What is the RN’s role regarding this newborn’s safety and outcome?

High-Risk Newborn Unfolding Case StudyPurpose: The purpose of this assignment is for students to recognize and identify abnormal assessment and lab findings in the high-risk newborn and use evidence-based practice guidelines for appropriate interventions and care.Instructions: This strategy can be used with individual students or with groups of students. In the classroom, each stage is presented one a time for the unfolding case study format. The use of this case study in the online environment would be after viewing a lecture. For either classroom or online environments, students would benefit from a lecture that discusses clinical findings and treatment for macrosomia and IDM, as well as preparatory reading of the Sugar/Safety and Airway sections in the S.T.A.B.L.E textbook and reference journal articles/websites. The S.T.A.B.L.E. textbook is the gold standard for sick newborn care and specifically covers evidence-based, patient-centered guidelines for the care of the IDM and airway management in sick newborns. This exercise is meant to be a formative, non-graded assignment and can also be a replacement for clinical time as an alternative assignment if necessary.Part 1You are the RN working in the Neonatal Intensive Care Unit and receive a report that you will be the admitting nurse for the shift. At 0830, the Charge Nurse calls to tell you that the Peds team is going on a stat c-section delivery and to be on stand-by that you may admit the patient. At 0905, the Charge Nurse calls back that you will be admitting the newborn and gives you the following delivery information: Davis, BB is a 4,135 g, 41-week male who was born via c-section delivery after a difficult labor and failure to progress. The mother has a history of gestational diabetes and hypertension.1. In your initial findings from the report, what are you specifically concerned about this infant?2. What criteria are present in the maternal and delivery history that align with the c-section being performed?3. What supplies and equipment should you consider gathering before the patient arrives at your unit for patient-centered care and preparedness?4. Discuss some patient-centered educational teaching and topics that can be addressed for the parents in relation to this NICU admission?Part 2Davis, BB is transferred from the stabilization room to the admission room in the NICU. He is transferred on nasal CPAP PEEP 8 @ 21% and has a PIV in the L forearm that’s infusing D10W @ 13.75 mL/hr rate. He has an OG tube placed at 26 cm. While assessing the infant and providing care, you notice that the infant has momentary decreases in his pulse oxygen reading, which dips down to 82% and fails to increase back to previous levels. The infant has respirations that are steadily ranging between 75-90 bpm.1. What is the pathophysiology behind the infant’s abnormal pulse oxygen reading and increased respirations?2. What other signs and symptoms will you be assessing the infant for related to respiratory distress?3. What is the RN’s role regarding this newborn’s safety and outcome?4. What treatments or interventions should be considered for this infant using evidence-based guidelines?Part 3During your initial assessment, vitals are 92/47 (45), HR 120, RR 75, Temp 99.2F. You obtain initial labs: VBG, glucometer, and hematocrit.VBG:pH 7.23CO2 52O2 62HCO3 25Glucometer: 26Hematocrit: 48%1. Using evidence-based knowledge about newborn lab values, which of these values are abnormal?2. What is your role as a communicator of the lab values to promote the patient-centered care and safety of the newborn?3. Based on your knowledge of macrosomic infants who are infants of diabetic mothers (IDM), what is the pathophysiology related to the infant’s blood sugar finding?4. What is the next intervention to promote the newborn’s safety regarding the infant’s blood sugar of 26?5. What signs will you be assessing the infant for related to symptoms of hypoglycemia based on evidence of hypoglycemic infants?