A nurse is assisting in the care of a newborn who is 72 hours old and is receiving treatment for neonatal abstinence syndrome.

Exhibits

Which of the following data collection findings should the nurse identify as requiring immediate follow-up? (Select all that apply.).

Choice A reason:

Hypertonic is not a type of cerebral palsy, but a term that describes increased muscle tone or stiffness. Hypertonicity can be a symptom of spastic cerebral palsy, which is the most common type of the disorder.

Choice B reason:

Spastic is a type of cerebral palsy that affects about 80% of people with the disorder. People with spastic cerebral palsy have stiff and jerky movements due to increased muscle tone.

Spastic cerebral palsy can be further classified by the body parts affected, such as spastic hemiplegia, spastic diplegia or spastic quadriplegia.

Choice C reason:

Hypotonic is a type of cerebral palsy that affects muscle tone and posture. People with hypotonic cerebral palsy have low muscle tone or floppiness, which makes them appear limp and relaxed. Hypotonic cerebral palsy can affect the whole body or specific parts, such as the trunk, limbs or face.

Choice D reason:

Ataxic is a type of cerebral palsy that affects balance and coordination. People with ataxic cerebral palsy have difficulty with precise movements, such as writing, buttoning a shirt or reaching for a book. They may also walk in an unsteady manner or have problems with depth perception.

Choice E reason:

Mixed is a type of cerebral palsy that includes symptoms of more than one type of the disorder. For example, a person with mixed cerebral palsy may have both spastic and dyskinetic movements, or both ataxic and hypotonic features. Mixed cerebral palsy is usually caused by damage to multiple areas of the brain.

Choice A reason:

Obesity is not a common complication of phenylketonuria (PKU), a genetic disorder that causes increased levels of phenylalanine (an amino acid) in the body. Obesity may be related to other endocrine disorders, such as hypothyroidism or Cushing syndrome.

Choice B reason:

Diabetes insipidus is a condition that causes excessive thirst and urination due to a lack of antidiuretic hormone (ADH) or a problem with the kidneys' response to ADH. It is not caused by PKU, which affects the metabolism of phenylalanine.

Choice C reason:

Respiratory distress is not a typical symptom of PKU, although some newborns with PKU may have a musty odor in their breath, skin, or urine due to the buildup of phenylalanine.

Respiratory distress may be caused by other conditions, such as asthma, pneumonia, or congenital heart defects.

Choice D reason:

Cognitive impairment is the most serious complication of PKU if it is not diagnosed and treated early. High levels of phenylalanine can damage the brain and cause irreversible intellectual disability, neurological problems, and behavioral issues. Early intervention with a special diet that limits phenylalanine intake can prevent or reduce cognitive impairment in children with PKU.