1.A nurse is performing an initial assessment of a newborn who was delivered with a nuchal cord. Which of the following clinical findings should the nurse expect?
Facial petechiae- seen over the presenting part with sof
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1.A nurse is performing an initial assessment of a newborn who was delivered with a nuchal cord. Which of the following clinical findings should the nurse expect?
Facial petechiae- seen over the presenting part with soft tissue injuries
-nuchal cord: umbilical cord around fetal neck. Will cause variable deceleration of FHR. Intervention: repositi on client from side to side or into knee chest, discontinue oxytocin if being infused, oxygen
2.A nurse is monitoring a newborn whose mother reports recent opiate use for neonatal abstinence syndrome. Which of the following findings indicates narcotic withdrawal?
1.Respiratory rate 50/min
2.Unequal pupils
3.Hypotonia
4.Excessive crying
•Substance withdrawal in the newborn occurs when the mother uses drugs during pregnancy.
•Hitch pitch shrill cries, incessant crying, tremors, increae deep tendon reflexes, disturbed sleep pattern, hypertonicity, convulsions
•Nasal congestion w/ flaring, apnea, tachypnea <60/min
3.A nurse is caring for a client who is in the second stage of labor. The nurse observes the fetal head retract against the clients perineum immediately following emergence . Which of the following actions should the nurse take?
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