Question

A nurse is assessing a newborn who is 16 hr old. Which of the following findings should the nurse report to the provider?

A. Substernal retractions
B. Acrocyanosis
C. Overlapping suture lines
D. Head circumference 33 cm (13 in)

Answer 1

The nurse should report the finding of substernal retractions to the healthcare provider, as it indicates respiratory distress in newborns.

Step-by-step explanation:

The nurse should report the finding of substernal retractions to the healthcare provider. Substernal retractions are a sign of respiratory distress in newborns and indicate that the baby is having difficulty breathing. This finding requires immediate medical attention to ensure the baby's airway is clear and to provide any necessary interventions to improve respiratory function.

Acrocyanosis, which is the bluish discoloration of the hands and feet, is a normal finding in newborns and does not require immediate medical attention. Overlapping suture lines can also be a normal finding if they are minimal and resolve on their own. A head circumference of 33 cm (13 in) is within the normal range for a newborn and does not require reporting to the healthcare provider.