Which of the following complications should a nurse monitor the newborn for following delivery of a client who is at 35 weeks of gestation and has preterm premature rupture of membranes?

Choice A reason: Polycythemia, an excess of red blood cells, is associated with conditions like chronic hypoxia or twin-to-twin transfusion, not preterm premature rupture of membranes (PPROM). PPROM increases infection risk, not hematocrit levels. Neonatal physiology in PPROM is more likely to involve inflammatory responses than erythrocytosis, making polycythemia an unlikely complication in this context. Choice B reason: Fractured clavicle typically occurs during difficult vaginal deliveries, particularly with shoulder dystocia, not PPROM. PPROM predisposes to infection due to prolonged amniotic fluid exposure, not mechanical trauma. The newborn’s skeletal system faces no increased fracture risk from PPROM, as it is unrelated to delivery mechanics or bone integrity. Choice C reason: Meconium aspiration occurs when a newborn inhales meconium-stained amniotic fluid, typically in term or post-term infants under stress. PPROM at 35 weeks increases infection risk, not meconium passage, as preterm infants rarely produce meconium. The complication is unrelated to PPROM’s primary pathophysiological concern of infection due to membrane rupture. Choice D reason: Sepsis is a significant risk in PPROM, as ruptured membranes allow bacterial ascent from the vagina, leading to intra-amniotic infection. Preterm newborns have immature immune systems, increasing susceptibility to pathogens like group B streptococcus. Monitoring for sepsis is critical, as it can cause systemic inflammation, organ dysfunction, and high mortality if untreated.