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A nurse is reviewing a newborn's laboratory results. Which of the following findings is the nurse's priority?

A.

Platelets 200,000/mm3

B.

Bilirubin 19 mg/dL

C.

Blood glucose 45 mg/dL

D.

Hemoglobin 22 g/dL

Answer and Explanation

The Correct Answer is B

   - A) A platelet count of 200,000/mm3 is within the normal range for a newborn and does not require immediate intervention.
    - B) A bilirubin level of 19 mg/dL is high and suggests the possibility of hyperbilirubinemia, which can lead to jaundice and, in severe cases, kernicterus, a form of brain damage. This is a critical value that requires immediate attention.
    - C) A blood glucose level of 45 mg/dL is on the lower end of the normal range, but it is not as immediately concerning as the elevated bilirubin level. Monitoring and appropriate feeding should address this issue.
    - D) A hemoglobin level of 22 g/dL is high, indicating polycythemia, which can be a risk factor for hyperviscosity syndrome. However, it is not as urgent as the bilirubin level of 19 mg/dL. Monitoring and partial exchange transfusion may be considered if symptoms develop.


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Related Questions

Correct Answer is A

Explanation

- A: Plantar creases covering 2/3 of the sole is indicative of a more mature newborn, which is a significant finding in assessing gestational age.
- B: Acrocyanosis of hands and feet is a common finding in the first few days after birth and is not specifically related to gestational age.
- C: The condition of the anterior fontanel being soft and level is a normal finding and does not contribute to the assessment of gestational age.
- D: The presence of vernix caseosa in inguinal creases can be seen in both preterm and full-term newborns, thus it is not a specific indicator of gestational age.

Correct Answer is D

Explanation

A. Preterm delivery may result in a newborn being small for gestational age, but it is not the primary cause of this condition.
B. Fetal hyperinsulinemia may contribute to macrosomia (large for gestational age) rather than small for gestational age.
C. Perinatal asphyxia may lead to intrauterine growth restriction but is not a primary cause of being small for gestational age.
D. Placental insufficiency is a common cause of intrauterine growth restriction and results in inadequate nutrient and oxygen delivery to the fetus, leading to a newborn being small for gestational age.

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