A nurse is preparing to examine a post-term newborn immediately following delivery. Which of the following findings should she expect to observe? (Select all that apply.).
A.
Moro reflex.
B.
Vernix in the folds and creases.
C.
Abundant lanugo.
D.
Heel to ear maneuverability.
The Correct Answer and Explanation is:
In preparing to examine a post-term newborn immediately following delivery, the nurse should expect to observe the following findings:
D. Heel to ear maneuverability.
Explanation:
A post-term newborn is defined as a baby born after 42 weeks of gestation. By this time, the baby has had additional time to develop and mature in utero, which significantly affects the physical characteristics observed at birth.
- Heel to Ear Maneuverability (D): In a post-term newborn, the increased maturity of the musculoskeletal system typically allows for greater flexibility and maneuverability of the limbs. This means that the baby may show a greater range of motion, including the ability to touch the heel to the ear. This finding is a result of the more developed and less restricted muscles compared to a preterm or early-term newborn.
- Vernix in the Folds and Creases (B): Vernix caseosa is a protective, white, cheesy substance that covers the skin of the fetus during pregnancy. In post-term newborns, the vernix is usually minimal or absent because it is absorbed or shed over time as the pregnancy progresses beyond the expected term. Therefore, finding significant amounts of vernix in the folds and creases is not typical for post-term babies.
- Abundant Lanugo (C): Lanugo is the fine, soft hair covering the fetus. By the time of delivery at term or post-term, much of the lanugo is usually gone. Abundant lanugo is more commonly observed in preterm infants as it is a sign of earlier gestational age.
- Moro Reflex (A): The Moro reflex, also known as the startle reflex, is present in newborns but is not specifically indicative of whether a baby is preterm or post-term. It is a normal reflex that should be observed in all newborns shortly after birth, regardless of gestational age.
In summary, the most expected finding in a post-term newborn is the increased maneuverability of the limbs, such as heel-to-ear flexibility. The presence of abundant vernix, lanugo, and the Moro reflex, while important for overall assessment, are not specifically indicative of post-term status.