Health Promotion and Maintenance

During the shift assessment of the healthy, full-term neonate born 24 hours ago to the 25-year-old G1P1 mother who had an uncomplicated pregnancy and delivery, the nurse notes the urethral meatus is on the ventral part of the penile shaft. The assessment is also notable for wide-spaced, downward-slanting eyes that resemble the baby’s father. The baby is pink, well-perfused, and breathing comfortably with normal heart and lung sounds. The mother reports the child is breastfeeding every 2 hours and has voided and stooled several times. Which additional assessment is most important? 

The 31-year-old patient G2P1 woman presents to the clinic for 30 week appointment. She was diagnosed at 24 weeks with gestational diabetes. For 6 weeks, she changed her diet and exercised more regularly while checking her blood sugars. She logged fasting glucose levels of 108-135 mg/dL. She has no proteinuria or glycosuria. The nurse provides which information to the patient?  

During the provider’s exam of the 6-hour-old neonate, the provider reports observing a red reflex in the neonate’s right eye, but not the left. The provider observes whiteness at the back of the eye. Enucleation is performed and the diagnosis of retinoblastoma with clear tumor margins is confirmed. No chemotherapy or radiation is required. The infant is ready to be discharged home as a healthy baby. Which health screening information is most relevant to this family? 

The 28-year-old G2P1 patient presents after rupture of membranes 2 hours ago at 39 weeks gestation. She has a history of prior cesarean section for failure to progress but is otherwise healthy; this pregnancy is uncomplicated. Contractions are painful and labor is progressing. Abruptly, the patient complains of extreme abdominal pain; the nurse observes a significant amount of blood coming from her vagina. Which action is most important? 

The 28-year-old G2P1 patient presents after rupture of membranes 2 hours ago at 39 weeks gestation. She has a history of prior cesarean section for failure to progress but is otherwise healthy; this pregnancy is uncomplicated. Contractions are painful and labor is progressing. Abruptly, the patient complains of extreme abdominal pain; the nurse observes a small amount of blood coming from her vagina. Which assessment prompts the nurse to prepare the patient for an emergency cesarean section? 

The semi-professional athlete requests intravenous hydration after a particularly grueling practice. Which response by the nurse is most appropriate? 

The nurse is teaching a community class on cardiopulmonary resuscitation (CPR). Which rationale is best to give the class for the difference between infant CPR with one rescuer, infant CPR with two rescuers, adult CPR with one rescuer, and adult CPR with two rescuers?

The nurse performs a 12-lead electrocardiogram on the 6-hour-old 39-week-gestation neonate admitted to the neonatal intensive care unit for respiratory distress syndrome. The baby initially required continuous positive airway pressure (CPAP) but is now comfortably tachypneic on room air, with an oxygen saturation of 98% in both the right and left hands. The chest x-ray indicates transient tachypnea of the newborn. Right axis deviation suggesting right ventricular hypertrophy is noted on the ECG. The nurse anticipates the provider to give the parents which information?