A nurse is educating the mother of a newborn who was born small for gestational age. Which of the following should the nurse include as a potential cause of this condition?
Perinatal asphyxia.
Preterm delivery.
Fetal hyperinsulinemia.
Placental insufficiency.
The Correct Answer is D
Choice A rationale
Perinatal asphyxia refers to a lack of oxygen flow to the fetus around the time of birth. This can lead to multiple organ dysfunction and neurological issues, but it is not a common cause of a newborn being small for gestational age.
Choice B rationale
Preterm delivery can result in a newborn being small for their gestational age simply because they have not had the full amount of time to grow in the womb. However, preterm babies are typically compared to other preterm babies when assessing size, not to full-term babies.
Choice C rationale
Fetal hyperinsulinemia, or an excess of insulin in the fetus, can lead to excessive growth and a larger-than-average baby size (macrosomia), not a smaller size.
Choice D rationale
Placental insufficiency, where the placenta does not work as well as it should, can limit the amount of oxygen and nutrients the fetus receives. This can restrict the baby’s growth, leading to a small size for gestational age.
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Correct Answer is D
Explanation
Choice A rationale
While seeing a counselor could be beneficial for some women experiencing doubts and second thoughts about their pregnancy, suggesting this as an initial response may make the client feel that her feelings are abnormal or require professional help.
Choice B rationale
Asking if the client has spoken to her mother about these feelings assumes that the client has a good relationship with her mother or that her mother is available for support, which may not be the case.
Choice C rationale
Telling the client not to worry and that she will be fine once the baby is born may minimize her feelings and does not acknowledge her current emotional state.
Choice D rationale
Ambivalent feelings are quite common for women early in pregnancy. This response validates the client’s feelings and reassures her that what she is experiencing is normal.
Correct Answer is D
Explanation
Choice A rationale
Covering the cord with the diaper can create a moist environment that promotes bacterial growth and delays healing.
Choice B rationale
Washing the cord daily with mild soap and water is not recommended. It’s better to keep the cord dry and clean.
Choice C rationale
Applying petroleum jelly to the cord stump is not advised. It can create a moist environment that can delay the drying and falling off of the stump.
Choice D rationale
Giving a sponge bath until the cord stump falls off is the correct instruction. This prevents the stump from getting wet, which can delay healing and increase the risk of infection.
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