During the first examination, a term newborn has a respiratory rate of 68 breaths per minute with grunting and chest retractions. What is the nurse's priority action?
Correct answer: B. Place the newborn under a warmer and assess breathing
- A. Observe the newborn again after routine feeding
- B. Place the newborn under a warmer and assess breathing
- C. Give oral glucose water to improve breathing
- D. Delay assessment until the newborn is one hour old
Explanation
Tachypnoea with grunting and retractions suggests respiratory distress, so the nurse should provide warmth and immediately assess breathing and oxygenation. Feeding and oral fluids are unsafe until respiratory stability is established, and delaying assessment can worsen hypoxia.
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About Care of the Newborn
Newborn care covers immediate assessment, Apgar scoring, thermal protection, airway management, cord care, identification, vitamin K, early breastfeeding and neonatal resuscitation. It also includes normal newborn findings, prevention of infection, care of premature or low-birth-weight infants, recognition of danger signs, jaundice and safe discharge counselling.
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