Which of the these assessment and monitoring data are abnormal for a 1-hour-old infant?

Select all that apply.

a. Fontanelles soft and flat
b. Pupils 2 cm, brisk reaction
c. No reaction when pulse oximeter is placed on right foot
d. Sleepy, squirms and fusses during pupil check
e. Breath sounds clear
f. Pulses 2+ and capillary refill time less than 2 to 3 seconds
g. Bilateral clubfeet
h. Sac in sacral region covered with sterile gauze that is moistened with saline
i. Acrocyanosis


c, g, h
The other items are normal findings in a newborn.

Nursing

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