Newborn Complications > Maternal & Newborn
Exam Review
Hypoglycemia
Total Questions : 13
Showing 13 questions, Sign in for moreA nurse is assessing a newborn who is displaying jitteriness, poor feeding, and seizures.
The nurse suspects the newborn is experiencing:.
Explanation
The correct answer is choice B. Hypoglycemia.Hypoglycemia is a condition where the blood sugar level is too low, which can affect the brain function and cause symptoms such as jitteriness, poor feeding, and seizures.Hypoglycemia is common in newborns, especially in preterm, small for gestational age, and infants of diabetic mothers.
Choice A is wrong because hyperglycemia is a condition where the blood sugar level is too high, which can cause dehydration, increased urination, and ketoacidosis.Hyperglycemia does not usually cause seizures in newborns.
Choice C is wrong because hypertension is a condition where the blood pressure is too high, which can cause damage to the blood vessels and organs.Hypertension can cause seizures in older children and adults, but it is rare in newborns.
Choice D is wrong because hypocalcemia is a condition where the calcium level in the blood is too low, which can affect the nerve and muscle function and cause symptoms such as twitching, spasms, and tetany.Hypocalcemia can also cause seizures in newborns, but it is less common than hypoglycemia.
A client with diabetes gives birth to a premature newborn.
The nurse should anticipate that the newborn is at risk for:.
Explanation
The correct answer is choice B. Hypoglycemia.
The newborn is at risk for hypoglycemia because of the maternal diabetes and the prematurity.Maternal diabetes causes fetal hyperinsulinism, which persists after birth and lowers the blood glucose level of the newborn.Prematurity causes inadequate glycogen stores and immature enzyme function, which also contribute to hypoglycemia.Hypoglycemia can cause symptoms such as tachycardia, cyanosis, seizures, and apnea.
Choice A is wrong because hyperglycemia is unlikely in a newborn with hyperinsulinism and deficient glycogen stores.
Choice C is wrong because hypertension is not a common complication of maternal diabetes or prematurity in newborns.
Choice D is wrong because hypothyroidism is not related to maternal diabetes or prematurity.Hypothyroidism can cause symptoms such as lethargy, poor feeding, jaundice, and hypotonia.
Normal ranges for blood glucose levels in newborns vary depending on the age, weight, and feeding status of the baby.
Generally, a level below 40 mg/dL (2.2 mmol/L) in symptomatic term newborns, below 45 mg/dL (2.5 mmol/L) in asymptomatic term newborns between 24 hours and 48 hours of life, or below 30 mg/dL (1.7 mmol/L) in preterm newborns in the first 48 hours is considered hypoglyc
A nurse is caring for a newborn who was born to a mother with diabetes mellitus.
The nurse should monitor the newborn for which of the following signs of hypoglycemia?
Explanation
The correct answer is choice A. Jitteriness.Jitteriness or tremors are the most common signs of hypoglycemia in a newborn baby.
Hypoglycemia is when the level of sugar (glucose) in the blood is too low.
Glucose is the main source of fuel for the brain and the body.In a newborn baby, low blood sugar can happen for many reasons, such as poor nutrition for the mother during pregnancy, making too much insulin because the mother has diabetes, or not enough oxygen at birth.
Choice B. Tachycardia is wrong because it is not a typical sign of hypoglycemia in a newborn baby.
Tachycardia is a fast heart rate that can be caused by other conditions, such as fever, infection, or dehydration.
Choice C. Hyperthermia is wrong because it is not a sign of hypoglycemia in a newborn baby.
Hyperthermia is a high body temperature that can be caused by overheating, infection, or inflammation.Hypoglycemia can cause low body temperature (hypothermia), not high body temperature.
Choice D. Hypertonia is wrong because it is not a sign of hypoglycemia in a newborn baby.
Hypertonia is increased muscle tone or stiffness that can be caused by brain damage, nerve damage, or genetic disorders.Hypoglycemia can cause weak or floppy muscles (poor muscle tone), not increased muscle tone.
A nurse is assessing a newborn who has intrauterine growth restriction (IUGR).
The nurse should recognize that this newborn is at risk for developing hypoglycemia because of which of the following factors?
Explanation
The correct answer is choice C. Increased insulin production.Infants with intrauterine growth restriction (IUGR) are at risk for hypoglycemia due to poor nutrient reserves and hyperinsulinism.
Hyperinsulinism is a condition where the pancreas produces too much insulin, which lowers the blood glucose level.Infants with IUGR may have hyperinsulinism because of placental insufficiency, maternal diabetes, or fetal stress.
Choice A is wrong because increased glycogen stores would protect against hypoglycemia, not cause it.
Glycogen is a form of stored glucose that can be broken down when blood glucose level is low.
Choice B is wrong because decreased gluconeogenesis would also protect against hypoglycemia, not cause it.
Gluconeogenesis is a process where the liver makes glucose from non-carbohydrate sources, such as amino acids or lactate.
Choice D is wrong because decreased glucose consumption would also protect against hypoglycemia, not cause it.
Glucose consumption is the rate at which cells use glucose for energy production.
If glucose consumption is low, blood glucose level would be high.
A nurse is performing a heel stick blood glucose test on a newborn who is preterm.
The nurse should apply a heel warmer to the newborn’s foot before obtaining the blood sample for which of the following reasons?
Explanation
The correct answer is choice B. To increase blood flow.A heel warmer is applied to the newborn’s foot before obtaining the blood sample to increase the blood flow to the area and make it easier to collect the sample.A heel warmer can also reduce pain and bruising by dilating the blood vessels and reducing the need for multiple punctures.
Choice A is wrong because a heel warmer does not prevent infection.Infection prevention requires proper cleaning of the puncture site and disposal of the lancet.
Choice C is wrong because a heel warmer does not reduce pain by itself.Pain reduction requires other measures such as cuddling, feeding, and distraction.
Choice D is wrong because a heel warmer does not prevent bruising.Bruising prevention requires applying pressure to the puncture site after collecting the sample.
Normal ranges for blood glucose levels in newborns vary depending on the method of measurement, but generally they are between 2.6 and 6.0 mmol/L.
A nurse is reviewing the laboratory results of a pregnant client.
Which finding would be considered abnormal regarding hCG levels?
Explanation
Decreased hCG levels are abnormal regarding hCG levels in pregnancy.hCG is a hormone that plays an important role in pregnancy, and levels can vary widely at this time and between individuals.However, during early pregnancy, hCG levels typically double every two to three days.Low or declining hCG levels can signal a problem with the pregnancy, such as an impending miscarriage or ectopic pregnancy.
Choice B is wrong because unchanged hCG levels are also abnormal regarding hCG levels in pregnancy.
As mentioned above, hCG levels should increase rapidly during the first few weeks of pregnancy.
Choice C is wrong because increased hCG levels are normal regarding hCG levels in pregnancy.Levels of hCG can vary widely from one pregnant woman to another, but they generally peak at around 8 to 14 weeks after conception.
Choice D is wrong because increased prolactin levels are not related to hCG levels in pregnancy.
Prolactin is another hormone that stimulates milk production in the breasts.
Prolactin levels rise during pregnancy and breastfeeding, but they do not affect hCG levels.
A nurse is teaching a pregnant client about nutrition during pregnancy and lactation.
Which of the following statements by the client indicates an understanding of the teaching?
Explanation
I will need to increase my protein intake by 25 g per day while I am pregnant.” Protein is essential for the growth and development of the fetus and the placenta, as well as for the increased blood volume and maternal tissues.
The recommended dietary allowance (RDA) for protein during pregnancy is 71 g per day, which is 25 g more than the RDA for non-pregnant women.
Choice B is wrong because the calcium intake does not need to increase during lactation.
The RDA for calcium for lactating women is the same as for non-lactating women, which is 1000 mg per day for women aged 19 to 50 years.
Calcium absorption and retention are enhanced during lactation, and bone loss that may occur is usually reversible after weaning.
Choice C is wrong because the calorie intake does not need to increase by 500 kcal per day during the third trimester.
The estimated energy requirement (EER) for pregnant women increases by 340 kcal per day in the second trimester and by 452 kcal per day in the third trimester.
However, these values may vary depending on the pre-pregnancy weight, activity level, and rate of weight gain of the individual woman.
Choice D is wrong because the iron intake needs to increase by more than 10 mg per day while pregnant.
The RDA for iron during pregnancy is 27 mg per day, which is 9 mg more than the RDA for non-pregnant women.
However, this amount may not be enough to prevent iron deficiency anemia in some pregnant women, especially those who start pregnancy with low iron stores or have high iron losses due to bleeding or multiple pregnancies.
Therefore, iron supplements are often recommended for pregnant women, especially in the second and third trimesters.
A nurse is caring for a client at risk for falls. Which intervention is most important for fall prevention?
Explanation
nswer: b. Encouraging the client to use the call bell for assistance. Explanation: Encouraging the client to use the call bell for assistance is the most important intervention for fall prevention. It promotes the client's involvement in their own safety and ensures that help is readily available when needed.
Incorrect choices: a. Placing a sign on the client's room door indicating fall risk is a helpful visual reminder, but it does not actively prevent falls. c. Providing a nonskid mat on the floor beside the client's bed can reduce the risk of slipping but does not address other factors that contribute to falls. d. Ensuring the client has adequate lighting in the room is important for preventing falls, but it is not the most critical intervention. The client's ability to seek assistance when needed is more crucial.
A nurse is caring for a client who has diabetic ketoacidosis and is receiving intravenous fluids. Which of the following electrolytes should the nurse monitor closely for signs of imbalance? (Select all that apply.)
Explanation
Choice A reason:
Chloride is not a major electrolyte that is affected by diabetic ketoacidosis (DKA) Chloride levels may be low, normal or high depending on the acid-base status and hydration of the client. Therefore, chloride is not a priority electrolyte to monitor for signs of imbalance.
Choice B reason:
Phosphate is also not a major electrolyte that is affected by DKA. Phosphate levels may be low due to insulin therapy or high due to renal impairment, but these are not directly related to DKA. Therefore, phosphate is not a priority electrolyte to monitor for signs of imbalance.
Choice C reason:
Bicarbonate is a major electrolyte that is affected by DKA. Bicarbonate levels are low in DKA due to metabolic acidosis caused by the accumulation of ketones in the blood. Low bicarbonate levels can lead to symptoms such as nausea, vomiting, abdominal pain, confusion and coma. Therefore, bicarbonate is a priority electrolyte to monitor for signs of imbalance.
Choice D reason:
Sulfate is not a major electrolyte that is affected by DKA. Sulfate levels are not routinely measured in clinical practice and have no significant role in DKA. Therefore, sulfate is not a priority electrolyte to monitor for signs of imbalance.
Choice E reason:
Potassium is a major electrolyte that is affected by DKA. Potassium levels can be high or low in DKA depending on several factors such as insulin therapy, fluid replacement, renal function and acid-base status. High or low potassium levels can cause cardiac arrhythmias, muscle weakness, paralysis and respiratory failure. Therefore, potassium is a priority electrolyte to monitor for signs of imbalance.
The practical nurse (PN) is caring for a child who was admitted after experiencing a generalized tonic-clonic seizure. When witnessing the child begin to seize again, which actions should the PN implement immediately? (Select all that apply.).
No explanation
The diagnosis of pregnancy is based on which positive signs of pregnancy? (Select all that apply.)
No explanation
Medications used to manage postpartum hemorrhage (PPH) include (Select all that apply.):.Medications used to manage postpartum hemorrhage (PPH) include (Select all that apply.):
No explanation
Which data would be included in a health history? (Select all that apply.)
No explanation
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