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A nurse is planning care for a newborn who is large for gestational age due to...

  1. A nurse is planning care for a newborn who is large for gestational age due to maternal gestational diabetes mellitus. The nurse should recognize that the newborn is at risk for which of the following conditions? (Select all that apply.)

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Ans:

Infants of diabetic mothers are often larger than other babies, especially if diabetic is not well controlled. This may make vaginal birth harder and may increase risk for nerve injuries and other trauma during birth. Also , cesarean birth are more likely same.

Nurse have to know newborn of diabetic mothers are prone to various neonatal adverse outcomes including -

* Metabolic and hematologic disorders

- Hypoglycemia : babies of mothers with gestational diabetes have low blood sugar shortly after birth may cause complication.

* Respiratory distress:

- During delivery due to larger size , newborn having risk of asphyxia which may cause respiratory distress. It is life treating condition , so monitoring apgar score and maintaining ventilation of baby is necessary.

* Cardiac disorders:

- Infants with gestational diabetes are prone to face cardiac disorders like bradicardia.

* Neurological impairment due to perinatal asphyxia and birth trauma

* Maternal hyperglycemia may cause for perinatal death and birth defects.

* Nurse should recognise symptoms of complication are following -

1. Sweating

2. Feeding difficulties, poor suck

3. Weak or high pitched cry

4. Tremors

5. Hypothermia

6. Irritability

7. Lethargy/ stuper

8. Hypotonia

For preventing all this risk , nurse should work on care plan for newborn with following objective -

1. Assessment of baby for neurological reflexes to find out birth trauma or. Neurological injuries.

2. Maintain blood glucose level of baby to prevent hypoglycemia.

3. Proper hydration and nutrition to baby to prevent metabolic and respiratory disorders.

4. Monitoring vitals and intake output of newborn

5. Heath education to mother and family members about taking care of newborn baby.


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