The nurse reinforces teaching regarding newborn hypoglycemia.
Which of the following client statements indicate understanding of newborn hypoglycemia? Select all that apply.
Glucose levels of 40 to 45 mg/dL are considered the normal lower limit for up to 72 hours after birth.
If my baby's blood glucose keeps going below 50 mg/dL in the next 24 hours, they will need intravenous glucose.
When my umbilical cord was clamped, my baby lost its source of glucose.
As long as I breastfeed my baby frequently, their blood glucose levels should improve.
It is common for term newborns to experience transient hypoglycemia within the first few hours of life.
The skin-to-skin contact immediately after birth promotes thermoregulation and stabilizes glucose levels.
Correct Answer : C,D,E,F
Choice A rationale
Neonatal hypoglycemia is typically defined as a blood glucose concentration below 40 mg/dL in the first 4 hours of life, or below 45 mg/dL between 4 and 24 hours. Glucose levels of 40 to 45 mg/dL are generally considered the goal range to prevent neurological injury, not the normal lower limit for up to 72 hours post-birth.
Choice B rationale
If a newborn's blood glucose levels remain persistently below 40 mg/dL after initial management (like feeding) or if they develop symptomatic hypoglycemia, intravenous dextrose will be required. A value persistently below 50 mg/dL is concerning, but the 40 mg/dL threshold is often the critical point for initiating IV glucose when oral methods fail.
Choice C rationale
The umbilical cord provides the fetus with a continuous supply of glucose via the placenta from the mother. Upon umbilical cord clamping, this maternal glucose supply is abruptly interrupted, requiring the newborn's immature metabolic systems to take over glucose homeostasis. This sudden loss of exogenous glucose is a primary factor in transient newborn hypoglycemia.
Choice D rationale
Frequent breastfeeding provides the newborn with a readily available source of lactose, which is metabolized into glucose, thereby promoting the stability of their blood glucose levels. Early and frequent feeding is the primary intervention for transient hypoglycemia in newborns who are able to feed, utilizing the oral route for caloric intake.
Choice E rationale
Transient hypoglycemia is a common and expected physiological adaptation in term newborns during the initial hours after birth. The abrupt cessation of maternal glucose supply necessitates the newborn's activation of gluconeogenesis and glycogenolysis, which may temporarily be insufficient, leading to a mild, self-limiting drop in blood glucose.
Choice F rationale
Skin-to-skin contact immediately after birth is vital as it prevents cold stress. When a newborn is cold, they must expend energy (calories) to produce heat, which consumes glucose, potentially leading to or exacerbating hypoglycemia. Thermoregulation thus indirectly stabilizes blood glucose levels by conserving energy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"B"},"E":{"answers":"B"}}
Explanation
- Cover the newborn's eyes with an eye shield ✅ This is essential to prevent retinal damage from the phototherapy light.
- Reposition the newborn every 2 to 3 hr ✅ Repositioning ensures even exposure to light and prevents pressure injuries.
- Apply lotion to the newborn's skin regularly ❌ Lotion is contraindicated as it may interfere with light absorption and increase the risk of burns.
- Ensure the newborn wears a hat during phototherapy ❌ A hat reduces the surface area exposed to light, decreasing phototherapy effectiveness.
- Move the lights closer to the newborn to increase temperature ❌ Phototherapy lights should be positioned at a safe distance to avoid overheating or burns. Temperature should be monitored, not manipulated this way.
Correct Answer is ["B","C","D"]
Explanation
Choice A rationale
The newborn's weight is an important metric used to assess appropriate growth. While deviations (e.g., small for gestational age or large for gestational age) are risk factors, the mere recording of the weight itself in the EMR is a standard measurement, not inherently a risk factor. It becomes a risk factor only when the measurement falls outside the expected range for the newborn's gestational age.
Choice B rationale
The type of birth (e.g., vaginal, Cesarean section) is a risk factor for complications. Cesarean birth, especially without labor, is associated with an increased risk of transient tachypnea of the newborn (TTN) due to retained fetal lung fluid. Conversely, a prolonged or operative vaginal birth can increase the risk of birth trauma, suggesting the type of birth itself introduces specific complication risks.
Choice C rationale
Apgar scores are a rapid assessment of five physiological signs (Appearance, Pulse, Grimace, Activity, Respiration) at one and five minutes of life. A low Apgar score (typically ≤ 7 at five minutes) is a significant and immediate indicator of neonatal distress and a strong risk factor for long-term neurological complications, necessitating prompt and potentially intensive resuscitation.
Choice D rationale
Gestational age is a primary determinant of neonatal maturity and viability. Preterm birth (less than 37 weeks) is a major risk factor for complications, including respiratory distress syndrome (due to surfactant deficiency), thermoregulation difficulties, and developmental issues. Post-term birth (over 42 weeks) is also a risk for placental insufficiency and meconium aspiration.
Choice E rationale
The recording of heart sounds in the EMR is part of a standard newborn physical assessment. The presence of a normal finding (e.g., regular rhythm, no murmurs) is a sign of health, not a risk factor. An abnormal finding, such as a persistent murmur suggestive of a congenital heart defect, would be the risk factor, but the standard documentation is just a physiological assessment.
Choice F rationale
The newborn's length is a standard anthropometric measurement, assessing overall growth and proportional development. Like weight, recording the length itself is a standard parameter, not a risk factor. It only becomes clinically significant as an indicator of an underlying issue if it is disproportionate or falls significantly outside the expected percentile range for the newborn's gestational age.
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