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A newborn who is 20 hours old has a respiratory rate of 66, is grunting when exhaling, and has occasional nasal flaring. the newborn's temperature is 98° f (36.6° c); he is breathing room air and is pink with acrocyanosis. the mother had membranes that were ruptured 26 hours before birth. what nursing actions are most indicated?

1 Answer

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The answer would be: Place a pulse oximeter, and contact the healthcare provider (HCP) for a prescription to draw blood

The mother had membranes that were ruptured 26 hours before births which will increase the risk of infection. The infant also has shown respiratory distress and other sign that point to sepsis. Assessing the oxygen level will help to diagnose the disease. Culture takes too long, recording vital sign is standard for any infant.
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User Sufiyan Ansari
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