Question

the nurse is teaching discharge instructions to the young parents of a healthy newborn whose vital signs are stable and whose circumcision appears clean and intact. the nurse should encourage the parents to call the health care provider if which situation is discovered?

redness at the base of the umbilical cord
a yellowish crusty substance on the circumcision site
straining when they are passing stools
crying for 2 hours or more each day

Explanation:

Analyze the clinical scenario

The question asks which situation requires parents to contact their health care provider following newborn discharge. The newborn is healthy, has stable vital signs, and has a clean, intact circumcision.

Evaluate umbilical cord findings

Redness, warmth, swelling, or foul-smelling drainage at the base of the umbilical cord are signs of infection (omphalitis). This is a potentially serious systemic infection in a newborn and requires immediate medical evaluation. Therefore, the nurse must instruct the parents to call the provider if redness is discovered.

Evaluate circumcision findings

A yellowish, crusty exudate normally forms over the circumcision site as it heals, typically appearing on the second day and lasting for a few days. Parents should be taught not to wash or scrape this yellow crust off, as it is a normal part of healing. This does not require calling the provider.

Evaluate stooling and crying behaviors

Straining during bowel movements is common and normal for newborns due to underdeveloped abdominal musculature, provided the stool is soft. Crying for up to 2 hours a day is also within normal limits for healthy infants as a form of communication and state regulation. Neither of these findings requires calling the provider.

Synthesize the correct intervention

Applying Newborn Circumcision Care knowledge helps rule out the normal yellow crust as a concern. The presence of redness at the base of the umbilical cord indicates a localized infection that can quickly become systemic, making it the critical finding that requires contacting the health care provider.

Answer:

• (A) redness at the base of the umbilical cord (Correct answer)
• (B) a yellowish crusty substance on the circumcision site
• (C) straining when they are passing stools
• (D) crying for 2 hours or more each day