A patient with pregestational diabetes mellitus delivers a neonate who is diagnosed with macrosomia. The nurse is aware that the neonate is at risk for additional long-term conditions related to maternal diabetes mellitus.
Which long-term effects may occur? Select all that apply.
Impaired intellectual development.
Development of metabolic syndrome.
Shoulder injury related to birth size.
Changes in genetic expression.
Increased risk for chronic illnesses.
Correct Answer : A,B,D,E
Choice A rationale
Impaired intellectual development in children born to mothers with diabetes can occur due to fluctuating blood glucose levels, which can affect brain development.
Choice B rationale
Development of metabolic syndrome is more likely in children born to mothers with diabetes due to genetic predispositions and prenatal exposure to hyperglycemia.
Choice C rationale
Shoulder injury related to birth size, although a possible immediate complication, is not typically considered a long-term effect of maternal diabetes.
Choice D rationale
Changes in genetic expression can occur due to epigenetic modifications from exposure to maternal diabetes, potentially leading to various health issues later in life.
Choice E rationale
Increased risk for chronic illnesses, such as type 2 diabetes and cardiovascular diseases, is higher in children born to mothers with diabetes, due to genetic and environmental factors.
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Correct Answer is B
Explanation
Choice A rationale
Decreased muscle tone is not typically associated with neonatal abstinence syndrome (NAS). Instead, NAS often presents with hypertonia or increased muscle tone due to
withdrawal symptoms.
Choice B rationale
A continuous high-pitched cry is a hallmark sign of NAS, indicating the newborn is experiencing withdrawal and discomfort. This symptom results from the overstimulation of the
central nervous system.
Choice C rationale
Newborns with NAS often have difficulty sleeping and may sleep for shorter periods due to irritability and discomfort. Prolonged sleep after feeding is not characteristic of NAS.
Choice D rationale
Tremors in newborns with NAS are usually pronounced and continuous, not just when disturbed. These tremors are a result of withdrawal effects on the nervous system.
Correct Answer is D
Explanation
Choice A rationale
Placing a pacifier in the baby's mouth is inappropriate because it does not address the underlying cause of grunting, which can be a sign of respiratory distress.
Choice B rationale
Checking the baby's diaper is not relevant to assessing the cause of grunting. Grunting is usually related to respiratory issues rather than a dirty diaper.
Choice C rationale
Having the mother feed the baby is inappropriate because grunting may indicate respiratory distress. Feeding should be deferred until the baby's respiratory status is assessed and stabilized.
Choice D rationale
Assessing the respiratory rate is appropriate because grunting in a newborn can indicate respiratory distress. The nurse should evaluate the respiratory status to determine the need for further intervention.