Question

Baby boy Elis, 2 hours old, is being evaluated in the newborn nursery by the nursing staff. Findings include temperature 37°C; apical heart rate 140 bpm; respirations 58 breaths per minute; BP (arms) 70/47, (calves) 62/39, head circumference 34 cm; chest circumference 31 cm; length 48 cm; weight 2,700 g. The infant is crying. (Learning Objectives 1, 2, 3, 4, and 8)

 A. Based on the physical findings, what should be the nurse's priority!?

 B. What assessments/tests should the nurse expect to be done on this infant? 

 C. What should the nurse include in the teaching plan for the parents of this infant?

Answer 1

a. Based on the physical findings, what should be the nurse's priority?

ANS: According to the given situation the nurse should refer the infant to a cardiologist to access the child's abnormal pulse rate. The nurse should also document all the test results in the infant's medical card.

B. What assessments/tests should the nurse expect to be done on this infant?

ANS: The nurse expected assessments/tests to this infant:

Newborn screening tests

Pulse oximetry tests

Hearing screen

Blood tests

C. What should the nurse include in the teaching plan for the parents of this infant?

ANS: Lactating guidelines

A complete Nutritional Plan for the infant

Hygienic practices