A nurse is reviewing the laboratory results of a newborn with macrosomia who has polycythemia.

Which of the following findings should the nurse expect?

“I should expect to have a cesarean section because vaginal delivery is too risky.” This statement indicates a need for further teaching because it is not true that all women with diabetes mellitus and macrosomia need to have a cesarean section.

The mode of delivery depends on several factors, such as the estimated fetal weight, the maternal pelvic size, the fetal position, and the presence of any complications.

The nurse should explain to the client that vaginal delivery may be possible if the conditions are favorable and the risks are low.

Choice A is wrong because it is a correct statement.

Women with diabetes mellitus should monitor their blood glucose levels closely and follow their prescribed diet to prevent hyperglycemia and fetal macrosomia.

Choice B is wrong because it is also a correct statement.

Women with diabetes mellitus and macrosomia should have regular prenatal visits and ultrasounds to monitor their baby’s growth and well-being.

Choice D is wrong because it is another correct statement.

Women with diabetes mellitus and macrosomia should be aware of the signs of hypoglycemia in their baby after birth, such as jitteriness, lethargy, poor feeding, and low temperature.

The baby may need glucose supplementation or intravenous fluids to maintain normal blood glucose levels.

Normal ranges:

• Blood glucose levels: 70-110 mg/dL (3.9-6.1 mmol/L) for fasting; <140 mg/dL (<7.8 mmol/L) for postprandial

• Estimated fetal weight: 2500-4000 g (5.5-8.8 lb) for term

A hematocrit of 75% indicates polycythemia, which is a condition of having too many red blood cells.Polycythemia is a common complication of macrosomia, which is a condition of having a birth weight of more than 8 pounds, 13 ounces.Polycythemia can cause problems such as jaundice, seizures, and organ dysfunction.

Choice B is wrong because a hemoglobin of 12 g/dL is within the normal range for a newborn, which is 14 to 24 g/dL.

Choice C is wrong because a platelet count of 150,000/mm3 is within the normal range for a newborn, which is 150,000 to 450,000/mm3.

Choice D is wrong because a white blood cell count of 9,000/mm3 is within the normal range for a newborn, which is 9,000 to 30,000/mm3.