A nurse is caring for a newborn who has macrosomia and whose mother has diabetes mellitus. The nurse should recognize which of the following newborn complications as the priority focus of care?

Hypocalcemia

Hyperbilirubinemia

Hypomagnesemia

Hypoglycemia

Answer and Explanation

The Correct Answer is D

Choice A reason: Hypocalcemia is not the priority focus of care, as it is a low level of calcium in the blood that can cause muscle twitching, seizures, or cardiac arrhythmias. Hypocalcemia can affect newborns who have mothers with diabetes mellitus, but it is less common and less severe than hypoglycemia.

Choice B reason: Hyperbilirubinemia is not the priority focus of care, as it is a high level of bilirubin in the blood that can cause jaundice, a yellowish discoloration of the skin and eyes. Hyperbilirubinemia can affect newborns who have macrosomia, but it is usually a benign and self-limiting condition that resolves within a few days.

Choice C reason: Hypomagnesemia is not the priority focus of care, as it is a low level of magnesium in the blood that can cause tremors, tetany, or seizures. Hypomagnesemia can affect newborns who have mothers with diabetes mellitus, but it is rare and usually asymptomatic.

Choice D reason: Hypoglycemia is the priority focus of care, as it is a low level of glucose in the blood that can cause diaphoresis, jitteriness, lethargy, or apnea. Hypoglycemia can affect newborns who have macrosomia and mothers with diabetes mellitus, as they have increased insulin production and decreased glucose supply after birth. Hypoglycemia can lead to brain damage or death if not treated promptly.

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Correct Answer is D

Explanation

Choice A reason: Using fingertips when calming the newborn is not recommended, as it can overstimulate the immature nervous system and cause stress. Instead, the nurse should use gentle, firm, and sustained touch, such as cupping the head and feet, or swaddling the newborn.

Choice B reason: Positioning the premature infant on their abdomen is contraindicated, as it can increase the risk of sudden infant death syndrome (SIDS). The nurse should position the newborn on their back or side, with a rolled blanket or towel to support the spine and prevent flattening of the head.

Choice C reason: Keeping the newborn in a well-lit nursery is not advisable, as it can interfere with the development of the circadian rhythm and sleep patterns. The nurse should provide a dark and quiet environment for the newborn, and expose them to natural light during the day.

Choice D reason: Clustering the newborn's care activities is beneficial, as it can reduce the number of disruptions and allow for longer periods of rest and growth. The nurse should plan and coordinate the care activities, such as feeding, bathing, changing, and assessing, to minimize the stress on the newborn.

A. To stay with the client and call for help B. To suction the mouth to prevent aspiration C. To administer oxygen by mask D. To insert an oral airway

Correct Answer is A

Explanation

Choice A reason: To stay with the client and call for help is the highest priority during a seizure, because it ensures the safety of the client and the fetus, and allows the nurse to monitor the vital signs and fetal heart rate. The nurse should also protect the client from injury and turn the client to the side to prevent aspiration.

Choice B reason: To suction the mouth to prevent aspiration is not the highest priority during a seizure, because it can cause more harm than good. Suctioning can stimulate the gag reflex and increase the risk of vomiting and aspiration. It can also injure the oral mucosa and trigger another seizure.

Choice C reason: To administer oxygen by mask is not the highest priority during a seizure, because it may not be effective or necessary. Oxygen administration can be difficult or impossible during a seizure, and it may not improve the oxygen saturation or fetal outcome. Oxygen should only be given if hypoxia is confirmed by pulse oximetry or arterial blood gas analysis.

Choice D reason: To insert an oral airway is not the highest priority during a seizure, because it can be dangerous and contraindicated. Inserting an oral airway can damage the teeth and tongue, and increase the risk of vomiting and aspiration. It can also provoke another seizure or laryngospasm. An oral airway should only be used if the client is unconscious and has no gag reflex.

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A nurse is caring for a newborn who has macrosomia and whose mother has diabetes mellitus. The nurse should recognize which of the following newborn complications as the priority focus of care?

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