A nurse is caring for a preterm newborn who is in an incubator to maintain a neutral thermal environment.
The father of the newborn asks the nurse why this is necessary. Which of the following responses should the nurse make?
Preterm newborns lack the ability to regulate their own temperatures.
The heat in the incubator rapidly dries the sweat of preterm newborns.
Preterm newborns have a smaller body surface area than normal newborns.
The added brown fat layer in a preterm newborn reduces his ability to generate heat.
The Correct Answer is A
Choice A rationale
Preterm newborns have underdeveloped mechanisms for thermoregulation, making it difficult for them to maintain stable body temperatures without external assistance.
Choice B rationale
Preterm newborns do not sweat significantly because their sweat glands are not fully developed; thus, this rationale is incorrect.
Choice C rationale
Preterm newborns actually have a larger body surface area relative to their weight, contributing to their difficulty in maintaining body temperature.
Choice D rationale
Preterm newborns have insufficient brown fat, not an excess, which impairs their ability to generate heat effectively.
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Correct Answer is B
Explanation
Choice A rationale
A pincer grasp, using the thumb and index finger to pick up small objects, typically develops around 9 to 12 months of age, not at 4 months.
Choice B rationale
The posterior fontanel typically closes by the age of 2 to 3 months, so a 4-month-old infant would be expected to have a closed posterior fontanel. This finding is consistent with normal development.
Choice C rationale
Lateral incisors, the teeth on either side of the front teeth, typically erupt around 9 to 13 months of age, not at 4 months.
Choice D rationale
Sitting steadily without support generally occurs closer to 6 to 8 months of age, so it would not be expected in a 4-month-old infant.
Correct Answer is D
Explanation
Choice A rationale
Administering vitamin K is important but not the immediate priority right after birth.
Choice B rationale
Administering eye prophylaxis is also necessary but comes after ensuring the newborn is dry to prevent heat loss.
Choice C rationale
Placing an identification bracelet is crucial but not as immediate as drying the skin to regulate the baby's temperature.
Choice D rationale
Drying the skin is the priority to prevent hypothermia by reducing evaporative heat loss right after birth