A nurse is providing teaching to the guardians of a preterm newborn about temperature instability. Which of the following statements should the nurse make?

Preterm newborns might have a thick layer of brown fat that can cause them to quickly become overheated.

Preterm newborns might shiver to warm up when they get too cool.

Preterm newborns might sweat to cool off when they get too warm.

Preterm newborns might have less muscle tone which exposes more body surfaces to heat loss.

Answer and Explanation

The Correct Answer is D

Choice A rationale
Preterm newborns do not have a thick layer of brown fat. Brown fat is a type of fat that generates heat and is typically found in full-term newborns. It helps them maintain their body temperature. Preterm newborns have less brown fat, which makes them more susceptible to hypothermia.
Choice B rationale
Shivering is a mechanism used by the body to generate heat when it’s cold. However, preterm newborns cannot shiver. Their nervous systems are not fully developed, and they lack the muscle coordination necessary to shiver.
Choice C rationale
Sweating is another mechanism the body uses to regulate temperature. When the body is too warm, it produces sweat to cool down. However, preterm newborns do not sweat to cool off when they get too warm. Their sweat glands are not fully developed, and they may not be able to sweat effectively.
Choice D rationale
Preterm newborns have less muscle tone, which exposes more body surfaces to heat loss. Muscle tone provides insulation and generates heat. Because preterm newborns have less muscle mass, they have less insulation and generate less heat, making them more susceptible to hypothermia.

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Correct Answer is B

Explanation

Choice A rationale
A WBC count of 11,000/mm is slightly above the normal range (5,000 to 10,000/mm), but it is not uncommon for the WBC count to increase during pregnancy due to physiological changes and increased stress on the body. However, a significantly elevated WBC count could indicate an infection or other medical condition, so it should be monitored closely.
Choice B rationale
A fasting blood glucose level of 180 mg/dL is significantly above the normal range (74 to 106 mg/dL), indicating hyperglycemia. This could be a sign of gestational diabetes, a condition that can develop during pregnancy and cause high blood sugar levels. Gestational diabetes can increase the risk of various pregnancy complications, including preeclampsia, premature birth, and having a baby with a high birth weight. Therefore, this finding should be reported to the provider immediately.
Choice C rationale
A hematocrit level of 37% is within the normal range (37% to 47%), so it would not typically be a cause for concern.
Choice D rationale
A creatinine level of 0.9 mg/dL is within the normal range (0.5 to 1 mg/dL), so it would not typically be a cause for concern.

A. The Plastibell will be removed 4 hours after the procedure. B. Yellow exudate will form at the surgical site in 24 hours. C. Notify the provider if the end of your baby’s penis appears dark red. D. Ensure the newborn’s diaper is snug.

Correct Answer is B

Explanation

Choice A rationale
The Plastibell is not removed 4 hours after the procedure. Instead, it remains on the penis until the foreskin falls off naturally in seven to 10 days.
Choice B rationale
Yellow exudate, which is a normal part of the healing process, will form at the surgical site within 24 hours after a Plastibell circumcision. Parents should be reassured that this is not a sign of infection.
Choice C rationale
The end of the baby’s penis may appear dark red immediately after the procedure, but this should improve within a few days. If the redness persists or worsens, parents should notify the provider.
Choice D rationale
Ensuring that the newborn’s diaper is snug is not specific to the Plastibell circumcision technique. While a snug diaper can help prevent leaks, it should not be so tight as to cause discomfort or restrict circulation.

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A nurse is providing teaching to the guardians of a preterm newborn about temperature instability. Which of the following statements should the nurse make?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

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