A nurse is assisting with the care of a newborn 1 hr after birth.

Select the 5 findings that the nurse should report to the provider.

Choice A:

Two arteries and two veins. This is incorrect because the umbilical cord normally has only three blood vessels: one vein and two arteries. Having four blood vessels is a rare anomaly that can be associated with congenital defects. •

Choice B:

Two veins and one artery. This is incorrect because the umbilical cord normally has only one vein and two arteries. Having two veins and one artery is another rare anomaly that can also be associated with congenital defects. •

Choice C:

One artery and one vein. This is incorrect because the umbilical cord normally has two arteries and one vein. Having only one artery and one vein is a common anomaly that occurs in about 1% of singleton pregnancies and 5% of twin pregnancies. It can be associated with intrauterine growth restriction, congenital anomalies, and perinatal mortality. •

Choice D:

Two arteries and one vein. This is correct because the umbilical cord normally has two arteries and one vein. The vein carries oxygenated blood from the placenta to the fetus, while the arteries carry deoxygenated blood from the fetus to the placenta. The umbilical cord also contains Wharton's jelly, which is a gelatinous substance that protects the blood vessels from compression.

Choice A reason:

This statement is incorrect because special lights are used to treat jaundice, not PKU. Jaundice is a condition that causes yellowing of the skin and eyes due to high levels of bilirubin in the blood. Bilirubin is a waste product that is normally removed by the liver. Special lights help break down bilirubin so that it can be excreted from the body.

Choice B reason:

This statement is correct because PKU is a genetic disorder that can be corrected by diet. PKU is caused by a lack of an enzyme that breaks down phenylalanine, an amino acid found in protein-rich foods. Phenylalanine can build up in the blood and cause brain damage and other health problems if not treated. A diet that is low in phenylalanine and high in a special formula can prevent these complications.

Choice C reason:

This statement is correct because sometimes the test is repeated in the doctor's office at the 2-week check-up. The PKU test is done one to three days after birth, but it may not be accurate if the baby has not had enough protein in their diet before the test. A repeat test may be needed to confirm or rule out PKU.

Choice D reason:

This statement is incorrect because the baby must take formula or breast milk after the test is done, not before. The test measures the level of phenylalanine in the blood, which will be higher if the baby has eaten protein-rich foods. The test should be done after the baby has fasted for at least two hours.