The nurse prepares to assess a newborn who is considered to be large-for-gestational-age (LGA). Which characteristic would the nurse correlate with this gestational age variation?

birthweight of 7 lb, 14 oz (3,572 g)

strong, brisk motor skills

difficulty in arousing to a quiet alert state

wasted appearance of extremities

Answer and Explanation

The Correct Answer is C

A.   A birthweight above the 90th percentile for gestational age is characteristic of large-for-gestational-age newborns. The above birth weight is within the normal ranges.
B.   Strong, brisk motor skills are not necessarily indicative of being large-for- gestational-age.
C.   Large-for-gestational-age newborns. They may have difficulty in arousing to a quiet alert state due to hypoglycemia, hypocalcemia, or polycythemia.
D.   A wasted appearance of extremities is more indicative of intrauterine growth restriction (IUGR) rather than being large-for-gestational-age. LGA newborns typically have plump and rosy appearance.

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Correct Answer is A

Explanation

A. This technique might be appropriate for younger children, but not for teenagers who want more autonomy and respect. Letting him choose juice or soda might make him feel like he is being treated like a child, and not as a partner in his own care.
B. Seeking the teenager's input on decisions promotes autonomy and empowerment, which can be effective in adolescent healthcare.
C. Avoiding undue criticism of noncompliance is important for maintaining a supportive and trustful nurse-patient relationship, especially with adolescents.
D. The nurse should also discuss the benefits of chemotherapy with him, such as how it can kill cancer cells, shrink tumors, and improve his chances of survival. The nurse should explain the rationale and goals of chemotherapy in a clear and honest way, and answer any questions or concerns the teenager might have. By doing so, the nurse can help him understand the importance of adhering to the treatment plan, and motivate him to cope with the challenges.

A. Have the parent stand near and/or rub the child's feet during the procedure. B. Use restraint or "holding down" of the child during the procedure to prevent injury. C. Insert a saline lock if the child will require multiple doses of parenteral medications. D. Avoid using numbing techniques for multiple blood draws or IV insertion.

Correct Answer is C

Explanation

A. Having the parent stand near and providing comfort measures, is not correct because it may not be enough to comfort the child or reduce anxiety during the procedure.
B. Using restraint or holding down the child during a procedure can increase anxiety, distress, and trauma, and is not recommended.
C. A saline lock is a device that allows access to a vein without having to insert a needle each time. This can reduce the number of painful procedures and lower the risk of infection or inflammation.
D. Numbing techniques can help reduce pain and discomfort during procedures and are typically used to enhance atraumatic care, especially for repeated procedures like blood draws or IV insertion. Therefore, avoiding them may not be beneficial.

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The nurse prepares to assess a newborn who is considered to be large-for-gestational-age (LGA). Which characteristic would the nurse correlate with this gestational age variation?

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