When observing a drug-exposed newborn, what symptom suggests that the newborn may be exhibiting withdrawal symptoms?

Choice A reason:

Scant scalp hair is not an expected finding for a newborn who is post-term. Scant scalp hair is more common in preterm infants who have not developed fully.

Choice B reason:

Copious vernix is not an expected finding for a newborn who is post-term. Vernix is a white, cheesy substance that covers the skin of the fetus and protects it from the amniotic fluid. Vernix is usually abundant in preterm infants and decreases as gestation progresses.

Choice C reason:

Increased subcutaneous fat is not an expected finding for a newborn who is post-term. Increased subcutaneous fat is a sign of adequate nutrition and growth, which is more likely in term infants. Post-term infants may have reduced subcutaneous fat due to placental insufficiency and decreased nutrient supply.

Choice D reason:

Dry, cracked skin is an expected finding for a newborn who is post-term. Dry, cracked skin is a result of prolonged exposure to the amniotic fluid, which causes dehydration and desquamation of the skin. Post-term infants may also have meconium staining on their skin due to fetal distress.

Choice A reason:

Protamine sulfate is an antidote for heparin overdose, not magnesium sulfate toxicity.

Choice B reason:

Naloxone is an antidote for opioid overdose, not magnesium sulfate toxicity.

Choice C reason:

Flumazenil is an antidote for benzodiazepine overdose, not magnesium sulfate toxicity.

Choice D reason:

Calcium gluconate is the antidote for magnesium sulfate toxicity. Magnesium sulfate is used to treat preeclampsia and prevent seizures, but it can cause respiratory depression, hypotension, and cardiac arrhythmias if given in excess. Calcium gluconate reverses the effects of magnesium by stabilizing the cell membrane and increasing the contractility of the heart.