A nurse is reinforcing teaching with the mother of a newborn who is small for gestational age. Which of the following should the nurse include as a cause of this condition?

Choice A reason:

Holding the newborn vertically, allowing one foot to touch the crib surface, will elicit the stepping reflex, not the Moro reflex. The stepping reflex is when the newborn makes stepping movements when held upright with one foot touching a flat surface.

Choice B reason:

Turning the newborn's head quickly to one side will elicit the tonic neck reflex, not the Moro reflex. The tonic neck reflex is when the newborn assumes a "fencing”. position, with the arm and leg extended on the side to which the head is turned and the opposite arm and leg flexed.

Choice C reason:

Performing a sharp hand clap near the infant will elicit the Moro reflex, also known as the startle reflex. The Moro reflex is when the newborn responds to a sudden loss of support or a loud noise by extending and abducting the arms, spreading the fingers, and then bringing the arms together and crying.

Choice D reason:

Placing a finger at the base of the newborn's toes will elicit the Babinski reflex, not the Moro reflex. The Babinski reflex is when the newborn fans out the toes and dorsiflexes the big toe when the sole of the foot is stroked.

Choice A reason:

Small for gestational age (SGA) newborns are at risk for respiratory distress syndrome (RDS) and respiratory acidosis because they have immature lungs that produce less surfactant, which is needed to keep the alveoli open and prevent atelectasis. SGA newborns also have less glycogen stores, which can lead to hypoglycemia and impaired oxygen delivery to the tissues.

Choice B reason:

Maternal history of asthma is not a risk factor for RDS or respiratory acidosis in the newborn. Asthma is a chronic inflammatory disorder of the airways that affects the mother, not the fetus. Maternal asthma can cause complications such as preterm labor, preeclampsia, or intrauterine growth restriction, but it does not directly affect the fetal lung development or function.

Choice C reason:

Ventricular septal defect (VSD) is a congenital heart defect that causes a hole in the wall between the ventricles of the heart. This can result in increased pulmonary blood flow and pressure, which can lead to pulmonary edema and heart failure in the newborn. However, VSD does not cause RDS or respiratory acidosis, which are related to lung maturity and surfactant production.

Choice D reason:

Cesarean birth is not a risk factor for RDS or respiratory acidosis in the newborn. Cesarean birth can increase the risk of transient tachypnea of the newborn (TTN), which is caused by delayed absorption of fetal lung fluid. TTN usually resolves within 24 to 48 hours and does not cause a significant acid-base imbalance in the newborn.