A nurse in a newborn nursery is monitoring a preterm newborn infant for respiratory distress syndrome. Which assessment signs, if noted in the newborn infant, would alert the nurse to notify the physician to the possibility of this syndrome?
Explanation
Answer - A - Tachypnea and retractions are assessment signs which, if noted in a newborn infant, would alert the nurse to notify the physician and to the possibility of this syndrome. A newborn infant with respiratory distress syndrome may present with clinical signs of cyanosis, tachypnea or apnea, nasal flaring, chest wall retractions, or audible grunts. Acrocyanosis is the bluish discoloration of the hands and feet, is associated with immature peripheral circulation, and is not uncommon in the first few hours of life.
