The nurse is caring for a newborn who was born after a long labor. Because of the length of labor, the nurse is alert for signs of intracranial hemorrhage, which would include: (Select all that apply.)
a. Forceful vomiting
b. High-pitched shrill cry
c. Strabismus
d. Inability to move normally
e. Equal pupils
A, B, D
Forceful vomiting, shrill cry, and inability to move normally would be clues to a possible hemorrhage. All babies are strabismic, and equal pupils are not an indicator of hemorrhage.
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