1. A nurse is performing an initial assessment of a newborn who was delivered with a nuchal cord. Which of the following clinical findings should the nurse expect? 1. Telangiectatic nevi- “stork bites” flat pink marks found on face that easily blanch. NORMAL 2. Periauricular papillomas 3. Erythema toxic -pink rash on newborn. normal 4. Facial petechiae- seen over the presenting part with soft tissue injuries -nuchal cord: umbilical cord around fetal neck. Will cause variable deceleration of FHR. Intervention: reposition client from side to side or into knee chest, discontinue oxytocin if being infused, oxygen 2. A nurse is monitoring a newborn whose mother reports recent opiate use for neonatal abstinence syndrome. Which of the following findings indicates narcotic withdrawal? 1. Respiratory rate 50/min 2. Unequal pupils 3. Hypotonia 4. Excessive crying • Substance withdrawal in the newborn occurs when the mother uses drugs during pregnancy. • Hitch pitch shrill cries, incessant crying, tremors, increae deep tendon reflexes, disturbed sleep pattern, hypertonicity, convulsions • Nasal congestion w/ flaring, apnea, tachypnea <60>

 

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