A nurse is reviewing the laboratory results of a post-term newborn who has polycythemia and hypoxemia.

What is the most likely hematocrit value for this newborn?

A post-term newborn who has macrosomia is at risk of hypoglycemia because the fetus produces more insulin in response to the high glucose levels from the mother.

After birth, the glucose supply from the mother is cut off, but the newborn still has high insulin levels, which can cause low blood glucose.

A heel stick blood glucose test is done to monitor the newborn’s blood glucose level and prevent complications from hypoglycemia.

Choice B is wrong because hyperglycemia is not a common problem for post-term newborns with macrosomia.

Hyperglycemia occurs when there is too much glucose and not enough insulin in the blood.

This is more likely to happen in infants of diabetic mothers who have poor glycemic control during pregnancy.

Choice C is wrong because polycythemia is not related to insulin or glucose levels.

Polycythemia is a condition where there are too many red blood cells in the blood, which can cause increased blood viscosity and clotting.

This can happen in post-term newborns due to chronic hypoxia in utero, which stimulates erythropoietin secretion.

Choice D is wrong because anemia is not related to insulin or glucose levels.

Anemia is a condition where there are not enough red blood cells or hemoglobin in the blood, which can cause decreased oxygen delivery to the tissues.

This can happen in newborns due to blood loss, hemolysis, or decreased production of red blood cells.

The normal range for blood glucose in newborns is 40 to 80 mg/dL (2.2 to 4.4 mmol/L).

A heel stick blood glucose test should be done within the first hour of life and repeated as needed based on the results and clinical signs of hypoglycemia.

Oligohydramnios is a condition where there is too little amniotic fluid surrounding the fetus.

This can cause the umbilical cord to become compressed by the fetal body parts or the uterine wall, reducing blood flow and oxygen to the fetus.

This can lead to fetal distress, hypoxia, and acidosis.

Choice B is wrong because fetal malposition is not directly caused by oligohydramnios.

Fetal malposition is when the fetus is in an abnormal position for delivery, such as breech, transverse, or face presentation.

This can increase the risk of complications during labor and delivery, such as cord prolapse, dystocia, or birth trauma.

Choice C is wrong because placental abruption is not directly caused by oligohydramnios.

Placental abruption is when the placenta separates from the uterine wall before delivery, causing bleeding and reduced blood flow to the fetus.

This can be triggered by trauma, hypertension, or cocaine use.

Choice D is wrong because premature rupture of membranes (PROM) is not directly caused by oligohydramnios.

PROM is when the amniotic sac breaks before the onset of labor, causing leakage of fluid and increased risk of infection.

This can be caused by infection, cervical incompetence, or mechanical factors.