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A nursery nurse is attending the birth of a post-term infant.

Exhibits
Upon review of the medical record, the infant newborn is at risk for developing which of the following symptoms? Select all that apply

A.

Meconium aspiration syndrome

B.

macrosomia

C.

intraventricular hemorrhage

D.

bronchopulmonary dysplasia

Answer and Explanation

Correct Answer : A,B

Rationale for Correct Choices

• Meconium aspiration syndrome: The presence of thick green amniotic fluid indicates meconium-stained fluid, which the post-term infant may aspirate during delivery. Meconium aspiration can obstruct the airways, cause chemical pneumonitis, and lead to respiratory distress requiring immediate intervention and supportive care.

• Macrosomia: Post-term infants are at increased risk of macrosomia due to prolonged gestation and continued growth in utero. Macrosomic infants face complications such as difficult labor, shoulder dystocia, and birth injuries, necessitating careful monitoring and potential interventions during delivery.

Rationale for Incorrect Choices

• Intraventricular hemorrhage: This condition is primarily associated with preterm infants due to fragile germinal matrix vasculature. The post-term infant in this scenario is less likely to develop intraventricular hemorrhage.

• Bronchopulmonary dysplasia: Chronic lung disease usually develops in preterm infants who have required prolonged mechanical ventilation or oxygen therapy. The term post-term infant is not at high risk for this condition immediately after birth.


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Related Questions

Correct Answer is D

Explanation

Rationale:
A. "Supplement breastfeedings with water every 12 hours.": Breastfed infants do not require water supplementation because breast milk provides adequate hydration. Giving water can reduce milk intake, interfere with nutrition, and increase the risk of electrolyte imbalance.

B. "Limit the time your infant feeds to 10 minutes on each breast.": Feeding duration should be guided by the infant’s cues rather than a strict time limit. Limiting feeds can prevent the infant from receiving the hindmilk, which is richer in fat and essential for growth.

C. "Begin each feeding using the same breast.": Alternating the starting breast for each feeding helps ensure equal stimulation and milk production in both breasts. Starting with the same breast consistently may lead to uneven milk supply.

D. "Offer your infant the breast when he shows signs of hunger.": Responsive, cue-based feeding supports adequate nutrition, growth, and bonding. Feeding on demand—such as rooting, sucking on hands, or fussiness—helps establish and maintain milk supply and meets the infant’s needs effectively.

Correct Answer is D

Explanation

Rationale:
A. Temperature 37.9° C (100.2° F): A mild temperature elevation is common in sickle cell crises due to inflammation or infection, but it does not independently indicate acute chest syndrome. It should be monitored but does not require immediate reporting unless it progresses or is accompanied by respiratory distress.

B. Sneezing: Sneezing is a nonspecific symptom often related to upper respiratory irritation or allergies. It does not signify acute chest syndrome or lower airway involvement and is not an immediate concern in this context.

C. Hematuria: Blood in the urine can occur from sickling in the renal vasculature but is not related to acute chest syndrome. While it requires evaluation, it does not pose an immediate respiratory threat.

D. Substernal retractions: Substernal retractions indicate increased work of breathing and respiratory distress, which are hallmark signs of acute chest syndrome. This complication involves pulmonary infarction or infection leading to hypoxia, and prompt provider notification is essential to prevent respiratory failure.

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