A nurse is performing an assessment on a post-term infant. Which physical characteristic should the nurse expect to observe?

Appeared in: DHS Staff Nurse - 2018 (Shift-2nd)

Explanation

A post-term infant is one born at or after 42 completed weeks of gestation.
Due to prolonged exposure to amniotic fluid after the protective vernix caseosa has disappeared, the infant's skin becomes dry, cracked, and often peels (desquamation).
This parchment-like skin is a classic sign of postmaturity.
Source SRC_13073 directly states that skin peeling is normal, especially in post-term and IUGR neonates.

Option B: Smooth soles without creases are a hallmark of a preterm infant, whose feet have not yet developed the extensive network of creases seen in term and post-term babies.
Option C: Lanugo, the fine, downy hair, is most abundant on preterm infants and gradually disappears as the fetus approaches term. A post-term infant would have very little or no lanugo.
Option D: A thick layer of vernix caseosa is characteristic of a term or near-term infant. This protective layer is lost in the post-term period.

Clinical Relevance

Nursing practice connection: Use the key finding related to Physical assessment findings in a post-term infant to guide bedside assessment, documentation, and the next nursing action.
Accurate gestational age assessment using physical characteristics (like the New Ballard Score) is a fundamental nursing skill in the neonatal unit to anticipate and manage potential risks.
Post-term infants require close monitoring for hypoglycemia due to depleted energy reserves. Nurses should perform blood glucose checks as per protocol.
Nurses must also be vigilant for signs of respiratory distress, as meconium aspiration is a significant risk in this population.

How to Approach the Question

First, identify the key term in the question: 'post-term infant'.
Recall the definition of a post-term infant, which is a baby born at or after 42 weeks of gestation.
Mentally review the classic physical characteristics associated with postmaturity. Think about what happens to the skin, vernix, lanugo, and creases after such a long time in the uterus.
Evaluate each option against your knowledge. Does it fit the profile of a post-term infant?
Option A: Peeling skin. Yes, this is due to the loss of vernix.
Option B: Smooth soles. No, that's a sign of prematurity.

Concept Tested & Keywords

Concept Tested: Physical assessment findings in a post-term infant.
Stem keywords: post-term infant, physical characteristic, assessment
Lead-in keywords: expect to observe
Clinical cues: The term 'post-term' indicates a gestational age of 42 weeks or more, which is the primary clue to the expected findings.
Negative lead-in flag: false

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E6 Ghai Essential Pediatrics(pp 26-904 of 913) pp. 132-134, 129-131

E6 Text Book Of Pediatric Nursing 3rd Panchali Pal — Part 1 (pp 36-238 of 713) p. 152-154

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