The nurse has received report for a term newborn after a vaginal birth. Maternal history includes diagnosis of gestational diabetes at 25 weeks gestation and poorly controlled blood glucose during pregnancy. When assessing the newborn, which finding should the nurse most likely expect?

Question

Quizplus · Accepted Answer

11ecbb05_cc20_e14a_b433_5793c06c689b_MD0009_00 Poorly controlled maternal diabetes negatively affects fetal growth and oxygenation throughout pregnancy. As a result, infants of diabetic mothers are at an increased risk for postnatal complications. In clients with poorly controlled diabetes, the fetus experiences hyperglycemia and produces excess insulin. To compensate, the fetus increases metabolic activity and oxygen consumption. Fetal erythropoietin production subsequently increases to produce additional red blood cells (erythropoiesis), which are needed to transport oxygen to tissues. This increased production of red blood cells leads to polycythemia (ie, hematocrit >65%) and increased circulatory viscosity (Option B). (Option A) Delayed meconium passage may be a sign of cystic fibrosis (a genetic condition with characteristically thick secretions that lead to intestinal blockages) or Hirschsprung disease (a condition in which a portion of the colon inhibits peristalsis). (Option C) Yawning, sneezing, and a high-pitched cry are features of neonatal abstinence (withdrawal) syndrome due to a history of maternal substance abuse. (Option D) A smooth philtrum, thin upper lip, and short palpebral fissures are classic facial features of infants with fetal alcohol syndrome. Educational objective: Poorly controlled diabetes negatively affects fetal oxygenation throughout pregnancy. In utero, erythropoiesis accelerates to meet additional fetal oxygen needs. Due to overproduction of red blood cells, infants of diabetic mothers commonly experience polycythemia (ie, hematocrit >65%).

The Nurse Has Received Report for a Term Newborn After