The pediatric clinic nurse is reviewing lab results with a ...

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The pediatric clinic nurse is reviewing lab results with a 2-month-old infant's mother. The infant's hemoglobin has decreased since birth. Which statement by the mother indicates the need for additional teaching?
 
  1. My baby isn't getting enough iron from my breast milk.
  2. Babies undergo physiologic anemia of infancy.
  3. This results from dilution because of the increased plasma volume.
  4. Delaying the cord clamping did not cause this to happen.

Question 2

A breastfeeding mother calls the pediatric clinic concerned about her 4-day-old baby's failure to gain weight. She states that the infant has lost several ounces since birth.
 
  The most appropriate response by the nurse would be which of the following? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Newborns tend to lose about 5 to 10 of their birth weight because of failure to give adequate supplements when breastfeeding.
  2. Newborns grow approximately 1 inch a month in the first 6 months. You will need to increase feedings to compensate for the growth spurt.
  3. Newborns have an initial weight loss in the first 3 to 4 days. Your baby's weight loss is normal.
  4. Newborns lose a lot of heat, so make sure you keep the baby's formula warm when you supplement the breast milk.
  5. Keep the baby from getting chilled or too warm because that can contribute to weight loss.

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Answer to Question 1

1
Rationale 1: At 2 months of age, infants increase their plasma volume, which results in dilutional physiologic anemia. This condition is not related to iron in the breast milk.
Rationale 2: At 2 months of age, infants increase their plasma volume, which results in dilutional physiologic anemia.
Rationale 3: At 2 months of age, infants increase their plasma volume, which results in a dilution.
Rationale 4: Early or delayed cord clamping does not affect hemoglobin levels at this age.

Answer to Question 2

3, 5
Explanation: 3. Newborns have a physiological weight loss of 5 to 10 in the first 3 or 4 days.
5. Weight loss in the newborn can be caused by temperature elevation or consistent chilling.