A nurse is educating the mother of a newborn who was born small for gestational age. Which of the following should the nurse include as a potential cause of this condition?
Perinatal asphyxia.
Preterm delivery.
Fetal hyperinsulinemia.
Placental insufficiency.
The Correct Answer is D
Choice A rationale
Perinatal asphyxia refers to a lack of oxygen flow to the fetus around the time of birth. This can lead to multiple organ dysfunction and neurological issues, but it is not a common cause of a newborn being small for gestational age.
Choice B rationale
Preterm delivery can result in a newborn being small for their gestational age simply because they have not had the full amount of time to grow in the womb. However, preterm babies are typically compared to other preterm babies when assessing size, not to full-term babies.
Choice C rationale
Fetal hyperinsulinemia, or an excess of insulin in the fetus, can lead to excessive growth and a larger-than-average baby size (macrosomia), not a smaller size.
Choice D rationale
Placental insufficiency, where the placenta does not work as well as it should, can limit the amount of oxygen and nutrients the fetus receives. This can restrict the baby’s growth, leading to a small size for gestational age.
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Related Questions
Correct Answer is C
Explanation
Choice A rationale
Neonatal abstinence syndrome is a condition that results from withdrawal from exposure to narcotics. It is not related to the newborn’s weight.
Choice B rationale
While a yellowish skin tone may indicate jaundice, this is not directly related to the newborn’s weight. Jaundice is caused by an excess of bilirubin, a yellow-orange substance in the blood.
Choice C rationale
Newborns with low birth weight are at risk for hypoglycemia because they have less stored glycogen. They may use up their glucose stores quickly and not have enough intake to maintain their blood glucose levels.
Choice D rationale
Neonatal sepsis is a severe infection in an infant less than 28 days old. It is not directly related to the newborn’s weight but can be associated with maternal infection.
Correct Answer is B
Explanation
Choice A rationale
While it is true that preterm newborns have a smaller body surface area than full-term newborns, this is not the primary reason for using an incubator. A smaller body surface area can contribute to heat loss, but the main issue is the lack of adequate temperature control mechanisms.
Choice B rationale
Preterm newborns lack the adequate temperature control mechanisms that full-term newborns have. They have less subcutaneous fat to insulate them and a higher surface area to volume ratio, which increases heat loss. They also lack the ability to shiver to generate heat.
Therefore, an incubator is used to maintain a neutral thermal environment.
Choice C rationale
The heat in the incubator does not rapidly dry the sweat of preterm newborns. In fact, preterm newborns do not sweat as efficiently as full-term newborns or adults, so they are less likely to lose heat through sweating.
Choice D rationale
The statement that the added brown fat layer in preterm newborn reduces his ability to generate heat is incorrect. In fact, preterm newborns have less brown fat than full-term newborns. Brown fat is a type of fat that generates heat when metabolized, and it is an important source of heat for newborns.
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