Which data should alert the nurse that the neonate is postmature

Which data should alert the nurse that the neonate is postmature?

A.
Presence of lanugo

B.
Short, chubby appearance

C.
Presence of vernix caseosa

D.
Cracked, peeling skin

The correct answer and Explanation is :

The correct answer is:

D. Cracked, peeling skin

Explanation:

A postmature neonate is a baby born after 42 weeks of gestation. When a neonate is postmature, certain physical characteristics can alert healthcare professionals, such as nurses, to their condition. These physical signs result from prolonged exposure to the intrauterine environment, leading to various skin and physical changes. Among the given options, cracked, peeling skin is the most telling feature of a postmature neonate.

1. Cracked, peeling skin (D):
   Postmature infants are typically born with dry, cracked, or peeling skin because they have been in the womb beyond the typical gestational period. The amniotic fluid’s ability to protect and hydrate the skin diminishes after the due date, and the protective vernix caseosa (a white, creamy biofilm that covers and moisturizes the baby’s skin) is less prevalent. As a result, the neonate’s skin can become overly dry, leading to cracks and peeling. This is a significant sign of postmaturity.
2. Presence of lanugo (A):
   Lanugo refers to fine, soft hair that covers the body of a fetus during gestation, especially between 24-32 weeks. It is more typical of preterm infants, not postmature neonates, as it typically sheds by the time a full-term baby is born.
3. Short, chubby appearance (B):
   A short, chubby appearance is more indicative of a healthy full-term neonate. Postmature infants tend to have a lean appearance due to insufficient nutrition in the later stages of pregnancy, leading to a loss of subcutaneous fat.
4. Presence of vernix caseosa (C):
   Vernix caseosa is a protective coating that covers the skin of a newborn. In postmature babies, vernix caseosa is minimal or absent since it diminishes as the pregnancy extends past the due date.

Thus, cracked and peeling skin is a clear indicator that a neonate might be postmature.