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 A
Explanation
Choice A rationale
Negative behaviors characterized by the need for autonomy are typical of toddlers. According to Erikson, this stage is known as autonomy versus shame and doubt, where toddlers
assert their independence and develop self-control.
Choice B rationale
Erikson's stage of initiative versus guilt applies to preschool children, not toddlers. This stage involves children beginning to assert power and control over their environment through
directing play and other social interactions.
Choice C rationale
The need to start a task and complete it is associated with Erikson's stage of industry versus inferiority, which applies to school-aged children, not toddlers. This stage involves
developing a sense of pride in their accomplishments.
Choice D rationale
The discovery of their identity is a characteristic of Erikson's stage of identity versus role confusion, which pertains to adolescence. During this stage, teenagers work on refining a
sense of self.
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.