A breastfed newborn has just been diagnosed with galactosemia. The therapeutic management for this newborn is to:

Stop breastfeeding

Add amino acids to the breast milk

Substitute a lactose-containing formula for breast milk

Give the appropriate enzyme along with breast milk.

Answer and Explanation

The Correct Answer is A

Choice A reason:

Stop breastfeeding. This is the correct answer because newborns and infants with galactosemia cannot metabolize galactose, a sugar found in milk and lactose-containing formulas, including breast milk. Galactose can build up in their blood and cause serious complications such as liver damage, cataracts, brain damage, and even death. Therefore, the therapeutic management for this newborn is to stop breastfeeding and switch to a soy or elemental formula that contains no galactose.

Choice B reason:

Add amino acids to the breast milk. This is incorrect because adding amino acids to breast milk will not prevent the accumulation of galactose in the newborn's blood. Amino acids are the building blocks of proteins, not sugars. Adding amino acids to breast milk will not change its galactose content or help the newborn metabolize it.

Choice C reason:

Substitute a lactose-containing formula for breast milk. This is incorrect because lactose is a disaccharide composed of glucose and galactose. Lactose-containing formulas will also expose the newborn to galactose, which they cannot break down. Lactose-containing formulas should be avoided in newborns and infants with galactosemia.

Choice D reason:

Give the appropriate enzyme along with breast milk. This is incorrect because there is no enzyme therapy available for galactosemia. Galactosemia is caused by a genetic defect in one of the enzymes involved in the breakdown of galactose, such as galactose-1-phosphate uridyltransferase (GALT), galactokinase (GALK), or uridine diphosphate galactose-4-epimerase (GALE). Giving an enzyme along with breast milk will not correct this defect or prevent the harmful effects of galactose accumulation.

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Correct Answer is A

Explanation

Choice A reason:

Hypoglycemia is a common complication for newborns whose mothers have diabetes mellitus. This is because the newborn's pancreas produces excessive insulin in response to the high glucose levels in the mother's blood during pregnancy. After birth, the newborn's glucose levels drop rapidly, while the insulin levels remain high, resulting in hypoglycemia. The nurse should monitor the newborn's blood glucose levels and signs of hypoglycemia, such as jitteriness, lethargy, poor feeding, and temperature instability.

Choice B reason:

Decreased RBC is not a likely complication for newborns whose mothers have diabetes mellitus. In fact, these newborns may have increased RBC due to chronic fetal hypoxia caused by placental insufficiency. The nurse should monitor the newborn's hematocrit and signs of polycythemia, such as ruddy skin, jaundice, and respiratory distress.

Choice C reason:

Hyperbilirubinemia is not a likely complication for newborns whose mothers have diabetes mellitus. In fact, these newborns may have increased bilirubin levels due to hemolysis of excess RBC and delayed hepatic clearance. The nurse should monitor the newborn's serum bilirubin levels and signs of jaundice, such as yellow skin and sclera, poor feeding, and lethargy.

Choice D reason:

Hypercalcemia is not a likely complication for newborns whose mothers have diabetes mellitus. In fact, these newborns may have hypocalcemia due to decreased parathyroid hormone secretion and increased calcium binding to albumin. The nurse should monitor the newborn's serum calcium levels and signs of hypocalcemia, such as jitteriness, tremors, seizures, and cardiac arrhythmias.

A. Temperature B. Respiratory findings C. Serum glucose D. Hematocrit E. White blood cell count F. Hemoglobin G. Heart rate

Correct Answer is ["C","D","F"]

Explanation

Choice A:

Temperature is not a finding that needs to be reported to the provider unless it is abnormally high or low. The normal temperature range for a newborn is 36.5°C to 37.5°C (97.7°F to 99.5°F).

Choice B:

Respiratory findings are not a finding that needs to be reported to the provider unless they indicate respiratory distress or infection. The normal respiratory rate for a newborn is 30 to 60 breaths per minute.

Choice C:

Serum glucose is a finding that needs to be reported to the provider, as it is higher than the normal range for a newborn. The normal serum glucose level for a newborn is usually just under 2 mmol/L (or 25 mg/dL) at birth, and it will rise to over 3 mmol/L (or 60 to 100 mg/dL) within two to three days. A serum glucose level of 130 mg/dL indicates hyperglycemia, which can have various causes and complications.

Choice D:

Hematocrit is a finding that needs to be reported to the provider, as it is lower than the normal range for a newborn. The normal hematocrit level for a newborn is 44% to 64%. A hematocrit level of 35% indicates anemia, which can have various causes and complications.

Choice E:

White blood cell count is not a finding that needs to be reported to the provider, as it is within the normal range for a newborn. The normal white blood cell count for a newborn is 9,000 to 30,000/mm³.

Choice F:

Hemoglobin is a finding that needs to be reported to the provider, as it is lower than the normal range for a newborn. The normal hemoglobin level for a newborn is 14 to 24 g/dL. A hemoglobin level of 9 g/dL indicates anemia, which can have various causes and complications.

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A breastfed newborn has just been diagnosed with galactosemia. The therapeutic management for this newborn is to:

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is ["C","D","F"]

Explanation

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