A breastfed newborn has just been diagnosed with galactosemia. The therapeutic management for this newborn is to:
Stop breastfeeding
Add amino acids to the breast milk
Substitute a lactose-containing formula for breast milk
Give the appropriate enzyme along with breast milk.
The Correct Answer is A
Choice A reason:
Stop breastfeeding. This is the correct answer because newborns and infants with galactosemia cannot metabolize galactose, a sugar found in milk and lactose-containing formulas, including breast milk. Galactose can build up in their blood and cause serious complications such as liver damage, cataracts, brain damage, and even death. Therefore, the therapeutic management for this newborn is to stop breastfeeding and switch to a soy or elemental formula that contains no galactose.
Choice B reason:
Add amino acids to the breast milk. This is incorrect because adding amino acids to breast milk will not prevent the accumulation of galactose in the newborn's blood. Amino acids are the building blocks of proteins, not sugars. Adding amino acids to breast milk will not change its galactose content or help the newborn metabolize it.
Choice C reason:
Substitute a lactose-containing formula for breast milk. This is incorrect because lactose is a disaccharide composed of glucose and galactose. Lactose-containing formulas will also expose the newborn to galactose, which they cannot break down. Lactose-containing formulas should be avoided in newborns and infants with galactosemia.
Choice D reason:
Give the appropriate enzyme along with breast milk. This is incorrect because there is no enzyme therapy available for galactosemia. Galactosemia is caused by a genetic defect in one of the enzymes involved in the breakdown of galactose, such as galactose-1-phosphate uridyltransferase (GALT), galactokinase (GALK), or uridine diphosphate galactose-4-epimerase (GALE). Giving an enzyme along with breast milk will not correct this defect or prevent the harmful effects of galactose accumulation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
Uterine atony is the failure of the uterus to contract and retract after delivery, which can lead to excessive bleeding and hemorrhage. It is the most common cause of postpartum hemorrhage, accounting for up to 80 percent of cases. Risk factors for uterine atony include large or multiple babies, prolonged or rapid labor, overdistended uterus, use of oxytocin or magnesium sulfate during labor, and previous history of uterine atony.
Choice B reason:
Puerperal infection is an infection of the reproductive tract that occurs within six weeks after delivery. It can affect the uterus (endometritis), the bladder (cystitis), the kidneys (pyelonephritis), the breast (mastitis), or the wound (cesarean section or episiotomy).
Symptoms include fever, chills, malaise, foul-smelling lochia, pelvic pain, and wound redness or drainage. Risk factors for puerperal infection include cesarean delivery, prolonged rupture of membranes, prolonged labor, multiple vaginal examinations, retained placental fragments, and poor hygiene.
Choice C reason:
Retained placental fragments are pieces of the placenta that remain in the uterus after delivery. They can cause postpartum hemorrhage, infection, or delayed involution of the uterus. Symptoms include heavy or prolonged bleeding, fever, abdominal pain, and an enlarged uterus. Risk factors for retained placental fragments include placenta previa, placenta accrete, manual removal of the placenta, and incomplete examination of the placenta after delivery.
Choice D reason:
Thrombophlebitis is the inflammation and clotting of a vein, usually in the legs or pelvis. It can cause pain, swelling, redness, and warmth in the affected area. It can also lead to pulmonary embolism if the clot breaks off and travels to the lungs. Risk factors for thrombophlebitis include pregnancy and the postpartum period, cesarean delivery, obesity, smoking, dehydration, immobility, varicose veins, and inherited or acquired clotting disorders.
Correct Answer is C
Explanation
Choice A reason:
Infection is not prevented by vitamin K administration. Vitamin K is needed for blood clotting, not for fighting infections. Newborns are given vitamin K injections to prevent a serious disease called hemorrhagic disease of the newborn (HDN), which is caused by bleeding in the brain or other organs.
Choice B reason:
Hyperbilirubinemia is not prevented by vitamin K administration. Hyperbilirubinemia is a condition in which there is too much bilirubin in the blood, causing jaundice. Bilirubin is a yellow pigment that is produced when red blood cells break down. Vitamin K does not affect the production or breakdown of bilirubin.
Choice C reason:
Bleeding is prevented by vitamin K administration. Vitamin K is needed for the synthesis of several clotting factors that help stop bleeding when there is an injury. Newborns have very low levels of vitamin K in their bodies because they do not get enough from the placenta or breast milk, and they do not have enough bacteria in their intestines to produce it. This puts them at risk for VKDB, which can cause life-threatening bleeding in the brain or other organs.
Choice D reason:
Potassium deficiency is not prevented by vitamin K administration. Potassium is an electrolyte that is important for nerve and muscle function, as well as fluid balance. Vitamin K does not affect the absorption or excretion of potassium.
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