Health Promotion and Maintenance
29. A client, who is multiparous, delivered a 9-pound, 12-ounce baby girl at 41 3/7 weeks' gestation. After 14 hours of labor, she had an arrest of descent and a cesarean section was performed. While performing an initial newborn assessment, what observations should a nurse expect to find in a neonate of this gestation? Select all that apply.
Test-Taking Tip
The question is focusing on evaluation of a neonate who has passed the estimated date of delivery. Think about what a neonate who is "postdates" looks like: dry, peeling, and wrinkled.
Content Area: Child Health, Newborn; Integrated Process: Nursing Process, Assessment; Cognitive Level: Application; Client Need/Subneed: Health Promotion and Maintenance/Ante/Intra/Postpartum and Newborn Care
Health Promotion and Maintenance
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Answer 1 is incorrect because vernix is usually absorbed in neonates who are past their estimated date of delivery. Answer 2 is incorrect because plethora is an indication of a high hematocrit and is not a normal finding in a neonate of any gestation. Answer 3 is correct because milia are clogged sebaceous glands usually found on the nose and are a normal finding in all gestational ages. Answer 4 is incorrect because crepitus is the crunching, crackling, or popping sounds and sensations that are felt under the skin when palpating the clavicles in a neonate who is suspected of having a fractured clavicle. Answer 5 is correct because parchment skin is a common finding in postdates neonates. The neonate who is postdates absorbs the vernix, which protects the skin. When the vernix is absorbed, the skin dries out and begins to peel off in large sheets that resemble parchment.
