A pregnant woman at 37 weeks of gestation has had ruptured membranes for 26 hours. A cesarean section is performed for failure to progress. The fetal heart rate before birth is 180 beats/min with limited variability
At birth, the newborn has 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 a. Hypoglycemia
b. Phrenic nerve injury
c. Respiratory distress syndrome
d. Sepsis
D
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A A differential diagnosis can be difficult because signs of sepsis are similar to
noninfectious problems such as anemia and hypoglycemia.
B Phrenic nerve injury is usually the result of traction on the neck and arm during
birth and is not applicable to this situation.
C The earliest signs of sepsis are characterized by lack of specificity—i.e.,
lethargy, poor feeding, and irritability—not respiratory distress syndrome.
D The prolonged rupture of membranes and the tachypnea (before and after birth)
both suggest sepsis.
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When the nurse notes that the ureteral catheter is no longer draining urine, the most appropriate action would be to
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The nurse is assessing a patient who has a family history of type 2 diabetes. Which finding would require follow-up by the nurse?
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