A young couple brings their new daughter in for a visit 1 week after her birth.

The nurse senses

they want to ask something, but they appear hesitant. Finally, they tell the nurse they are very
concerned about what the doctor called a birthmark found on the nape and which blanched easily.
They said they have been doing research online and are very concerned it is something more
serious, and they want it treated and/or removed.

1. How should the nurse respond to the birthmark?

- the birthmark found on the nape of the newborn is called stork bite or Telangiectatic nevi, it
blanches on pressure, but they should not worry because it fades or disappear over time.
2. The child's birthweight is 6 lbs and 3 oz., during their consultation it is now 6lbs. The
parents are worried about their baby not gaining weight. What is the nurse's best
response regarding the weight of the newborn.
- This is normal since a newborn loses between 5% and 10% of their birth weight, or 6 to 10 oz,
in the first few days after delivery. This is because fluid-retaining maternal hormones have been
withheld, dieresis, effective sucking has not yet developed, or because the baby voids and passes
waste. For the first six months of life, they gained roughly 2 lbs a month after losing weight initially.

3. In a table compare the characteristics, causes and interventions of cephalhematoma,

caput succedaneum, and craniotabes.

Characteristics Causes Intervention

Cephalhematoma The collection of It is caused by the Will go away without
blood between the rupture of a treatment. The blood
periosteum of a skull periosteal capillary beneath the
bone and the bone due to the pressure periosteum doesn't
itself of birth. absorb for a few
weeks.
Caput An edema of the The continued No treatment
succedaneum scalp in the pressure of the fetal needed, it is
presenting part of the skull against the gradually absorbed
head, it resembles a cervix which and disappears at the
large egg. becomes edematous. third day of life.
Craniotabes Softening of the caused by the After a few months,
cranial bones, pressure of the fetal the condition will go
pressure of an skull against the away by itself as the
examining finger can mother’s pelvic bone infant consumes milk
indent it. in the utero. which has calcium.

4. The couple is also worried that the eyes of the newborn sometimes cross. How should
the nurse respond to this?
It is common for newborns to occasionally cross their eyes because they have underdeveloped
extraocular muscles which is why they have a hard time with eye coordination.
5. The nurse noticed that the newborn has flaring nostrils while breathing, is this normal
or abnormal? Justify your answer.
If the newborn has flaring nostrils while breathing it should be evaluated because it is not normal
and it is an indication of respiratory distress.