ATI RN maternal newborn A questions and answers 2024/25

Exhibit 1: Medical hx Newborn delivered by repeat cesarean birth at 40 weeks of gestation. Birth weight 3,515 g (7 lb 12 oz) Apgar scores 8 at 1 min and 9 at 5 min. Maternal history of methadone use during pregnancy. Exhibit 2: VS @0700: Heart rate 156/min. Respiratory rate 58/min. Temperature 37.2° C (98.9° F) Oxygen saturation 98% on room air @1100: Heart rate 160/min. Respiratory rate 60/min. Temperature 37.3° C (99.2° F) Oxygen saturation 96% on room air Exhibit 3: Phys Exam Newborn is inconsolable with a high-pitched cry. Newborn sucks vigorously on pacifier but breastfeeds poorly. Respirations unlabored. Lungs sound clear on auscultation. Increased muscle tone with moderate to severe tremors when disturbed. Hyperactive Moro reflex noted. Several loose stools today. Exhibit 4: Diagnostic Results Maternal urine toxicology screen positive for opiates (-). Newborn urine toxicology screen positive for opiates (- - ANSWER Respiratory findings is incorrect. The newborn's respiratory rate is within the expected reference range of 30 to 60/min. There is no indication the newborn has an alteration in respiratory status; therefore, this finding does not need to be reported to the provider. Temperature is incorrect. The newborn's temperature is within the expected reference range of 36.5° to 37.5° C (97.7° to 99.5° F). Therefore, this finding does not need to be reported to the provider. Oxygen saturation is incorrect. The newborn's oxygen saturation is within the expected reference range of greater than 94%; therefore, this finding does not need to be reported to the provider. Central nervous system findings is correct. The newborn is displaying inconsolability, high-pitched cry, increased muscle tone, tremors, hyperactive Moro reflex, and excessive sucking. These findings are manifestations of NAS and should be reported to the provider. Gastrointestinal findings is correct. The newborn is displaying poor feeding and loose stools. These findings are manifestations of NAS and should be reported to the provider. Exhibit 1: RN note @ 0900: Client reports a small amount of bright red blood in their underwear upon awakening. Client denies contractions or abdominal pain. External fetal monitor applied. @0930: Client passed large amount of bright red blood from vagina. Denies pain. Uterine tone soft and nontender to palpation. Contraction pattern: no contractions noted. Fetal heart rate pattern: Fetal heart rate baseline 135/min. Moderate variability. No decelerations noted. Exhibit 2: VS @0900: Temperature 36.2°C (97.2° F)