The nurse is completing a gestational assessment on a newborn whose parent was treated for preeclampsia during labor. The neonate is demonstrating “frog-like” posturing. The nurse knows this is likely due to what medication during labor?

Correct Answer: C

Rationale: The correct answer is C) magnesium sulfate for the treatment of preeclampsia. Magnesium sulfate is a common medication used to manage preeclampsia in pregnant individuals. It is a central nervous system depressant that crosses the placenta and can affect the newborn. One of the potential side effects of maternal magnesium sulfate administration is neonatal neuromuscular blockade, which can present as "frog-like" posturing in the newborn. This is known as hypotonia or decreased muscle tone, which can manifest as the infant's limbs being extended and abducted similar to a frog's posture. Option A) fentanyl in the epidural is unlikely to cause the described posturing in the newborn as fentanyl is primarily a pain medication and does not typically have effects on muscle tone. Option B) penicillin for the treatment of group B strep infection is an antibiotic used to treat bacterial infections and is not associated with neuromuscular effects like the "frog-like" posturing seen in this case. Option D) prenatal vitamins are essential for maternal and fetal health but do not cause neuromuscular effects such as hypotonia in newborns. Understanding the effects of medications used during labor and their potential impact on the newborn is crucial for nurses caring for neonates. Recognizing and managing these effects promptly can ensure optimal outcomes for both the newborn and the mother.

Correct Answer: A

Rationale: The correct answer is A) This parent-newborn couplet is at risk for delayed attachment. The Brazelton assessment is a comprehensive tool used to evaluate newborn behavior and interactions with their parents to assess their overall well-being and identify any potential issues. In this case, the newborn of a 15-year-old parent may be at higher risk for delayed attachment due to the parent's age and potential lack of readiness or knowledge about newborn care. This assessment can help the nurse identify any signs of delayed attachment early on and provide appropriate support and intervention. Option B) The newborn is likely going home soon, is incorrect because the timing of discharge does not determine the need for a Brazelton assessment. This assessment is more about the newborn's behavioral responses and interactions rather than their discharge status. Option C) The EHR is prompting her to do so, is incorrect as the decision to perform a Brazelton assessment should be based on clinical judgment and assessment of the specific needs of the newborn and parent, not just because the electronic health record prompts it. Option D) The infant is likely withdrawing from a substance, is incorrect as the Brazelton assessment is not specifically designed to assess substance withdrawal in newborns. It focuses more on overall behavior and interaction patterns between the newborn and parents. In the educational context, understanding the rationale behind using the Brazelton assessment in specific cases helps nurses provide individualized care and support to newborns and their families. It highlights the importance of early identification of issues such as delayed attachment and the role of assessment tools in guiding nursing interventions.

Correct Answer: B

Rationale: In the context of pharmacology and nursing care of the newborn, understanding the motoric process is crucial for assessing the newborn's overall health and development. In this scenario, the correct answer is B) They have hyper- or hypotonic movements. The rationale behind this is that hyper- or hypotonic movements indicate an abnormality in muscle tone, which can be a sign of neurological issues or developmental delays in the newborn. This can impact the newborn's ability to feed, grow, and reach developmental milestones. Option A, having good reflexes, is not an indicator of a poor motoric process. Good reflexes are actually a positive sign of neurological development in newborns. Option C, having good head control, is also a positive sign of motor development in newborns. It reflects the strength of the neck muscles and coordination, which are important for overall motor function. Option D, having moderate activity levels, is not necessarily indicative of a poor motoric process. Activity levels can vary among newborns and do not necessarily correlate with motor development issues. Educationally, understanding these nuances in newborn assessment is vital for nurses to provide appropriate care, detect potential issues early, and support the newborn's development. By recognizing signs of abnormal muscle tone, nurses can intervene promptly and collaborate with healthcare providers to address any underlying concerns for optimal newborn outcomes.

Correct Answer: C

Rationale: In the context of nursing care of the newborn, identifying a high-risk newborn and birthing person is crucial for ensuring appropriate interventions are in place. Option C, referring the couplet to social work for early intervention, is the correct choice. This is because social workers are trained to assess social and environmental factors that may impact the health and well-being of the newborn and the family. Social workers can provide support, resources, and interventions to address any challenges that the high-risk newborn and birthing person may be facing. Option A, documenting in the chart, is important but alone it does not address the immediate needs of the high-risk newborn and birthing person. Option B, reassuring the parent, is not sufficient in addressing the potential risks and challenges that the high-risk couplet may be facing. Option D, referring to a pediatric health-care provider for a well-baby checkup, is important for routine care but may not address the specific needs of a high-risk newborn and birthing person that require early intervention and additional support beyond a typical well-baby checkup. Educationally, understanding the importance of early identification of high-risk situations and knowing how to appropriately intervene and refer to other healthcare professionals is crucial for nurses caring for newborns and their families. This ensures comprehensive care and support for those in need, promoting positive health outcomes for both the newborn and the birthing person.

Correct Answer: D

Rationale: The correct answer is D) give the baby a bath in an infant tub now. This instruction is appropriate because the umbilical cord stump has already fallen off, indicating the area is healed and no longer needs to be kept dry. Bathing the baby helps in maintaining good hygiene and promoting skin health without increasing the risk of infection. Option A is incorrect as covering the umbilicus with a band-aid can trap moisture, leading to potential infection. Option B is incorrect as using alcohol to clean the stump is no longer necessary once it has fallen off and healed. Option C is incorrect as applying antibiotic ointment unnecessarily may disrupt the natural healing process and could lead to resistance issues in the future. In an educational context, it's essential for nurses to provide evidence-based care instructions to parents to promote optimal newborn care. Understanding the normal healing process of the umbilical cord stump and when it is appropriate to introduce bathing helps parents feel confident in caring for their newborn and prevents unnecessary interventions that could potentially harm the baby.