CCRN Critical Care Nursing

Category - Neonatal

Which of the following infants should the nurse see first?
  1. A one-day-old infant with a bulging anterior fontanel when crying
  2. A one-day-old infant born at 43 weeks with parchment-like skin
  3. A 3-month-old infant with a respiratory rate of 55 breaths per minute, who experiences brief pauses of breathing during sleep.
  4. A one-day-old infant lying quietly and awake with an apical rate of 180
Explanation
Answer - D - The normal apical rate for newborns is between 120 to 160 beats per minute when sleeping and around 180 beats per minute when crying. A bulging fontanel caused by crying is a common finding in infants. It becomes a concern if the fontanel does not return to normal when the infant is already calm. Parchment-like skin is usually seen in babies born after 42 weeks of gestation. Brief episodes of apnea during sleep, lasting no more than 20 seconds, are usually observed in newborns. The respiratory pattern in newborns is caused by immaturity of the part of the brain that controls breathing.
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