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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

Breastfeeding a newborn 6-8 times a day is insufficient. Newborns typically need more frequent feedings to ensure adequate nutrition and growth, generally more than 8 times.

Choice B rationale

Newborns should be breastfed 8-12 times in a 24-hour period. This frequent feeding ensures they receive enough nutrients, helps establish milk supply, and supports healthy growth.

Choice C rationale

Feeding 10-14 times a day can be appropriate for some newborns but may not be necessary for all. The standard recommendation is 8-12 times, balancing nourishment and mother's comfort.

Choice D rationale

Breastfeeding 12-16 times a day is excessive and may cause maternal fatigue and discomfort. The general guideline of 8-12 times is sufficient to meet a newborn's nutritional needs.

Correct Answer is A

Explanation

Choice A rationale

History of uterine rupture poses a significant risk for a trial of labor after cesarean (TOLAC) due to the potential recurrence of uterine rupture, which can be life-threatening for both mother and fetus.

Choice B rationale

Previous cesarean section for breech presentation is not a contraindication for TOLAC. Patients with prior cesarean deliveries can consider TOLAC if there are no additional risk factors.

Choice C rationale

Previous low transverse cesarean section birth is often considered suitable for TOLAC, as the lower segment incision has a lower risk of rupture compared to vertical or classical incisions.

Choice D rationale

Low-risk pregnancy alone is not a contraindication for TOLAC. It is essential to assess other factors such as uterine scarring, maternal health, and fetal status when considering TOLAC eligibility.

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