When reviewing laboratory results for a 1-day-old infant, the ...

[sjones]

When reviewing laboratory results for a 1-day-old infant, the nurse notes that the infant's IgM antibodies are elevated. Which is the least likely cause of the infant's IgM antibody level elevation?
 
  1. Maternal-fetal transfer of IgM while in utero
  2. Placental leakage
  3. Intrauterine exposure to syphilis
  4. Intrauterine exposure to TORCH syndrome

Question 2

A postpartum patient calls the nursery to report that her 3-day-old newborn has passed a bright green stool. The nurse's best response is:
 
  1. Take your newborn to the pediatrician.
  2. There may be a possible food allergy.
  3. Your newborn has diarrhea.
  4. This is a normal occurrence.

[Awesome]

Answer to Question 1

Correct Answer: 1
Rationale 1: Because IgM does not normally cross the placenta, most or all of it is produced by the fetus beginning at 10 to 15 weeks' gestation. Elevated levels of IgM at birth may indicate placental leaks or, more commonly, antigenic stimulation in utero.
Rationale 2: Elevated levels of IgM at birth may indicate placental leaks.
Rationale 3: Elevations in IgM may be due to newborn exposure to an intrauterine infection such as syphilis.
Rationale 4: Elevations in IgM at birth may be due to newborn exposure to an intrauterine infection such as syphilis or TORCH syndrome (toxoplasmosis, rubella, cytomegalovirus, herpesvirus hominis type 2 infection).

Answer to Question 2

Correct Answer: 4
Rationale 1: It is not necessary for the patient to take her newborn to the pediatrician.
Rationale 2: The green color of stool is not due to food allergies.
Rationale 3: The green color of stool is not characterized as diarrhea, but is a transitional stool that consists of part meconium and part fecal material.
Rationale 4: By the third day of life, the newborn's stools appear brown to green in color.