An infant of a Diabetic Mother (IDM) has a blood glucose of 60 upon admission to the well-baby nursery. Which of the following is an appropriate nursing action?
Select one:

Prepare for IV dextrose administration.

Provide routine care, per hospital IDM protocol.

Place the infant in a warmed incubator.

Alert the clinician immediately for orders.

Answer and Explanation

The Correct Answer is B

Choice A Reason: Prepare for IV dextrose administration. This is an incorrect answer that indicates an unnecessary and invasive intervention for an IDM with normal blood glucose. IV dextrose administration is indicated for an IDM with severe or persistent hypoglycemia, which is defined as a blood glucose below 40 mg/dL or below 60 mg/dL after two feedings.

Choice B Reason: Provide routine care, per hospital IDM protocol. This is because a blood glucose of 60 is within the normal range for an IDM, which is 40 to 80 mg/dL. An IDM is a newborn whose mother has pre-existing or gestational diabetes, which can aﬀect the fetal and neonatal glucose metabolism and regulation. An IDM may have hypoglycemia (low blood glucose), hyperglycemia (high blood glucose), or other complications such as macrosomia, polycythemia, or congenital anomalies. An IDM requires routine care and monitoring according to the hospital IDM protocol, which may include blood glucose testing, feeding, temperature regulation, and observation for signs of distress.

Choice C Reason: Place the infant in a warmed incubator. This is an incorrect answer that suggests an irrelevant and potentially harmful action for an IDM with normal blood glucose. Placing the infant in a warmed incubator is indicated for an IDM with hypothermia, which is a low body temperature that can impair glucose utilization and increase oxygen consumption. However, placing the infant in a warmed incubator without proper indication can cause hyperthermia, which is a high body temperature that can lead to dehydration, electrolyte imbalance, or brain damage.

Choice D Reason: Alert the clinician immediately for orders. This is an incorrect answer that implies an urgent and unwarranted situation for an IDM with normal blood glucose. Alerting the clinician immediately for orders is indicated for an IDM with signs of distress or complications, such as apnea, cyanosis, seizures, or jaundice.

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Correct Answer is B

Explanation

Choice A Reason: Physiologic anemia due to maternal increased plasma volume. This is an incorrect answer that refers to a diﬀerent condition that aﬀects hemoglobin levels, not blood pressure. Physiologic anemia is a condition where the maternal plasma volume increases more than the red blood cell mass during pregnancy, which dilutes the hemoglobin concentration and lowers the hematocrit value. Physiologic anemia does not cause significant symptoms or complications in pregnant women, as it is an adaptive mechanism that enhances oxygen delivery and prevents ﬂuid overload.

Choice B Reason: Pressure of the gravid uterus on the maternal inferior vena cava and aorta. This is because this statement explains the cause of supine hypotensive syndrome, which is a condition where lying ﬂat on the back causes compression of the major blood vessels by the gravid uterus, which reduces venous return and cardiac output, which lowers blood pressure and perfusion to vital organs. Supine hypotensive syndrome can cause symptoms such as dizziness, lightheadedness, nausea, pallor, or syncope in pregnant women, especially in the third trimester.

Choice C Reason: Pressure of the presenting fetal part on the maternal diaphragm. This is an incorrect answer that indicates a diﬀerent condition that aﬀects respiratory function, not blood pressure. Pressure of the presenting fetal part on the maternal diaphragm is a result of cephalic engagement or lightening, which occurs when the fetal head descends into the pelvis and occupies more space in the abdominal cavity. Pressure of the presenting fetal part on the maternal diaphragm can cause symptoms such as dyspnea, heartburn, or rib pain in pregnant women.

Choice D Reason: A 50% increase in maternal blood volume during pregnancy. This is an incorrect answer that describes a normal physiological change that occurs during pregnancy, not a cause of supine hypotensive syndrome. A 50% increase in maternal blood volume during pregnancy is due to increased production of plasma and red blood cells, which helps meet the increased oxygen and nutrient demands of the fetus and placenta, and prepares the mother for blood loss during delivery. A 50% increase in maternal blood volume during pregnancy does not cause hypotension or dizziness in pregnant women.

A. "It's okay to want a small baby when you're a teen." B. "You shouldn't be worrying about your figure." C. "Your baby needs adequate nutrition to develop and to be healthy." D. "You are causing harm to your baby."

Correct Answer is C

Explanation

Choice A Reason: "It's okay to want a small baby when you're a teen." This is an incorrect answer that validates the patient's misconception and reinforces her unhealthy behavior. It also implies that there is something wrong with having a normal-sized baby or being a teen mother.

Choice B Reason: "You shouldn't be worrying about your figure." This is an incorrect answer that dismisses the patient's feelings and concerns and may make her defensive or resistant to change. It also does not address the underlying issues or provide any guidance or support.

Choice C Reason: ""Your baby needs adequate nutrition to develop and to be healthy." This is because this response provides factual information and education to the patient about the importance of nutrition during pregnancy. It also conveys empathy and concern for both the mother and the baby without being judgmental or accusatory.

Choice D Reason: "You are causing harm to your baby." This is an incorrect answer that blames and criticizes the patient and may make her feel guilty or ashamed. It also does not oﬀer any help or solutions for her situation.

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An infant of a Diabetic Mother (IDM) has a blood glucose of 60 upon admission to the well-baby nursery. Which of the following is an appropriate nursing action? Select one:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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An infant of a Diabetic Mother (IDM) has a blood glucose of 60 upon admission to the well-baby nursery. Which of the following is an appropriate nursing action?
Select one: