Review Introduction

Newborn Complications > Maternal & Newborn

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Total Questions : 5

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Question 1:

A nurse is caring for a newborn who exhibits signs of hypotonicity, weak reflexes, and a weak cry.

A. Hypoglycemia B. Hyperbilirubinemia C. Preterm birth D. Macrosomia

Answer and Explanation

Choice A:

Hypoglycemia is a condition where the blood glucose level is too low, which can affect the brain and nervous system function. Hypoglycemia can cause symptoms such as hypotonia (low muscle tone), weak reflexes, and a weak cry in newborns. These symptoms are due to the lack of energy supply to the muscles and nerves.

Choice B:

Hyperbilirubinemia is wrong because it is a condition where the blood level of bilirubin, a waste product from red blood cell breakdown, is too high. Hyperbilirubinemia can cause jaundice (yellowing of the skin and eyes), but not hypotonia, weak reflexes, or a weak cry.

Choice C:

Preterm birth is wrong because it is a condition where the baby is born before 37 weeks of gestation. Preterm birth can cause many complications, such as respiratory distress, bleeding in the brain, and infection, but not hypotonia, weak reflexes, or a weak cry.

Choice D:

Macrosomia is wrong because it is a condition where the baby is larger than average at birth, usually weighing more than 4 kg (8 lb 13 oz). Macrosomia can cause problems during delivery, such as shoulder dystocia, birth injury, and low blood sugar, but not hypotonia, weak reflexes, or a weak cry.

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Question 2:

A nurse is assessing a newborn who appears wasted, with peely, cracked, and leathery skin.

This presentation is consistent with:.

A. Preterm birth B. Macrosomia C. Hyperbilirubinemia D. Post-term birth

Answer and Explanation

Choice A:

Preterm birth is associated with low birth weight, immature skin, and lanugo (fine hair) on the body.

Choice B:

Macrosomia is a condition where the newborn is significantly larger than average, usually due to maternal diabetes or obesity.

Choice C:

Hyperbilirubinemia is a condition where the newborn has high levels of bilirubin in the blood, causing jaundice (yellowing of the skin and eyes).

Choice D:

This presentation is consistent with a newborn who has been in the womb for longer than 42 weeks. Post-term newborns often have dry, peeling, loose skin and may appear abnormally thin. They may also have overgrown nails and large amount of hair on the head

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Question 3:

A nurse is caring for a newborn with elevated serum bilirubin levels and jaundice.

The nurse suspects that the newborn is experiencing:.

A. Physiologic jaundice B. Pathologic jaundice C. Hypoglycemia D. Preterm birth.

Answer and Explanation

Choice A:

Physiologic jaundice is a normal and common condition that occurs in most newborns due to the immaturity of their liver and the high turnover of red blood cells. Physiologic jaundice usually appears between the second and fourth day after birth and resolves within one to two weeks without treatment.

Choice B:

Pathologic jaundice is a type of jaundice that occurs due to an underlying health problem, such as blood group incompatibility, infection, liver disease, or enzyme deficiency. Pathologic jaundice usually appears within the first 24 hours of life and can cause severe complications if not treated promptly.

Choice C:

Hypoglycemia is a low blood sugar level that can cause symptoms such as jitteriness, poor feeding, lethargy, and seizures in newborns. Hypoglycemia is not directly related to bilirubin levels or jaundice, although some conditions that cause hypoglycemia, such as prematurity or infection, can also increase the risk of jaundice.

Choice D:

Preterm birth is a risk factor for jaundice, not a cause of it. Preterm babies have higher bilirubin levels because their liver is less developed and their red blood cells have a shorter lifespan than term babies. Preterm birth can also be associated with other causes of pathologic jaundice, such as infection or hemolysis (breakdown of red blood cells)

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Question 4:

A client is concerned about their newborn's risk for respiratory distress.

The nurse explains that the highest risk for respiratory distress is seen in:.

A. Preterm infants. B. Macrosomic babies. C. Post-term infants D. Newborns with hyperbilirubinemia.

Answer and Explanation

Choice A:

Preterm infants are at the highest risk for respiratory distress syndrome (RDS), a common breathing disorder that affects newborns. RDS occurs because of a lack of surfactant, a foamy substance that keeps the lungs fully expanded. Surfactant is usually produced by the lungs during the third trimester of pregnancy, which starts after the 26th week. Therefore, babies born before their due date, especially before 28 weeks of pregnancy, are more likely to have RDS.

Choice B:

Macrosomic babies, or babies who are larger than average at birth, are not at increased risk for RDS. However, they may have other complications such as birth injuries or low blood sugar levels.

Choice C:

Post-term infants, or babies who are born after 42 weeks of pregnancy, are not at increased risk for RDS. However, they may have other complications such as meconium aspiration or low blood sugar levels.

Choice D:

Newborns with hyperbilirubinemia, or high levels of bilirubin in the blood, are not at increased risk for RDS. However, they may have other complications such as jaundice or brain damage.

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Question 5:

A client asks the nurse about the main complication associated with untreated hyperbilirubinemia.

The nurse explains that untreated hyperbilirubinemia can lead to:.

A. Cerebral palsy B. Hypoglycemia C. Necrotizing enterocolitis D. Hypotonicity

Answer and Explanation

Choice A:

Hyperbilirubinemia is a condition where there is too much bilirubin in the blood. Bilirubin is a yellow pigment that is produced when red blood cells break down. Normally, the liver processes bilirubin and excretes it in bile. However, if the liver is immature or damaged, or if there is excessive hemolysis of red blood cells, bilirubin can accumulate in the blood and cause jaundice. If the bilirubin level is very high, it can cross the blood-brain barrier and damage the brain cells, leading to a condition called kernicterus. Kernicterus can cause cerebral palsy, which is a group of disorders that affect movement and posture.

Choice B:

It is a condition where the blood glucose level is too low. It can be caused by many factors, such as inadequate intake, excessive insulin or oral hypoglycemic agents, infection, stress, or exercise. Hypoglycemia can cause symptoms such as sweating, trembling, hunger, confusion, dizziness, or seizures. It can be treated by giving glucose orally or intravenously.

Choice C:

Necrotizing enterocolitis is wrong because it is a condition where the intestinal tissue becomes inflamed and dies. It can affect premature infants or infants with low birth weight, congenital heart disease, or sepsis. Necrotizing enterocolitis can cause symptoms such as abdominal distension, bloody stools, vomiting, lethargy, or shock. It can be treated by stopping enteral feeding, giving antibiotics, and providing supportive care. In severe cases, surgery may be needed to remove the necrotic tissue.

Choice D:

Hypotonicity is wrong because it is a condition where the muscle tone is abnormally low. It can be caused by many factors, such as nerve damage, spinal cord injury, brain injury, genetic disorders, or electrolyte imbalance. Hypotonicity can cause symptoms such as weakness, flaccidity, poor posture, or difficulty swallowing. It can be treated by physical therapy, braces, splints, or medication.

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