A nurse providing dietary teaching for a client who is at 29 weeks of gestation and has phenylketonuria. Which of the following suggested foods should the nurse include in the teaching?

The correct answer is: A. Hemoglobin 12 g/dL.

Choice A reason:

Hemoglobin levels in newborns are expected to be significantly higher than in adults due to the physiological adaptation to life outside the womb. The normal range for a newborn’s hemoglobin is approximately 14 to 24 g/dL1234. A level of 12 g/dL is below the expected range and could indicate anemia or other underlying conditions that may require further investigation and intervention by the healthcare provider.

Choice B reason:

The glucose level in a newborn can vary, especially within the first few hours after birth. Normal blood glucose levels for a newborn 1 to 2 hours old can be as low as 25 mg/dL and can rise to adult levels (60-100 mg/dL) within the first few days5. A glucose level of 50 mg/dL in a 24-hour-old newborn falls within the acceptable range and would not typically require reporting to the provider unless accompanied by symptoms of hypoglycemia.

Choice C reason:

Bilirubin levels in newborns can be elevated due to the normal breakdown of fetal hemoglobin as the baby’s liver matures. Normal bilirubin levels for a newborn can range from 1.0 to 12.0 mg/dL6. A bilirubin level of 4 mg/dL is within the normal range for a 24-hour-old newborn and is not typically a cause for concern unless there are signs of jaundice or other symptoms.

Choice D reason:

The normal platelet count for a newborn ranges from 150,000 to 450,000/mm³7. A platelet count of 200,000/mm³ is well within the normal range for a newborn and would not need to be reported to the healthcare provider.

Choice A rationale:

Gravida refers to the number of times a woman has been pregnant, and Para indicates the number of pregnancies that have reached viability (at least 20 weeks) Since the client has

been pregnant for the fourth time and delivered two full-term newborns (reached viability), she is gravida 4, and since she had one spontaneous abortion (miscarriage) at 10 weeks of gestation, she is para 2 (two pregnancies reached viability)

Choice B rationale:

This choice would be incorrect because it indicates that the client has had three pregnancies reaching viability, but she has only had two full-term newborns and one miscarriage.

Choice C rationale:

This is the correct choice, as explained above. Choice D rationale:

This choice would be incorrect because it indicates that the client has had four pregnancies reaching viability, but she has only had two full-term newborns and one miscarriage.