A nurse is caring for a client who is at 42 weeks of gestation and is in labor.

The client asked the nurse what to expect because the baby is postmature.

Which of the following statements should the nurse make?

Your baby will have excess body fat

Your baby will have flat areola without breast buds

Your babies heels will easily move to his ears

Your baby skin will have a leathery appearance.

Answer and Explanation

The Correct Answer is D

This is because postmature babies lose the protective vernix that covers their skin in utero, and their skin becomes dry and cracked. Postmature babies also have less subcutaneous fat, which makes them look thin and wrinkled.

Choice A is wrong because postmature babies have less body fat than term babies, not more. They use up their fat stores to survive in the womb beyond 42 weeks of gestation.

Choice B is wrong because postmature babies have well-developed breast buds and areola, not flat ones. Breast development is a sign of fetal maturity that occurs around 36 weeks of gestation.

Choice C is wrong because postmature babies have less flexibility in their joints and muscles, not more. They have less amniotic fluid to cushion their movements, and their bones become more ossified as they grow older.

Normal ranges for gestational age are 37 to 42 weeks. Babies born before 37 weeks are considered preterm, and babies born after 42 weeks are considered postmature.

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Correct Answer is D

Explanation

All of the above factors increase the risk of hyperbilirubinemia in this newborn.Hyperbilirubinemia is a condition of high levels of bilirubin in the blood that can cause jaundice and brain damage.

Choice A is wrong because prematurity is a risk factor for hyperbilirubinemia, especially in babies born before 38 weeks of gestation.Premature babies have immature livers that are less able to process bilirubin and eliminate it from the body.

Choice B is wrong because breastfeeding is a risk factor for hyperbilirubinemia, particularly in some breast-fed babies who do not get enough milk or calories.Breastfeeding can also cause increased enterohepatic circulation of bilirubin, which means that bilirubin is reabsorbed from the intestines into the bloodstream instead of being excreted in the stool.

Choice C is wrong because Asian ethnicity is a risk factor for hyperbilirubinemia, as some Asian populations have higher rates of glucose-6-phosphate dehydrogenase deficiency, a genetic condition that causes red blood cells to break down more easily and release more bilirubin.Asian infants may also have lower levels of uridine diphosphate glucuronosyltransferase, an enzyme that helps convert bilirubin into a form that can be excreted by the liver.

Normal ranges for bilirubin levels vary depending on the age, weight, and health status of the newborn.Generally, bilirubin levels peak between the third and seventh day after birth and then decline gradually.The AAP recommends using a nomogram based on the infant’s age in hours and serum bilirubin level to determine the risk of severe hyperbilirubinemia and the need for treatment.Treatment options include phototherapy and exchange transfusion.

A. The newborn’s skin color is pink B. The newborn’s stools are clay-colored C. The newborn’s bilirubin level is 12 mg/dL D. The newborn’s urine is dark yellow.

Correct Answer is A

Explanation

The newborn’s skin color is pink.This indicates that the phototherapy is effective in lowering the serum bilirubin level by transforming it into water-soluble isomers that can be eliminated without liver conjugation.

A pink skin color also means that the newborn is not jaundiced, which is a sign of high bilirubin levels.

Choice B is wrong because clay-colored stools indicate a problem with the liver or bile ducts.Bile is needed to give stools their normal brown color, and if bile is absent or blocked, the stools may become pale or clay-colored.This could be a sign of a serious condition such as biliary atresia, which is a congenital defect that causes bile ducts to be absent or malformed.

Choice C is wrong because a bilirubin level of 12 mg/dL is still high for a newborn and may require further treatment.The American Academy of Pediatrics recommends phototherapy for newborns with bilirubin levels above 15 mg/dL at 25 to 48 hours of age, 18 mg/dL at 49 to 72 hours of age, and 20 mg/dL at more than 72 hours of age.However, these thresholds may vary depending on the gestational age, risk factors, and clinical condition of the newborn.

Choice D is wrong because dark yellow urine may indicate dehydration or concentrated urine, which can increase the risk of bilirubin toxicity.Newborns receiving phototherapy should be well hydrated and have frequent wet diapers to help eliminate bilirubin from the body.Normal urine color for a newborn is pale yellow or clear.

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A nurse is caring for a client who is at 42 weeks of gestation and is in labor. The client asked the nurse what to expect because the baby is postmature. Which of the following statements should the nurse make?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a newborn who was born at 35 weeks of gestation and has physiologic jaundice. Which of the following factors increases the risk of hyperbilirubinemia in this newborn?

Correct Answer is D

Explanation

A nurse is evaluating a newborn who has hyperbilirubinemia and is receiving phototherapy. Which of the following outcomes indicates that the therapy is effective?

Correct Answer is A

Explanation

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A nurse is caring for a client who is at 42 weeks of gestation and is in labor.

The client asked the nurse what to expect because the baby is postmature.

Which of the following statements should the nurse make?