A pregnant woman at 37 weeks of gestation has had ruptured ...

[s.tung]

A pregnant woman at 37 weeks of gestation has had ruptured membranes for 26 hours. A cesarean section is performed for failure to progress. Fetal heart rate before birth is 180 beats/min with limited variability.
 
  At birth, the newborn had Apgar scores of 6 and 7 at 1 and 5 minutes and is noted to be pale and tachypneic. Based on the maternal history, the cause of this newborn's distress is most likely to be: 1. hypoglycemia.
  2. phrenic nerve injury.
  3. respiratory distress syndrome.
  4. sepsis.

Question 2

When planning care for an infant with a fractured clavicle, the nurse should recognize that in addition to gentle handling:
 
  1. prone positioning will facilitate bone alignment.
  2. no special treatment is necessary.
  3. parents should be taught range of motion exercises.
  4. the shoulder should be immobilized with a splint.

[reversalruiz]

Answer to Question 1

4
1, 2, 3. Incorrect. The prolonged rupture of membranes is the most indicative clinical cue to this infant's condition. Additionally, an FHR of 180 beats/min is also indicative. This infant is at high risk for sepsis.
4. Correct. The prolonged rupture of membranes accompanied by tachypnea (before and after birth) suggest sepsis.

Answer to Question 2

2
1. Incorrect. Fractures in newborns generally heal rapidly. Except for use of gentle handling, no accepted treatment for fractured clavicle exists.
2. Correct. Fractures in newborns generally heal rapidly. Except for use of gentle handling, no accepted treatment for fractured clavicle exists.
3. Incorrect. Movement should be limited and the infant should be gently handled. It is not necessary to perform range of motion exercises on the infant.
4. Incorrect. A fractured clavicle does not require immobilization with a splint.

[s.tung]

Excellent

[kthug]

TYSM