Which of the following statements should the nurse include in the teaching to the parents of a newborn about the critical congenital heart disease screening?

Choice A reason: Polycythemia, an excess of red blood cells, is associated with conditions like chronic hypoxia or twin-to-twin transfusion, not preterm premature rupture of membranes (PPROM). PPROM increases infection risk, not hematocrit levels. Neonatal physiology in PPROM is more likely to involve inflammatory responses than erythrocytosis, making polycythemia an unlikely complication in this context.

Choice B reason: Fractured clavicle typically occurs during difficult vaginal deliveries, particularly with shoulder dystocia, not PPROM. PPROM predisposes to infection due to prolonged amniotic fluid exposure, not mechanical trauma. The newborn’s skeletal system faces no increased fracture risk from PPROM, as it is unrelated to delivery mechanics or bone integrity.

Choice C reason: Meconium aspiration occurs when a newborn inhales meconium-stained amniotic fluid, typically in term or post-term infants under stress. PPROM at 35 weeks increases infection risk, not meconium passage, as preterm infants rarely produce meconium. The complication is unrelated to PPROM’s primary pathophysiological concern of infection due to membrane rupture.

Choice D reason: Sepsis is a significant risk in PPROM, as ruptured membranes allow bacterial ascent from the vagina, leading to intra-amniotic infection. Preterm newborns have immature immune systems, increasing susceptibility to pathogens like group B streptococcus. Monitoring for sepsis is critical, as it can cause systemic inflammation, organ dysfunction, and high mortality if untreated.

Choice A reason: Spontaneous rupture of membranes indicates labor progression but does not directly guide oxytocin titration. Oxytocin stimulates uterine contractions, and titration depends on contraction strength and frequency, not membrane status. Rupture enhances labor but lacks specificity for adjusting oxytocin, as it does not reflect myometrial response or contraction adequacy.

Choice B reason: A Bishop score of 2 indicates an unfavorable cervix, suggesting the need for cervical ripening, not immediate oxytocin titration. Oxytocin efficacy depends on contraction patterns, not cervical readiness alone. The score assesses dilation and effacement, but titration requires monitoring uterine response, making this finding irrelevant for adjusting the infusion rate.

Choice C reason: Mild contractions indicate inadequate uterine response to 1 milliunit/min of oxytocin, warranting titration to 2 milliunits/min to achieve an expected labor pattern. Oxytocin stimulates myometrial contractions, and mild intensity suggests insufficient stimulation. Increasing the dose enhances contraction strength and frequency, aligning with labor induction protocols to promote effective labor.

Choice D reason: Contractions every 1 minute indicate hyperstimulation, risking fetal distress due to reduced placental perfusion. Oxytocin titration aims for contractions every 2-3 minutes. This frequency suggests excessive uterine activity, requiring a decrease or pause in oxytocin, not an increase, to prevent hypoxia and ensure fetal safety during labor.