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The nurse is caring for a newborn one hour after delivery. Which of the following assessment findings does the nurse identify as signs of respiratory distress? (Select all that apply)

A.

Flexion of arms.

B.

Caput succedaneum.

C.

Heart rate 158 bpm.

D.

Respiratory rate 66/min.

E.

Acrocyanosis.

F.

Subcostal retractions.

G.

Nasal flaring.

H.

Grunting.

Question Solution

Correct Answer : D,F,G,H

Choice A rationale

 

Flexion of arms is a normal finding in newborns and does not indicate respiratory distress.

 

Choice B rationale

 

Caput succedaneum is a common condition where the scalp swells due to pressure during delivery. It does not indicate respiratory distress.

 

Choice C rationale

 

A heart rate of 158 bpm is within the normal range for newborns and does not indicate respiratory distress.

 

Choice D rationale

 

A respiratory rate of 66/min is above the normal range (30-60 breaths per minute) and indicates respiratory distress.

 

Choice E rationale

 

Acrocyanosis is common in newborns and does not indicate respiratory distress.

 

Choice F rationale

 

Subcostal retractions indicate increased work of breathing and are a sign of respiratory distress.

 

Choice G rationale

 

Nasal flaring is a sign of respiratory distress as it indicates increased effort to breathe.

 

Choice H rationale

 

Grunting is a sign of respiratory distress as it indicates difficulty in maintaining lung expansion.

 


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Correct Answer is B

Explanation

Choice A rationale

Shivering is not a primary concern for newborns as they have limited ability to shiver. Instead, they rely on non-shivering thermogenesis to maintain body temperature.

Choice B rationale

Cold stress is a significant concern for newborns as it can lead to hypothermia, increased oxygen consumption, and metabolic acidosis. Placing a newborn under a radiant heat warmer helps maintain their body temperature and prevent cold stress.

Choice C rationale

Brown fat production is a natural process in newborns that helps generate heat. However, the primary purpose of using a radiant heat warmer is to prevent cold stress, not to stimulate brown fat production.

Choice D rationale

Basal metabolic rate reduction is not the primary concern. The focus is on preventing cold stress and maintaining the newborn’s body temperature.

Correct Answer is B

Explanation

Choice A rationale

Administering only the Hepatitis B vaccine within 1 hour of birth is not sufficient for a newborn born to a Hepatitis B positive mother. The newborn also needs Hepatitis B immunoglobulin (HBIG) to provide immediate passive immunity.

Choice B rationale

Administering both the Hepatitis B vaccine and Hepatitis B immunoglobulin (HBIG) within 12 hours of delivery is the recommended practice for newborns born to Hepatitis B positive mothers. This provides both active and passive immunity.

Choice C rationale

Administering only Hepatitis B immunoglobulin (HBIG) within 12 hours of birth is not sufficient. The newborn also needs the Hepatitis B vaccine to develop long-term immunity.

Choice D rationale

Administering Hepatitis B immunoglobulin (HBIG) within 12 hours, followed by monthly Hepatitis B vaccines for 12 months, is not the standard practice. The newborn should receive the Hepatitis B vaccine series according to the recommended schedule. .

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