A nurse is assessing a newborn who has Trisomy 21 (Down's Syndrome). Which of the following are common characteristics? (Select all that apply.)

Large ears

Protruding tongue

Transverse palmar creases

Muscular hypertonicity

Low birth weight

Answer and Explanation

Correct Answer : B,C

B. A protruding tongue, often due to a small mouth and poor muscle tone (hypotonia), is a common feature of Down syndrome. This tongue appearance can contribute to difficulties with feeding and speech development.

C. Instead of a single palmar crease (known as a simian crease), individuals with Down syndrome often have transverse palmar creases. This occurs in about 45-50% of cases and is considered a characteristic feature.

A. While large ears are not typically listed as a common feature, individuals with Down's Syndrome may have unusually shaped or small ears.

D. Hypertonicity refers to increased muscle tone or stiffness. In Down syndrome, however, hypotonia (reduced muscle tone) is more common, especially in infancy. Therefore, muscular hypertonicity is not typically associated with Down syndrome.

E While low birth weight can occur in some infants with Down syndrome, it is not a universal characteristic. In fact, some infants with Down syndrome may be born at average or even slightly higher birth weights.

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Correct Answer is C

Explanation

C. Breathing into a paper bag can help the client rebreathe some of the exhaled CO2, which can help correct respiratory alkalosis caused by hyperventilation. This intervention helps increase the CO2 levels in the blood and alleviate symptoms such as lightheadedness and tingling.

A. Instructing the client to increase her respiratory rate would exacerbate the hyperventilation and is not appropriate. This action would further decrease the carbon dioxide (CO2) levels in the blood, worsening symptoms such as lightheadedness and tingling.

B: Administering oxygen is not indicated for hyperventilation because the client's oxygen levels are typically normal in this situation. Oxygen therapy does not address the underlying cause, which is respiratory alkalosis due to excessive CO2 loss. Therefore, it would not alleviate the client's symptoms.

D. Tucking the chin to the chest is not relevant to addressing hyperventilation or its symptoms. This action is more associated with techniques like chest breathing rather than addressing the respiratory alkalosis associated with hyperventilation.

A. Glipizide B. Acarbose C. Insulin D. Repaglinide

Correct Answer is C

Explanation

C. Insulin is the preferred treatment for gestational diabetes that cannot be controlled with diet and exercise alone. Insulin does not cross the placenta, making it safe for both the mother and the developing fetus. It is effective in controlling blood glucose levels and is commonly prescribed if lifestyle interventions are insufficient.

A. Glipizide belongs to the sulfonylurea class of medications, which stimulates insulin release from pancreatic beta cells. However, it is not recommended for use in pregnancy, including gestational diabetes, due to potential risks to the fetus, such as increased insulin secretion and potential hypoglycemia in the newborn.

B. Acarbose is an alpha-glucosidase inhibitor that slows down the digestion of carbohydrates in the intestine, thereby reducing postprandial glucose levels. It is generally considered safe in pregnancy. However, it is not typically the first-line medication for managing gestational diabetes and is less commonly prescribed compared to insulin or other agents.

D. Repaglinide is a meglitinide insulin secretagogue that stimulates insulin release from pancreatic beta cells. While it is not typically contraindicated in pregnancy, its safety profile in pregnancy is less well- established compared to insulin. Insulin remains the preferred choice due to its long-standing safety record in pregnancy.

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A nurse is assessing a newborn who has Trisomy 21 (Down's Syndrome). Which of the following are common characteristics? (Select all that apply.)

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