The parents require further teaching if they suggest that congenital hypothyroidism is not screened. The newborn screening tests are performed at 24 to 48 hours after birth. Newborn screening requires a blood sample taken from the infant's heel, and only one blood sample is needed for all tests. Tests performed within the first 24 hours of life are less sensitive than those performed after 24 hours. Infants tested before 12 to 24 hours of age should have repeat tests at 1 to 2 weeks of age so that disorders are not missed because of early testing.

Correct Answer: C

Rationale: The correct answer is C) We wish the tests would screen for congenital hypothyroidism, it runs in our family. This statement indicates a lack of understanding on the part of the parents regarding the importance of newborn screening for congenital hypothyroidism. Newborn screening is a critical component of pediatric healthcare as it helps to detect potential health issues early on, allowing for timely interventions and treatment. Congenital hypothyroidism, if left untreated, can lead to serious developmental delays and health complications. Therefore, it is essential for parents to be informed about the significance of screening for this condition. Option A) We understand the tests are performed at 24 to 48 hours - This statement shows an understanding of the timing of newborn screening tests, but it does not address the importance of screening for congenital hypothyroidism. Option B) We're glad all the tests can be done on one blood sample - While this statement acknowledges a positive aspect of newborn screening (the convenience of multiple tests from one sample), it does not address the specific issue of screening for congenital hypothyroidism. In an educational context, it is crucial to emphasize to parents the rationale behind newborn screening, the conditions that are screened for, and the potential consequences of undetected disorders. By providing this information, parents can make informed decisions about their child's healthcare and advocate for appropriate screening measures.

Correct Answer: C

Rationale: The priority question is to determine when the mother will be nursing the baby to observe a feeding session, especially if she is breastfeeding. This helps assess milk supply, adequacy of breastfeeding, and provide support. The other options are not as crucial for determining the best time for the visit.

Correct Answer: D

Rationale: Engorgement occurs when the breasts are not adequately emptied at each feeding or if feedings are not frequent enough. Breast milk moves through the stomach within 1.5 to 2 hours, therefore waiting 4 hours to feed is too long. Frequent feedings are important to empty the breast and establish lactation. Fluid intake should not be limited with a breastfeeding mother; that would decrease the amount of breast milk produced. Warm packs should be applied to the breast before feedings.

Correct Answer: C

Rationale: The correct answer is C because recent studies have shown that breast milk is low in vitamin D, and supplementation with 400 IU is recommended. This is important for infants who are not exposed to the sun or have dark skin, as they are at risk for insufficient vitamin D. While a well-balanced diet is important for the mother's health, it does not address the need for vitamin D supplementation in breastfed infants. Asking about the mother's concerns or abilities does not provide the necessary information about vitamin D supplementation.

Correct Answer: C

Rationale: The correct answer is C because SGA infants are defined as below the tenth percentile in growth when compared with other infants of the same gestational age. SGA is not defined by weight. Infants born before 38 weeks are classified as preterm. There are many factors that contribute to the development of an SGA infant, not just placental malfunction.