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A nurse is caring for a newborn in the neonatal intensive care unit (NICU).

Exhibits

A nurse reviews the assessment findings and determines the findings are consistent with which of the following complications? For each assessment finding, click to specify if the assessment finding is consistent with hypoglycemia or neonatal abstinence syndrome (NAS). Each finding may support more than one disease process.

A.

Jittery extremities

B.

Poor sucking reflex

C.

Excessive sweating

D.

Irritability

E.

Weak cry

F.

Mild tremors

G.

Low blood glucose level

H.

Positive urine toxicology

Answer and Explanation

The Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"A,B"},"C":{"answers":"A,B"},"D":{"answers":"A,B"},"E":{"answers":"A,B"},"F":{"answers":"A,B"},"G":{"answers":"A"},"H":{"answers":"B"}}

  1. Jittery Extremities
    • Hypoglycemia: Jittery extremities are a common sign of low blood glucose levels.
    • Neonatal Abstinence Syndrome: Jitteriness can occur due to withdrawal symptoms in newborns exposed to opioids.
  2. Poor Sucking Reflex
    • Hypoglycemia: Newborns with low blood glucose levels may have difficulty feeding and a poor sucking reflex.
    • Neonatal Abstinence Syndrome: Poor feeding and sucking reflex can be part of withdrawal symptoms in newborns.
  3. Excessive Sweating
    • Hypoglycemia: Excessive sweating can be a symptom of low blood glucose levels.
    • Neonatal Abstinence Syndrome: Sweating is one of the possible signs of withdrawal in newborns.
  4. Irritability
    • Hypoglycemia: Irritability can result from low blood glucose levels.
    • Neonatal Abstinence Syndrome: Irritability is a common symptom of withdrawal in newborns exposed to opioids.
  5. Weak Cry
    • Hypoglycemia: A weak cry can be a symptom of low blood glucose levels.
    • Neonatal Abstinence Syndrome: Weak cry can also be part of withdrawal symptoms in newborns.
  6. Mild Tremors
    • Hypoglycemia: Tremors or shaking can be a sign of low blood glucose levels.
    • Neonatal Abstinence Syndrome: Tremors are common withdrawal symptoms in newborns exposed to opioids.
  7. Low Blood Glucose Level
    • Hypoglycemia: A blood glucose level of 40 mg/dL is considered low and indicates hypoglycemia.
    • Neonatal Abstinence Syndrome: Low blood glucose level is not a direct indicator of NAS but may occur due to poor feeding.
  8. Positive Urine Toxicology
    • Hypoglycemia: Not relevant.
    • Neonatal Abstinence Syndrome: Positive urine toxicology for opioids indicates in utero exposure to opioids, which can lead to NAS.


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Related Questions

Correct Answer is B

Explanation

Choice A rationale

Blood glucose level changes are unrelated to hyperbilirubinemia and phototherapy, which specifically target bilirubin metabolism in the newborn's liver and skin.

Choice B rationale

A decrease in transcutaneous bilirubin (TcB) levels shows effective phototherapy, as it converts bilirubin into water-soluble isomers that can be excreted.

Choice C rationale

Skin color changes from yellow to normal indicate reduced bilirubin levels, but the most accurate measure of phototherapy efficacy is the decrease in TcB levels.

Choice D rationale

Weight gain is not an indicator of effective phototherapy; it reflects overall nutrition and hydration status rather than bilirubin metabolism and excretion.

Correct Answer is D

Explanation

Choice A rationale

Azithromycin is an antibiotic used to treat infections and is not indicated for promoting lung maturity in preterm infants.

Choice B rationale

Indomethacin is a tocolytic agent used to delay preterm labor but does not promote lung maturity in the fetus.

Choice C rationale

Magnesium sulfate is used for neuroprotection and to prevent seizures in preeclampsia, but it does not enhance lung maturity.

Choice D rationale

Betamethasone is a corticosteroid that accelerates fetal lung development and surfactant production, promoting lung maturity in preterm infants.

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