Which patient should be assessed first?

Correct Answer: A

Rationale: The correct answer is A. An infant with a blood glucose level of 45 mg/dL and a maternal history of gestational diabetes should be assessed first to rule out hypoglycemia, which can be life-threatening in newborns. Hypoglycemia can lead to seizures, brain damage, or even death if not promptly treated. Infants born to mothers with gestational diabetes are at higher risk for hypoglycemia due to their own insulin production in response to high maternal glucose levels. Therefore, immediate assessment and intervention are crucial. Choice B is incorrect because growth parameters within normal ranges do not indicate an immediate need for assessment. Choice C is also incorrect as the mother's age and gestational age do not necessarily indicate an urgent need for assessment. Choice D is incorrect as the presence of a green stain and bruising may indicate meconium aspiration syndrome, but hypoglycemia poses a more immediate threat to the infant's health.

Correct Answer: D

Rationale: The correct answer is D: greater surface area in proportion to weight. Preterm infants have a higher surface area to weight ratio due to their smaller size and underdeveloped body systems. This increased surface area makes them more susceptible to heat loss and requires special care to maintain their body temperature. A: more subcutaneous fat - This is incorrect because preterm infants actually have less subcutaneous fat compared to full-term infants. B: well-developed flexor muscles - This is incorrect as preterm infants typically have less muscle tone and may exhibit muscle weakness. C: few blood vessels visible through the skin - This is incorrect as preterm infants often have fragile skin with visible blood vessels due to their underdeveloped skin layers.

Correct Answer: A

Rationale: The correct answer is A: Encourage the parents to touch their infant. This is important as physical touch promotes bonding between the parents and the infant, which is crucial for the infant's emotional and psychological development. It also helps the parents feel connected and involved in the care of their child. Choice B is incorrect because reassurance alone may not address the parents' need for physical closeness and bonding with their infant. Choice C is incorrect as discussing future care at this moment may overwhelm the parents and distract from the immediate need for bonding. Choice D is incorrect because limiting the parents' visit time may create more anxiety and hinder the bonding process.

Correct Answer: D

Rationale: The correct answer is D: Teach the parents signs of overstimulation, such as turning the face away or stiffening and extending the extremities and fingers. Rationale: 1. Teaching parents signs of overstimulation empowers them to recognize and respond to their infant's cues effectively. 2. Parents can then modify the environment or interactions to reduce overstimulation, hence decreasing oxygen use. 3. This intervention promotes parental involvement in the care of the preterm infant, fostering a supportive and nurturing environment. 4. By educating parents, the nursing staff can work collaboratively with families to optimize the infant's care and well-being. Summary: A: Grouping care activities may help with rest but does not directly address overstimulation and increased oxygen use. B: Keeping charts on top of the incubator is irrelevant to addressing overstimulation. C: Providing a soft report does not directly address overstimulation or involve parents in recognizing signs.

Correct Answer: C

Rationale: The correct answer is C: Intraventricular hemorrhage (IVH). High arterial blood oxygen levels can lead to IVH in preterm infants due to increased cerebral blood flow and disruption of immature blood vessels in the brain. This can cause bleeding into the brain's ventricles. NEC (A) is more associated with feeding issues, ROP (B) with high oxygen levels, and BPD (D) with prolonged use of mechanical ventilation.