The newborn at 24 hours of age has a red blood cell count of 5.4 million per ml. Which of the following entries would the nurse expect to find in the newborn's chart?
1. Cord clamping delayed until pulsation ceased
2. CBC drawn from the anterior surface of the left hand
3. Placental abruption noted to be 80% at time of delivery
4. Infant is breastfed 15–20 minutes every three hours
Correct Answer: 1
Rationale 1: Delayed cord clamping can cause an increase of up to 61%, resulting in a slightly higher-than-average red blood cell count.
Rationale 2: Venous blood has lower red cell counts than do capillary blood samples.
Rationale 3: Maternal or fetal blood loss cause hypovolemia and low red blood cell counts (less than 5.2 million per ml).
Rationale 4: Breastfeeding does not impact red cell counts in the first day of life.
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