A breastfednewborn 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.
The Correct Answer is A
Choice A reason:
All milk- and lactose-containing formulas, including breast milk, must be stopped during infancy. Soy protein is the formula of choice for newborns and infants with galactosemia. Breast milk should not be used in newborns and infants with galactosemia because it contains galactose, which they cannot metabolize properly.
Choice B reason:
Adding amino acids to the breast milk will not help the newborn with galactosemia, because the problem is not a lack of amino acids, but a deficiency of the enzyme that breaks down galactose. Amino acids are the building blocks of proteins, not sugars.
Choice C reason:
Substituting a lactose-containing formula for breast milk will worsen the condition of the newborn with galactosemia because lactose is composed of glucose and galactose. The newborns will still be exposed to galactose, which will accumulate in the blood and tissues and cause damage.
Choice D reason:
Giving the appropriate enzyme along with breast milk is not a feasible option for the newborn with galactosemia, because there is no oral enzyme replacement therapy available for this condition. The only treatment is dietary restriction of galactose.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","D","F"]
Explanation
Choice A:
Temperature is not a priority finding to report to the provider. The newborn's temperature may vary slightly depending on the environment and the method of measurement. A 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 important to report to the provider because the newborn had a low Apgar score at 1 minute and required positive pressure ventilation and oxygen. The nurse should assess the newborn's respiratory rate, effort, breath sounds, and oxygen saturation. Any signs of respiratory distress, such as tachypnea, grunting, retractions, nasal flaring, or cyanosis, should be reported immediately.
Choice C:
Serum glucose is a critical finding to report to the provider because the newborn is at risk for hypoglycemia due to the abruptio placenta and the emergency cesarean birth. Hypoglycemia can cause neurological damage and seizures in newborns. A normal serum glucose level for a newborn is 40 to 60 mg/dL.
Choice D:
Hematocrit is a significant finding to report to the provider because the newborn may have polycythemia or anemia due to the abruptio placenta and the blood loss during delivery.
Polycythemia can cause hyperviscosity and thrombosis, while anemia can cause hypoxia and shock. A normal hematocrit level for a newborn is 42% to 65%.
Choice E:
White blood cell count is not a priority finding to report to the provider. The newborn's white blood cell count may be elevated due to the stress of birth or a maternal infection. A normal white blood cell count for a newborn is 9,000 to 30,000/mm3.
Choice F:
Hemoglobin is an important finding to report to the provider because the newborn may have polycythemia or anemia due to the abruptio placenta and the blood loss during delivery.
Hemoglobin is the main component of red blood cells that carries oxygen to the tissues. A normal hemoglobin level for a newborn is 14 to 24 g/dL.
Choice G:
Heart rate is a vital finding to report to the provider because the newborn had a non- reassuring fetal heart rate during labor and delivery. The nurse should monitor the newborn's heart rate and rhythm for any signs of bradycardia, tachycardia, or arrhythmias. A normal heart rate range for a newborn is 110 to 160 beats per minute.
Correct Answer is D
Explanation
Choice A reason:
Fetal heart rate irregularities are not a sign of hydatidiform mole, as this condition involves an abnormal fertilization of the egg that results in an abnormal or absent fetus.
Choice B reason:
A hydatidiform mole is more commonly associated with dark brown to bright red vaginal bleeding, not whitish discharge. The bleeding may resemble prune juice and is often a sign of the abnormality.
Choice C reason:
Rapidly dropping human chorionic gonadotropin (hCG) levels are not a sign of hydatidiform mole, as this condition causes very high levels of hCG due to the proliferation of trophoblastic tissue.
Choice D reason:
In a hydatidiform mole, the uterus often enlarges more rapidly than expected for the gestational age due to the overgrowth of trophoblastic tissue and the accumulation of fluid-filled vesicles. This excessive uterine enlargement is a key sign that could indicate the presence of a molar pregnancy.
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