The nurse assesses a sleeping 1-hour-old, 39-weeks' gestation newborn. Which data should cause the nurse the most concern?
1. Respirations 68/min
2. Blood pressure 72/44 mmHg
3. Skin temperature 97.6°F
4. Heart rate 156 beats/min
1
Explanation:
1. Normal respiratory rate is 30 to 60 breaths/min. Respirations of 68/min could represent a less-than-expected transition.
2. This blood pressure is within the normal range of 90 to 60/50 to 40 mm Hg.
3. This is within the normal temperature range of 96.8 to 97.7°F.
4. This heart rate is within the normal range of 120 to 160 beats/min.
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