A mother called the maternity ward four days after the birth of ...

[jayhills49]

A mother called the maternity ward four days after the birth of her baby girl. She tells the nurse that she has noticed her infant's skin tone is yellow and asks if she should bring the infant to the hospital.
 
  What is the most likely cause of the infant's skin tone?
  1. Pathologic jaundice
  2. Acute bilirubin encephalopathy
  3. Physiologic jaundice
  4. Hemolytic disease of the newborn

Question 2

A diabetic mother has just given birth to a baby boy. The baby appears lethargic and has a high-pitched cry. The initial plasma glucose level was 19 mg/dL. What is the proper nursing action for this infant?
 
  1. Wait 30 minutes and re-test plasma glucose levels.
  2. Have the mother breastfeed the infant.
  3. Start an IV with D5W dextrose solution.
  4. Start an IV with D10W dextrose solution.

[Cheesycrackers]

Answer to Question 1

Correct Answer: 3
Rationale 1: Pathologic jaundice usually appears before 24 hours of life and is the result of a more serious underlying condition.
Rationale 2: Acute bilirubin encephalopathy, or kernicterus, is a serious medical condition resulting from very high bilirubin levels as a result of pathologic jaundice. This is unlikely to occur with physiologic jaundice.
Rationale 3: Most infants will develop physiologic jaundice 4-5 days after birth as a result of a shortened red blood cell lifespan, slow uptake of bilirubin by the liver, a lack of intestinal bacteria, or poorly established hydration from initial breastfeeding.
Rationale 4: Hemolytic disease of the newborn occurs as a result of blood incompatibility between the mother and infant and is usually diagnosed shortly after birth.

Answer to Question 2

Correct Answer: 4
Rationale 1: This infant is suffering from severe hypoglycemia. Aggressive treatment with D10W dextrose by IV is recommended.
Rationale 2: This is an appropriate nursing action if the infant's plasma glucose levels are between 25 and 40 mg/dl. This infant needs more aggressive treatment.
Rationale 3: D5W dextrose is primarily use to either prevent hypoglycemia or titrate down the concentration of administered glucose when the infant is transitioning off the glucose. A higher concentration of glucose is required for severely hypoglycemic infants.
Rationale 4: This is the proper nursing action. Infants with severe hypoglycemia should be aggressively treated with IV infusion of D10W dextrose.

[jayhills49]

TYSM

[blakcmamba]

Excellent