Editing Maternal and Newborn Nursing – RN Practice Questions (section)

==Question 10==
A nurse is caring for a 1-hour-old newborn weighing 4,200 g born to a mother with gestational diabetes. The infant is jittery, has a weak cry, and feels cool. Which action should the nurse take '''first'''?
# Obtain a bedside blood glucose level.
# Place the infant skin to skin with the mother.
# Notify the neonatal provider.
# Swaddle the infant and recheck in 30 minutes.

'''Answer:''' 1 (A). Obtain a bedside blood glucose level.

''Rationale:'' A large-for-gestational-age infant of a diabetic mother has been exposed to maternal hyperglycemia in utero, has developed hyperinsulinemia, and loses the maternal glucose supply abruptly at birth, making hypoglycemia highly likely. Jitteriness, weak cry, and temperature instability are classic nonspecific signs. Assessment precedes intervention when the finding is easily and quickly measurable and will determine treatment. Skin-to-skin contact (option 2) is valuable and will follow, and early feeding is the usual treatment for an asymptomatic infant, but a symptomatic infant needs a value first. Option 3 is premature without data. Option 4 delays recognition of a condition that can cause seizures and neurologic injury.