A nurse is teaching a client who gave birth to a term newborn 24 hours ago about the newborn screening for phenylketonuria. Which of the following statements should the nurse include in the teaching?
Your newborn will have a heel stick blood test now for the newborn screening and phenylketonuria test.
Your newborn does not have manifestations, so the test will not be done.
Your newborn will be tested one week after birth.
Your newborn will be given nothing by mouth for 6 hours prior to testing.
The Correct Answer is A
Choice A reason: Newborn screening for phenylketonuria involves a heel stick blood test within 24-48 hours post-birth to detect elevated phenylalanine levels. Early testing ensures timely diagnosis, preventing intellectual disability from untreated phenylketonuria, a genetic disorder impairing phenylalanine metabolism, requiring immediate dietary intervention.
Choice B reason: Lack of manifestations does not exempt newborns from phenylketonuria screening, as symptoms appear later. Screening is universal, as early detection prevents severe neurological damage from phenylalanine accumulation, making this statement incorrect for standard newborn care protocols.
Choice C reason: Testing one week after birth delays phenylketonuria screening, risking untreated phenylalanine buildup, which causes irreversible brain damage. Screening occurs within 24-48 hours to ensure early intervention, making this timing incorrect for effective management of this metabolic disorder.
Choice D reason: Fasting for 6 hours is not required for phenylketonuria screening. The heel stick test is performed regardless of feeding status, as phenylalanine levels are detectable early. Fasting risks hypoglycemia in newborns, making this an unnecessary and harmful requirement.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is B
Explanation
Choice A reason: Pooling of blood in a cerebral space, such as a hematoma, can cause seizures by exerting pressure on brain tissue, disrupting neural activity. However, this is unrelated to febrile seizures, which are specifically triggered by rapid temperature changes, not vascular abnormalities, making this an incorrect cause.
Choice B reason: Febrile seizures are caused by a sudden rise in body temperature, often due to infections like viral illnesses. The rapid temperature increase stimulates neuronal hyperexcitability in young children, leading to seizures. This is the primary mechanism, typically seen in children aged 6 months to 5 years.
Choice C reason: Head or neck trauma causing a concussion can trigger seizures by disrupting brain function through inflammation or neuronal damage. However, febrile seizures are specifically linked to fever, not trauma. Concussive seizures require different management, making this an incorrect cause for febrile seizures.
Choice D reason: Structural brain defects, such as cortical dysplasia, can cause seizures by creating abnormal neural circuits. These are associated with epilepsy, not febrile seizures, which are benign and triggered by fever. Structural defects are a chronic condition, unlike the acute temperature-related mechanism of febrile seizures.
Correct Answer is B
Explanation
Choice A reason: Removing the traction boot during baths disrupts Buck extension traction, used to stabilize the femoral head in Legg-Calve-Perthes disease. Continuous traction maintains alignment, and removal risks joint displacement, delaying healing of the avascular necrosis affecting the femoral head.
Choice B reason: Repositioning every 2 hours prevents pressure ulcers and maintains circulation in a child in Buck traction for Legg-Calve-Perthes disease. Regular movement within traction limits reduces skin breakdown and promotes comfort, supporting healing of the femoral head by maintaining proper positioning.
Choice C reason: Antibiotic ointment is used for skeletal traction with pins, not Buck extension traction, which uses skin traction. Legg-Calve-Perthes disease treatment does not involve pins, making this action irrelevant, as there are no pin sites to manage for infection prevention.
Choice D reason: Reducing fluid intake is inappropriate, as adequate hydration supports circulation and healing in Legg-Calve-Perthes disease. Dehydration risks urinary and cardiovascular complications, hindering recovery from avascular necrosis, making this action counterproductive to the child’s overall health and treatment.
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