly elevated but normal in pregnancy due to physiological leukocytosis from increased immune activity. This supports maternal and fetal protection against infections. It does not indicate pathology requiring reporting, as it aligns with expected gestational changes in immune function, per hematological norms.

Choice B reason: Hematocrit of 37% is within the normal pregnancy range (37-47%), reflecting hemodilution from increased plasma volume. This ensures adequate placental perfusion and oxygen delivery. It does not indicate anemia or other complications requiring reporting, as it aligns with physiological adaptations in pregnancy, per hematological reference ranges.

Choice C reason: Creatinine of 0.9 mg/dL is normal (0.5-1 mg/dL) in pregnancy, reflecting increased glomerular filtration rate due to higher renal blood flow. This supports waste clearance for maternal and fetal health. It does not indicate renal dysfunction or require reporting, as it aligns with expected gestational renal physiology.

Choice D reason: Fasting blood glucose of 180 mg/dL indicates gestational diabetes, as it exceeds the normal range (74-106 mg/dL). Elevated glucose crosses the placenta, risking fetal macrosomia, hypoglycemia, or congenital anomalies. This requires immediate reporting for management to prevent adverse perinatal outcomes, per endocrinological and obstetric guidelines.