Practice Question
A newborn is experiencing cold stress. Which of the following would the nurse potentially expect to assess? Select all that apply.
Answer Choices:
Correct Answer:
Hypoglycemia
Rationale:
Hypoglycemia
🧊 In cold stress, the newborn’s body increases metabolic rate to generate heat, which rapidly uses up glucose stores.
🧊 Because newborns have limited glycogen reserves, this increased demand quickly leads to low blood glucose (hypoglycemia).
🧊 Hypoglycemia may manifest as jitteriness, lethargy, poor feeding, or seizures, so it is a critical complication to monitor in cold stress.
🧊 Cold stress and hypoglycemia are closely linked, forming a vicious cycle: more cold → more glucose use → lower blood sugar → poorer ability to generate heat.
🧊 Therefore, hypoglycemia is a classic expected finding when a newborn is experiencing cold stress.
Respiratory distress
🧊 Cold stress causes an increase in oxygen consumption as the infant’s body attempts to produce more heat.
🧊 This higher oxygen demand places added workload on the lungs and can quickly lead to tachypnea, grunting, nasal flaring, and retractions.
🧊 As the infant tires, gas exchange becomes less efficient, resulting in respiratory distress and possible respiratory failure if uncorrected.
🧊 The combination of increased metabolic demand and immature lungs makes newborns particularly vulnerable in cold stress.
🧊 Thus, respiratory distress is an expected and serious assessment finding in a newborn with cold stress.
Cyanosis
🧊 With cold stress, the newborn’s oxygen needs increase, and if these needs are not met, hypoxemia can develop.
🧊 Cyanosis (bluish discoloration of skin, lips, or mucosa) indicates inadequate oxygenation of tissues, often due to respiratory compromise.
🧊 Peripheral vasoconstriction in response to cold also reduces perfusion to the extremities, further contributing to cyanotic appearance.
🧊 Central cyanosis in particular is an urgent sign that the infant is not maintaining adequate oxygen levels.
🧊 Therefore, cyanosis is a possible expected sign of worsening cold stress in the newborn.
Decreased oxygen needs
🧊 In cold stress, the infant’s oxygen needs actually increase, not decrease, due to heightened metabolic activity for heat production.
🧊 So decreased oxygen needs is the opposite of what happens and would not be an expected finding in cold stress.
Metabolic alkalosis
🧊 Cold stress is more commonly associated with metabolic acidosis from increased anaerobic metabolism and lactic acid buildup.
🧊 Metabolic alkalosis does not match the usual physiologic response to cold stress and is not an expected assessment finding.
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This question is from ATI Maternal Newborn which contains 27 questions.
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Question Details
- Category: RN Nursing Exam(s)
- Subcategory: ATI Exam(s)
- Domain: RN ATI Maternal & Newborn Care
- Answer Choices: 5