Three hours after birth, a newborn of a mother with diabetes becomes jittery, has weak, high- pitched cry , and exhibits irregular respirations. The nurse recognizes that these signs are often associated with:

Correct Answer: C

Rationale: The signs described in the scenario - jitteriness, weak high-pitched cry, irregular respirations - are indicative of hypoglycemia in a newborn. Babies born to mothers with diabetes are at risk for hypoglycemia due to their exposure to high blood sugar levels in utero. After birth, when the baby is separated from the mother's blood supply, their own insulin production may lead to a sudden drop in blood glucose levels.

Correct Answer: B

Rationale: In assessing for proper latch during breastfeeding, the correct answer is B) Ensure the baby's lips are sealed around the areola. This is crucial because a good latch ensures effective milk transfer, prevents nipple pain or damage, and promotes optimal milk supply. When the baby's lips are sealed around the areola, it signifies that the baby is positioned correctly and is able to suck efficiently. Option A) Ensure the baby's nose is covered during feeding is incorrect and potentially dangerous as it can lead to suffocation. The baby's nose should remain uncovered to allow for proper breathing during feeding. Option C) Check for audible swallowing during feeding is a good indicator of effective feeding but does not directly assess the latch itself. Option D) Encourage frequent feeding attempts is important for establishing and maintaining milk supply but does not specifically address the assessment of proper latch. Educationally, understanding how to assess for proper latch is fundamental for nurses working with breastfeeding mothers and infants. It ensures optimal nutrition for the newborn, promotes bonding between mother and baby, and helps prevent breastfeeding challenges. Nurses play a critical role in supporting breastfeeding success by accurately assessing latch and providing guidance and support to mothers.

Correct Answer: A

Rationale: In the case of a newborn with meconium-stained amniotic fluid, the correct action for the nurse is to suction the airway immediately after birth (Option A). Meconium aspiration syndrome can occur if the meconium is aspirated into the lungs, leading to respiratory distress. By suctioning the airway promptly, the nurse can prevent potential complications and ensure proper oxygenation for the newborn. Monitoring for signs of aspiration (Option B) is important, but immediate intervention through suctioning takes precedence to prevent aspiration from occurring in the first place. Encouraging immediate skin-to-skin contact (Option C) is beneficial for bonding and thermoregulation but is not the priority in this situation. Administering antibiotics (Option D) is not indicated as a routine intervention for a newborn with meconium-stained amniotic fluid unless there are signs of infection. From an educational perspective, understanding the pathophysiology of meconium aspiration syndrome and the importance of prompt airway management can help nurses provide safe and effective care to newborns in this critical situation. This knowledge ensures that nursing interventions are prioritized based on the immediate needs of the newborn to promote positive outcomes.

Correct Answer: D

Rationale: A previous diagnosis of type 2 diabetes is a known risk factor for developing gestational diabetes mellitus (GDM). Women who have had diabetes prior to pregnancy are more likely to develop GDM due to pre-existing insulin resistance. This increased risk is why healthcare providers closely monitor pregnant women with a history of type 2 diabetes. It is important for these women to manage their blood sugar levels carefully during pregnancy to reduce the risk of complications for both the mother and the baby.

Correct Answer: A

Rationale: CPD (cephalopelvic disproportion) occurs when the baby's head or body is too large to pass through the mother's pelvis. In cases where CPD is diagnosed and labor has stalled despite adequate efforts (such as pushing for 2 hours with no progress), the safest and most appropriate method to deliver the baby is through a cesarean section (C/S). This surgical procedure allows for a safe delivery when vaginal delivery is not possible due to CPD, ensuring the well-being of both the baby and the mother. Induced labor, vaginal birth with vacuum, or inserting a foley catheter to empty the bladder would not be effective or safe in cases of CPD where the baby cannot pass through the birth canal.