In a term infant with membranes ruptured for 26 hours, the infant has been breastfeeding well and is preparing to room in. On day of life 3, the RN’s assessment shows a weak central pulse, HR 200, RR 85. The RN can anticipate which of the following orders?

In a term infant with membranes ruptured for 26 hours, the infant has been breastfeeding well and is preparing to room in. On day of life 3, the RN’s assessment shows a weak central pulse, HR 200, RR 85. The RN can anticipate which of the following orders?

• A. CBC with diff, C-reactive protein, and blood culture
• B. Chest X-ray, ABG, and troponin
• C. Serum electrolytes, liver enzymes, and amylase
• D. Urinalysis and culture only

Answer: (A)

Recognizing neonatal sepsis risk factors and performing the appropriate sepsis workup is being assessed. Prolonged rupture of membranes increases neonatal exposure to bacteria such as GBS, raising sepsis risk in a newborn. When a term infant shows signs suggestive of sepsis—tachycardia with a weak perfusion pulse and elevated respiratory rate on day 3—a lab-based evaluation is essential rather than imaging or isolated tests. A CBC with differential helps detect infection through white blood cell counts and left shift; C-reactive protein reflects inflammation; and blood culture confirms the causative organism to guide therapy. Taken together, these tests provide essential evidence of infection and steer timely treatment. Other options miss the systemic infection assessment needed in suspected neonatal sepsis.

Recognizing neonatal sepsis risk factors and performing the appropriate sepsis workup is being assessed. Prolonged rupture of membranes increases neonatal exposure to bacteria such as GBS, raising sepsis risk in a newborn. When a term infant shows signs suggestive of sepsis—tachycardia with a weak perfusion pulse and elevated respiratory rate on day 3—a lab-based evaluation is essential rather than imaging or isolated tests. A CBC with differential helps detect infection through white blood cell counts and left shift; C-reactive protein reflects inflammation; and blood culture confirms the causative organism to guide therapy. Taken together, these tests provide essential evidence of infection and steer timely treatment. Other options miss the systemic infection assessment needed in suspected neonatal sepsis.