The respiratory therapist is called to assist in the labor of a pregnant woman whose NST reported two accelerations in fetal heart rate, each of at least 15 beats per minute and lasting at least 15 seconds, associated with maternal perception of fetal movement over a period of 20 minutes. What is the best course of action?

Correct Answer: B

Rationale: The correct answer is B) No action is required because this reactive NST is associated with normal uteroplacental function. In this scenario, the NST findings indicate that the fetus is responding well to maternal movement, suggesting good oxygenation and overall well-being. Therefore, there is no immediate need for intervention or acceleration of the delivery process. Option A is incorrect as scheduling a C-section based solely on the NST findings without further assessment could lead to unnecessary interventions and potential risks associated with cesarean delivery. Option C suggests performing a CST before fetal stress is confirmed, which is not indicated in this case as the NST results already indicate fetal well-being. Option D recommending oxytocin administration is not appropriate as there is no indication of fetal distress or need for labor augmentation based on the NST results. Educationally, it is crucial for healthcare providers to understand the interpretation of NST results and appropriate actions based on those findings to provide optimal care for both the mother and the fetus. Understanding normal variations in NST results is essential to avoid unnecessary interventions and ensure appropriate management in obstetric care.

Correct Answer: B

Rationale: In a newborn with respiratory distress, the correct indication for starting surfactant therapy is an oxygen requirement greater than 40% for the first 6 hours of life (Option B). Surfactant therapy is indicated in preterm infants with respiratory distress syndrome (RDS) who have significant oxygenation impairment despite conventional respiratory support. Option A, persistent respiratory acidosis despite ventilation, may indicate the need for respiratory support but not specifically surfactant therapy. Option C, frequent episodes of apnea, could suggest a need for respiratory support but not a direct indication for surfactant therapy. Option D, signs of meconium aspiration syndrome, would require supportive care and possibly respiratory interventions but not necessarily surfactant therapy. Educationally, understanding the indications for surfactant therapy in newborns is crucial for pediatric nurses caring for infants with respiratory distress. It is essential to differentiate between various respiratory conditions and interventions to provide optimal care and improve outcomes for these vulnerable patients. Early recognition of the need for surfactant therapy can significantly impact the management and prognosis of newborns with respiratory distress syndrome.

Correct Answer: C

Rationale: In pediatric respiratory distress, the primary goal of post-resuscitation care for a neonate is to support lung function and oxygenation (Option C). This is crucial because respiratory distress in neonates can lead to hypoxemia, which can have severe consequences on their overall health and wellbeing. By focusing on supporting lung function and oxygenation, healthcare providers aim to ensure that the neonate receives adequate oxygen to meet the body's metabolic demands, preventing further complications. Option A, preventing infection, while important in overall neonatal care, is not the primary goal in the immediate post-resuscitation phase. Similarly, maintaining normal blood glucose levels (Option B) and ensuring normal temperature regulation (Option D) are essential aspects of neonatal care but take a secondary role to supporting lung function and oxygenation in the context of post-resuscitation care. Educationally, understanding the priority of interventions in pediatric respiratory distress is key for nurses and healthcare providers working in neonatal settings. By recognizing the primary goal of post-resuscitation care, healthcare professionals can prioritize their actions effectively to optimize outcomes for neonates experiencing respiratory distress. This knowledge enhances patient safety and quality of care in neonatal units, contributing to better overall patient outcomes.

Correct Answer: A

Rationale: In pediatric nursing, recognizing signs of neonatal hypoglycemia is crucial for timely intervention. The correct answer is A) Jitteriness and tremors. Neonates with hypoglycemia often exhibit neurologic signs such as jitteriness and tremors due to inadequate glucose supply to the brain. It is essential to identify these signs early to prevent serious complications like seizures and brain injury. Option B) Excessive crying is not typically a sign of neonatal hypoglycemia. While infants may cry when they are hungry or uncomfortable, it is not a specific indicator of low blood sugar levels. Option C) High-pitched cry is also not a typical sign of neonatal hypoglycemia. Infants may have varying cries for different reasons, but a high-pitched cry is not specifically associated with hypoglycemia. Option D) Poor feeding can be a sign of hypoglycemia in neonates, but it is not as specific or early a sign as jitteriness and tremors. Poor feeding can be caused by various factors, so it is essential to look for more specific neurological signs like jitteriness when suspecting hypoglycemia. Educationally, understanding the signs and symptoms of neonatal hypoglycemia is vital for pediatric nurses to provide prompt and appropriate care. By recognizing these signs early, nurses can intervene effectively to prevent complications and promote optimal outcomes for neonates at risk for hypoglycemia.

Correct Answer: B

Rationale: In pediatric nursing, understanding the rationale behind physical assessment findings is crucial for providing effective care to children. In this case, the correct answer is B) Underdeveloped abdominal muscles. The protruding abdomen in an 18-month-old child can be explained by the underdeveloped abdominal muscles at this age. Infants and young children have less developed muscle tone compared to adults, which can lead to a protruding abdomen appearance. As children grow and develop, their abdominal muscles strengthen, and this protrusion typically diminishes. Option A) Increased food intake owing to age is incorrect because while toddlers may experience increased appetite and food intake, it does not directly cause a protruding abdomen. Option C) Bowlegged posture is unrelated to the abdominal protrusion and is more related to skeletal development in the lower body. Option D) Linear growth curve does not explain the protruding abdomen but rather describes the pattern of growth over time. Educationally, understanding normal growth and development patterns in children is essential for pediatric nurses to differentiate between normal variations and potential concerns. By knowing the age-appropriate physical assessment findings, nurses can provide accurate assessments, interventions, and education to support the health and well-being of pediatric patients.