Which of the following findings should the nurse identify as manifestations of the newborn's suspected condition?
Mother's report of feedings.
Oral mucosa findings.
Respiratory findings.
Temperature change.
Correct Answer : B,C
Choice A rationale
Feeding reports are useful for general nutritional assessments but are not typically indicative of the newborn’s suspected pathological condition.
Choice B rationale
Oral mucosa changes, such as pallor or cyanosis, may occur due to hypoxia or circulatory compromise, which are key findings related to the suspected condition.
Choice C rationale
Respiratory changes, including tachypnea or retractions, are significant manifestations of stress or pulmonary involvement in neonatal conditions like asphyxia.
Choice D rationale
Temperature fluctuations, while concerning, are nonspecific and often related to general neonatal instability rather than the suspected pathology. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D"]
Explanation
Choice A rationale
Handwashing before breastfeeding minimizes the risk of pathogen transmission, protecting both the mother and infant. This practice is critical for managing mastitis, which can be complicated by infection.
Choice B rationale
Proper latching techniques reduce nipple trauma, aiding in the prevention of further mastitis development. Correct latching also facilitates effective milk drainage, minimizing milk stasis and associated risks.
Choice C rationale
Alternating breastfeeding with formula feeding reduces milk removal, increasing the risk of milk stasis and infection. Breastfeeding exclusively, if tolerated, is vital for resolving mastitis and maintaining milk supply.
Choice D rationale
Allowing nipples to air dry promotes healing of any nipple trauma. Moist environments facilitate bacterial growth, complicating mastitis recovery. Air drying reduces infection risk and improves comfort.
Correct Answer is C
Explanation
Choice A rationale
Amnioinfusion addresses variable decelerations by relieving cord compression; however, discontinuing oxytocin to prevent further decelerations precedes procedural interventions for labor augmentation.
Choice B rationale
Vaginal/speculum exams are not the priority during recurrent variable decelerations as they delay immediate measures addressing cord compression and fetal oxygenation concerns.
Choice C rationale
Discontinuing oxytocin reduces uterine contractions, alleviating cord compression and improving fetal oxygenation, which is the first step in managing recurrent variable decelerations of fetal heart rate.
Choice D rationale
Instructions about potential birth preparation are important but not immediate for addressing variable decelerations, as they do not directly resolve underlying cord compression concerns. .
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