A neonate is displaying mottled skin, has a large fontanel and tongue, is lethargic, and is having difficulty feeding. The nurse recognizes that this is most suggestive of
a. Hypocalcemia
b. Hypothyroidism
c. Hypoglycemia
d. Phenylketonuria (PKU)
B
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A When hypocalcemia is present, neonates may display twitching, tremors,
irritability, jitteriness, electrocardiographic changes, and, rarely, seizures.
B An infant with hypothyroidism may exhibit skin mottling, a large fontanel, a
large tongue, hypotonia, slow reflexes, a distended abdomen, prolonged
jaundice, lethargy, constipation, feeding problems, and coldness to touch.
C Hypoglycemia causes the neonate to exhibit jitteriness, poor feeding, lethargy,
seizures, respiratory alterations including apnea, hypotonia, high-pitched cry,
bradycardia, cyanosis, and temperature instability.
D Infants with PKU may initially have digestive problems with vomiting, and they
may have a musty or mousy odor to the urine, infantile eczema, hypertonia, and
hyperactive behavior.
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