A nurse is assessing a newborn who was born at 42 weeks of gestation.
Which of the following findings should the nurse expect?
Copious vernix.
Dry, cracked skin.
Increased subcutaneous fat.
Scant scalp hair.
The Correct Answer is B
Choice A rationale
Copious vernix is typically found on preterm newborns, not those born post-term.
Choice B rationale
Dry, cracked skin is a common finding in post-term newborns due to prolonged exposure to amniotic fluid.
Choice C rationale
Decreased subcutaneous fat is more likely in preterm newborns, while post-term newborns might lose some fat due to nutrient depletion.
Choice D rationale
Scant scalp hair is more common in preterm infants, whereas post-term infants usually have more developed hair. .
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Correct Answer is A
Explanation
Choice A rationale
Brisk patellar deep tendon reflexes can indicate central nervous system irritability, which might suggest conditions like preeclampsia or eclampsia if accompanied by other symptoms. It's critical to assess and monitor for further complications.
Choice B rationale
A moderate amount of lochia on the perineal pad over 2 hours is normal postpartum bleeding and does not typically indicate an immediate concern if within expected ranges.
Choice C rationale
A fundus at the level of the umbilicus is an expected finding 4 hours postpartum and indicates normal uterine involution. It is not a priority concern at this stage.
Choice D rationale
Approximated edges of an episiotomy indicate that the incision is healing properly without signs of infection or dehiscence. This is a normal and expected finding in the postpartum period.
Correct Answer is A
Explanation
Choice A rationale
Uteroplacental insufficiency leads to late decelerations, which are characterized by a gradual decrease in fetal heart rate after the peak of a contraction. This indicates compromised blood flow between the uterus and placenta, affecting the fetus.
Choice B rationale
Umbilical cord compression usually causes variable decelerations, not late decelerations.
Choice C rationale
Maternal bradycardia does not cause changes in fetal heart rate patterns like late decelerations.
Choice D rationale
Fetal head compression causes early decelerations, which coincide with contractions, not late decelerations.