A nurse is assisting with the care of a newborn 1 hr after birth.

Select the 5 findings that the nurse should report to the provider.

Choice A reason:

Drowsy. This is not the best state for feeding a newborn, because the baby may fall asleep before finishing the feed or may not latch on well. A drowsy baby may also have trouble swallowing or coordinating sucking and breathing. •

Choice B reason:

Crying. This is also not a good state for feeding a newborn, because crying is a late sign of hunger and indicates that the baby is already distressed. A crying baby may have difficulty calming down enough to feed or may gulp air and become gassy. •

Choice C reason:

Active alert. This is a possible state for feeding a newborn, but not the most optimal one. An active alert baby may be easily distracted by noises or movements around them or may become fussy or overstimulated if they are not fed quickly enough. •

Choice D reason:

Alert. This is the best state for feeding a newborn because the baby is awake, calm, and attentive to their surroundings. An alert baby will show signs of hunger such as rooting, smacking their lips, or sucking their fingers, and will be ready to latch on and feed well.

Choice A reason:

Obesity is not a common complication of phenylketonuria (PKU), a genetic disorder that causes increased levels of phenylalanine (an amino acid) in the body. Obesity may be related to other endocrine disorders, such as hypothyroidism or Cushing syndrome.

Choice B reason:

Diabetes insipidus is a condition that causes excessive thirst and urination due to a lack of antidiuretic hormone (ADH) or a problem with the kidneys' response to ADH. It is not caused by PKU, which affects the metabolism of phenylalanine.

Choice C reason:

Respiratory distress is not a typical symptom of PKU, although some newborns with PKU may have a musty odor in their breath, skin, or urine due to the buildup of phenylalanine.

Respiratory distress may be caused by other conditions, such as asthma, pneumonia, or congenital heart defects.

Choice D reason:

Cognitive impairment is the most serious complication of PKU if it is not diagnosed and treated early. High levels of phenylalanine can damage the brain and cause irreversible intellectual disability, neurological problems, and behavioral issues. Early intervention with a special diet that limits phenylalanine intake can prevent or reduce cognitive impairment in children with PKU.