A baby is grunting in the neonatal nursery.
Which of the following actions by the nurse is appropriate?
Place a pacifier in the baby's mouth.
Check the baby's diaper.
Have the mother feed the baby.
Assess the respiratory rate.
The Correct Answer is D
Choice A rationale
Placing a pacifier in the baby's mouth is inappropriate because it does not address the underlying cause of grunting, which can be a sign of respiratory distress.
Choice B rationale
Checking the baby's diaper is not relevant to assessing the cause of grunting. Grunting is usually related to respiratory issues rather than a dirty diaper.
Choice C rationale
Having the mother feed the baby is inappropriate because grunting may indicate respiratory distress. Feeding should be deferred until the baby's respiratory status is assessed and stabilized.
Choice D rationale
Assessing the respiratory rate is appropriate because grunting in a newborn can indicate respiratory distress. The nurse should evaluate the respiratory status to determine the need for further intervention.
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Correct Answer is D
Explanation
Choice A rationale
Placental abruption involves the detachment of the placenta from the uterine wall before delivery, causing bleeding, abdominal pain, and uterine tenderness. It does not typically cause dyspnea, hypotension, frothy sputum, or loss of consciousness.
Choice B rationale
Uterine rupture is a tear in the uterine wall, often in a scarred uterus. Symptoms include severe abdominal pain, abnormal fetal heart rate, and vaginal bleeding. It can cause shock, but not frothy sputum or sudden dyspnea.
Choice C rationale
Uterine inversion occurs when the uterus turns inside out, often during placental delivery. It leads to pain, hemorrhage, and shock. Like uterine rupture, it does not cause frothy sputum or sudden dyspnea.
Choice D rationale
Anaphylactoid syndrome (amniotic fluid embolism) occurs when amniotic fluid enters the maternal circulation, causing an anaphylactic reaction. Symptoms include sudden dyspnea, hypotension, frothy sputum, and loss of consciousness, fitting the scenario described.
Correct Answer is ["A","B","D","E"]
Explanation
Choice A rationale
Impaired intellectual development in children born to mothers with diabetes can occur due to fluctuating blood glucose levels, which can affect brain development.
Choice B rationale
Development of metabolic syndrome is more likely in children born to mothers with diabetes due to genetic predispositions and prenatal exposure to hyperglycemia.
Choice C rationale
Shoulder injury related to birth size, although a possible immediate complication, is not typically considered a long-term effect of maternal diabetes.
Choice D rationale
Changes in genetic expression can occur due to epigenetic modifications from exposure to maternal diabetes, potentially leading to various health issues later in life.
Choice E rationale
Increased risk for chronic illnesses, such as type 2 diabetes and cardiovascular diseases, is higher in children born to mothers with diabetes, due to genetic and environmental factors.