Editing Maternal and Newborn Nursing – RN Practice Questions (section)

==Question 13==
A nurse assesses a 12-hour-old newborn and finds a firm, unilateral swelling over the right parietal bone that does not cross the sagittal suture and was not present at birth. Which nursing action is most appropriate?
# Document the caput succedaneum and reassure the parents it will resolve in a few days.
# Monitor the infant for hyperbilirubinemia and report the finding to the provider.
# Apply gentle pressure to the area to reduce the swelling.
# Prepare the infant for immediate cranial imaging.

'''Answer:''' 2 (B). Monitor the infant for hyperbilirubinemia and report the finding to the provider.

''Rationale:'' Swelling that does not cross suture lines and appears after birth is a '''cephalhematoma''', a subperiosteal collection of blood bounded by the periosteum of a single cranial bone. As the trapped red cells break down they release a bilirubin load that an immature liver may not conjugate fast enough, so these infants need bilirubin surveillance, and resolution takes weeks to months. Option 1 describes '''caput succedaneum''', which is soft scalp edema, is present at birth, ''does'' cross suture lines, and resolves in days. Option 3 could cause further bleeding and tissue injury. Option 4 is not routinely indicated for an uncomplicated cephalhematoma in an otherwise well infant.