A nurse is caring for a newborn who was born to a mother with gestational diabetes. The newborn is large for gestational age.
The nurse should recognize which of the following newborn complications as the priority focus of care?
Monitoring for hypoglycemia.
Monitoring for physiological jaundice.
Monitoring for hyperthermia.
Monitoring for development of rash.
The Correct Answer is A
Choice A rationale
Monitoring for hypoglycemia is critical in newborns born to mothers with gestational diabetes, as they can experience significant drops in blood sugar levels post-birth due to the
sudden discontinuation of the high glucose supply from the mother.
Choice B rationale
Physiological jaundice is common in many newborns but does not represent the most immediate threat. It typically resolves within a few days with appropriate monitoring and care.
Choice C rationale
Hyperthermia can be a concern for newborns, but it is not the primary immediate complication in newborns born to gestational diabetic mothers. Hypoglycemia poses a greater
immediate risk.
Choice D rationale
Development of rash is generally a less critical concern and does not represent an immediate threat to the newborn’s well-being in comparison to hypoglycemia.
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Correct Answer is D
Explanation
Choice A rationale
Examining the tympanic membrane at the beginning may cause distress to the child and make the rest of the exam difficult.
Choice B rationale
Before auscultating the chest and abdomen, the child needs to be calm and cooperative, which might not be the case if their ear is examined first.
Choice C rationale
Examining the tympanic membrane before the head and neck could lead to increased anxiety and uncooperativeness in the child during the rest of the exam.
Choice D rationale
Examining the tympanic membrane at the end allows for a more accurate and complete examination without causing the child to become distressed early in the process.
Correct Answer is B
Explanation
Choice A rationale
Vitamin K has no role in stabilizing blood glucose levels; hypoglycemia in newborns is managed differently.
Choice B rationale
Vitamin K is essential for blood clotting, and newborns typically have low stores at birth, necessitating supplementation to prevent bleeding disorders.
Choice C rationale
There is no established link between maternal fever and the need for vitamin K; prophylaxis is standard for all newborns regardless of maternal health.
Choice D rationale
Newborns do not have sufficient prothrombin or other clotting factors, which is why vitamin K administration is critical.