A nurse is caring for a newborn who is 70 hours old in the newborn nursery.

Exhibits

For each assessment finding, click to specify if the finding is consistent with hypoglycemia or neonatal abstinence syndrome (NAS). Each finding may support more than one disease process.

Choice A rationale

Mongolian spots are benign, flat bluish or bluish-gray birthmarks that commonly appear on the buttocks, lower back, or thighs of newborns, particularly those with darker skin tones, including African Americans, Asians, and Hispanics. They are caused by the entrapment of melanocytes (pigment-producing cells) deep within the dermis during fetal development. These spots typically fade spontaneously within a few years and are not indicative of any underlying medical condition or trauma.

Choice B rationale

Lanugo is fine, downy hair that covers the body of some newborns, especially preterm infants. It is usually shed within the last few weeks of gestation or shortly after birth and is unrelated to bruising or pigmented spots on the buttocks.

Choice C rationale

Nevus flammeus, also known as a port-wine stain, is a vascular malformation of the skin that appears as a flat, pink, red, or purple birthmark. It is caused by dilated capillaries and does not typically occur as bluish spots on the buttocks. Port-wine stains are usually permanent and may darken with age.

Choice D rationale

Vascular nevus, also known as a strawberry hemangioma, is a raised, red, bumpy birthmark composed of extra blood vessels. While it is a type of birthmark, it does not present as flat, bluish spots on the buttocks. Hemangiomas typically grow rapidly in the first few months of life and then gradually shrink over several years.

Choice A rationale

Placenta previa is a condition where the placenta partially or totally covers the cervix. While it poses risks for hemorrhage during labor and delivery, it does not directly increase the risk of postpartum infection. The primary risks associated with placenta previa are related to bleeding, not infection.

Choice B rationale

Meconium aspiration occurs when a fetus inhales meconium-stained amniotic fluid. This primarily affects the newborn's respiratory system and does not directly increase the postpartum client's risk of infection. The complications of meconium aspiration are focused on the neonate.

Choice C rationale

A midline episiotomy is a surgical incision made in the perineum during childbirth to enlarge the vaginal opening. This incision creates a break in the skin and mucous membranes, providing a potential portal of entry for bacteria. Therefore, a midline episiotomy places the postpartum client at an increased risk for local infection at the incision site.

Choice D rationale

Gestational hypertension is high blood pressure that develops during pregnancy and typically resolves after delivery. While it poses risks to both the mother and the fetus, it does not directly increase the postpartum client's risk of infection. The primary concerns with gestational hypertension are related to blood pressure control and potential end-organ damage.