AQ Newborn
A nurse is assessing a newborn with caput succedaneum. How does the nurse explain the cause of this fetal condition to the new mother? Overlap of fetal bones as they pass through the maternal birth canal Swelling of the soft tissue of the scalp as a result of pressure during labor Hemorrhage of ruptured blood vessels that does not cross the suture lines Accumulation of fluid resulting from partial blockage of cerebrospinal fluid drainage
Swelling of the soft tissue of the scalp as a result of pressure during labor Caput succedaneum is a diffuse pattern of edema above the periosteum; it results from an even distribution of pressure on the fetal head during labor. Overlap of fetal scalp bones is called molding. Swelling that does not cross the suture line is cephalhematoma, not caput succedaneum; it occurs when the fetal head is pressing on the rim of the pelvis during the birthing process. Accumulation of fluid resulting from a partial blockage of cerebrospinal fluid is hydrocephalus; in hydrocephalus the circumference of the head is larger than expected.
One minute after birth a nurse notes that a newborn is crying, has a heart rate of 140 beats/min, is acrocyanotic, resists the suction catheter, and keeps the arms extended. What Apgar score should the nurse assign to the newborn? Record your answer using a whole number.
The Apgar score is 8. A perfect score is 10; 1 point is deducted for lessened muscle tone (the baby's arms do not flex) and 1 point for acrocyanosis, which is manifested by bluish hands and feet.
A new mother asks the nurse administering erythromycin ophthalmic ointment to her newborn why her baby must be subjected to this procedure. What is the best response by the nurse? "It will keep your baby from going blind." "This ointment will protect your baby from bright lights." "There is a law that newborns must be given this medicine." "This antibiotic helps keep babies from contracting eye infections."
"This antibiotic helps keep babies from contracting eye infections." Erythromycin ophthalmic ointment is used to treat gonorrhea and Chlamydia infections, which may be transmitted during birth. It is administered prophylactically. Although it will prevent the newborn from becoming blind if the infant is born with these infections, there is not enough information in the answer to help the mother understand how the ointment prevents blindness. The antibiotic ointment is not administered to protect the newborn from bright lights. Newborns are in fact required by law to receive erythromycin ophthalmic ointment, but simply stating this does not explain why it is administered.
The nurse is assessing a male newborn. Which characteristics should alert the nurse to conclude that the newborn is a preterm infant? Small breast buds Wrinkled thin skin Multiple sole creases Presence of scrotal rugae Pinnae that remain flat when folded
1 Small breast buds 2 Wrinkled thin skin 5 Pinnae that remain flat when folded Breast buds are small, with underdeveloped nipples, in the preterm infant. Preterm newborns have little subcutaneous fat; the skin is wrinkled, and blood vessels and bony structures are visible. Preterm infants' ears contain little cartilage and are very inelastic when folded; at term, the ears contain cartilage, and the pinnae are firm. Sole creases develop progressively during pregnancy and cover the entire foot at term. A preterm male infant's testes are undescended; rugae develop progressively and cover the entire scrotum of the full-term male newborn.
A newborn of 30 weeks' gestation has a heart rate of 86 beats/min and slow, irregular respirations. The infant grimaces in response to suctioning, is cyanotic, and has flaccid muscle tone. What Apgar score should the nurse assign to this neonate? Record your answer using a whole number.
3 A heart rate of less than 100 beats/min receives 1 point; slow and irregular respirations receive 1 point; grimaces in response to suctioning receive 1 point; flaccid muscle tone receives 0 points; and cyanosis receives 0 points. This infant's Apgar score is 3. A score of 2 is too low. A score of 4 is too high, as is a score of 5.
While changing a newborn girl's diaper a nurse observes a brick-red stain on the diaper. How does the nurse interpret this clinical finding? A sign of low iron excretion An uncommon benign occurrence An expected occurrence in female newborns The result of a medication administered during labor
An uncommon benign occurrence The brick-red color in the urine is caused by albumin and urates that are found in the first week of life. Iron is eliminated by way of the gastrointestinal tract. The finding is unrelated to the sex of the infant; it is not hormonally based. No medication administered during labor will cause this discoloration.
A client gives birth to a full-term male with an 8/9 Apgar score. What should the immediate nursing care of this newborn include? Assessing respirations, keeping him warm, and identifying him Applying an antibiotic to the eyes, administering vitamin K, and bathing him Aspirating the oropharynx, rushing him to the nursery, and stimulating him often Weighing him, placing him in a crib, and waiting until the mother is ready to hold him
Assessing respirations, keeping him warm, and identifying him Establishing a patent airway, diminishing cold stress, and identifying the newborn are the priorities. Application of eye prophylaxis and administration of vitamin K are often delayed to allow the parents to bond with the infant; a bath at this time will increase the risk of cold stress. Aspirating the oropharynx, rushing him to the nursery, and stimulating him frequently are measures appropriate for a compromised newborn; an 8/9 Apgar score is indicative of a healthy newborn. Weighing him, placing him in a crib, and waiting until the mother is ready to hold him are not the priority care for a newborn.
An infant has had surgery for repair of a myelomeningocele. For which early sign of impending hydrocephalus should the nurse monitor the infant? Frequent crying Bulging fontanels Change in vital signs Difficulty with feeding
Bulging fontanels After closure, spinal fluid may accumulate and reach the brain, increasing intracranial pressure (ICP) and causing the fontanels to bulge. Frequent crying may be a typical pattern for the neonate; it does not, in and of itself, indicate changes in ICP. Changes in vital signs are not among the early signs of increasing ICP in an infant. Difficulty with feeding can indicate changes in ICP but is not one of the initial signs.
The nurse is caring for a neonate who is undergoing phototherapy. What specific care should the nurse plan for this infant? Applying mineral oil to the skin to prevent excoriation Covering the infant's head with a cap to minimize heat loss Regulating radiant heat to maintain optimum skin temperature Discontinuing therapy during feeding to meet the infant's emotional needs
Discontinuing therapy during feeding to meet the infant's emotional needs Discontinuing therapy during feedings is necessary to ensure psychosocial contact. Mineral oil may block light rays from acting on bilirubin deposits; cleansing after each voiding and defecation will prevent skin excoriation. All parts of the body may contain bilirubin deposits and should be exposed to the light. Radiant heaters are not used; a fluorescent light source is used.
A nurse teaches a new mother about neonatal weight loss in the first 3 days of life. How does the nurse explain the cause of this weight loss? An allergy to formula A hypoglycemic response Ineffective feeding techniques Excretion of accumulated excess fluids
Excretion of accumulated excess fluids Early weight loss occurs because excess fluid is lost, not body mass. Weight loss is expected; there are no data to support an allergic response. Weight loss is not related to hypoglycemia. Neither breast nor formula feeding will prevent the 10% weight loss that is expected in the first few days of life.
When calculating the Apgar score for a newborn, what does the nurse assess in addition to the heart rate? Muscle tone Amount of mucus Degree of head lag Depth of respirations
Muscle tone The five areas that are assessed when the Apgar score is calculated are heart rate, respiratory effort, muscle tone, reflex irritability, and color. The rate of respirations, not the depth, is assessed for an Apgar score. Amount of mucus, degree of head lag, and depth of respirations are not tested for an Apgar score
A newborn is found to have a diaphragmatic hernia. What is the immediate intervention after the neonate is admitted to the neonatal intensive care unit? Hydrating the infant with isotonic enemas Limiting formula feedings to small amounts Placing the infant in the Trendelenburg position Providing gastric decompression via nasogastric tube
Providing gastric decompression via nasogastric tube When a diaphragmatic hernia is present, intra-abdominal pressure must be minimized; this is accomplished with the use of gastric decompression. Hydrating the infant with isotonic enemas is not beneficial. These infants are not fed orally; intravenous fluids are given with careful measurement of electrolytes and intake and output to guide replacement therapy. The Trendelenburg position is contraindicated; the abdominal organs will increase pressure on the diaphragm.
Which newborn assessment finding will probably necessitate prolonged follow-up care? Apgar score of 5 Weight of 3500 g Umbilical cord with two blood vessels Blood glucose level of 50 mg/dL (1.7 to 3.3 mmol/L)
Umbilical cord with two blood vessels The congenital absence of a blood vessel in the umbilical cord is often associated with life-threatening congenital anomalies. There should be two arteries and one vein. The interval at which the Apgar score was obtained was not provided. A weight of 3500 g is average for a full-term newborn. The expected glucose level in a healthy newborn is 40 to 69 mg/dL (1.7 to 3.3 mmol/L)
A preterm newborn appears to have a strong sucking reflex. How should the nurse plan to feed the infant to prevent respiratory compromise? Through a nasogastric feeding tube Every 2 to 3 hours with diluted formula Every 4 to 6 hours with a special nipple With small amounts of breast milk at each feeding
With small amounts of breast milk at each feeding Feeding small amounts of breast milk at each feeding prevents the neonate's stomach from becoming too distended and pressing upward against possibly compromised lungs. A nasogastric feeding tube will not prevent respiratory embarrassment. The infant with a strong sucking reflex should be fed with a nipple; otherwise the sucking reflex will diminish. Four to 6 hours is too long between feedings; a preterm infant should be fed every 2 to 3 hours because it takes this long for the preterm infant's stomach to empty. Preterm infants need the full caloric value of breast milk with fortification.
A mother asks the neonatal nurse why her infant must be monitored so closely for hypoglycemia when her type 1 diabetes was in excellent control during the entire pregnancy. How should the nurse best respond? "A newborn's glucose level drops after birth, so we're being especially cautious with your baby because of your diabetes." "A newborn's pancreas produces an increased amount of insulin during the first day of birth, so we're checking to see whether hypoglycemia has occurred." "Babies of mothers with diabetes do not have large stores of glucose at birth, so it's difficult for them to maintain the blood glucose level within an acceptable range." "Babies of mothers with diabetes have a higher-than-average insulin level because of the excess glucose received from the mothers during pregnancy, so the glucose level may drop."
"Babies of mothers with diabetes have a higher-than-average insulin level because of the excess glucose received from the mothers during pregnancy, so the glucose level may drop." The infant of a diabetic mother (IDM) produces a higher level of insulin in response to the increased maternal glucose level; after birth it takes several hours for the newborn to adjust to the loss of the maternal glucose. A healthy newborn's glucose level does not drop significantly after birth. A newborn's pancreas usually produces more insulin as a response to the maternal glucose level, but this response is not specific to the IDM. IDMs have the same glucose stores as other newborns; their responses to the loss of maternal glucose levels differ.
The nurse in the birthing room is assessing a newborn. Which characteristic would be assigned an Apgar value of 2? A strong cry A heart rate of 90 beats/min Slight flexion of legs and arms Pink body and blue extremities
A strong cry A strong cry indicates effective respiratory function and is assigned a value of 2. If flexion of the arms and legs is slight and movement is diminished, a value of 1 is assigned. A value of 1 is assigned when the body is pink and the extremities are blue. The heart rate should be more than 100 beats/min; therefore a pulse of 90 beats/min is assigned a value of 1.
A newborn has an intracranial hemorrhage because of a tear in the tentorial membrane sustained during birth. Which clinical finding does the nurse expect the infant to display? Extreme lethargy Weak, timorous cry Generalized purpura Abnormal breathing pattern
Abnormal breathing pattern Tears in the tentorial membrane result in bleeding into the cerebellum, pons, or medulla oblongata; because the respiratory regulation centers are located in the medulla and pons, an abnormal breathing pattern may result. Lethargy is more indicative of cerebellar injury. A weak, timorous cry is more indicative of cardiac or respiratory difficulty; a high-pitched, shrill cry is usually present with central nervous system (CNS) problems. Purpura is unrelated to tentorial or other CNS injuries.
An infant born at 40 weeks' gestation weighs 6 lb 13 oz (3090 g). What is the nurse's assessment of the neonate? <p>An infant born at 40 weeks' gestation weighs 6 lb 13 oz (3090 g). What is the nurse's assessment of the neonate?</p> Small for gestational age (SGA) and term SGA and preterm Appropriate for gestational age (AGA) and term AGA and preterm
Appropriate for gestational age (AGA) and term Birth between 38 and 42 weeks' gestation is considered term; at term, healthy neonates weigh between 5 lb 10 oz and 8 lb 6 oz (2551 to 3799 g). Although the birth took place between 38 and 42 weeks' gestation (term infant), an SGA infant weighs less than the expected range for the gestational age. A preterm infant is one born before 38 weeks' gestation; the infant's weight is within the expected range for 40 weeks' gestation. Although the infant's weight is appropriate for the gestational age of 40 weeks, the infant is not preterm, because birth occurred between 38 and 42 weeks' gestation.
A nurse in the clinic determines that a 4-day-old neonate who was born at home has a purulent discharge from the eyes. Which condition does the nurse suspect? Chlamydia trachomatis infection Human immunodeficiency virus (HIV) infection Retinopathy of prematurity (retrolental fibroplasia) A reaction to the ophthalmic antibiotic instilled after birth
Chlamydia trachomatis infection Chlamydia trachomatis infection occurs 3 to 4 days after birth; if it is not treated prophylactically with an antibiotic at birth or within 3 days, chronic follicular conjunctivitis with conjunctival scarring will occur. HIV infection in the newborn does not manifest with conjunctivitis. The high oxygen concentrations given to severely compromised preterm infants cause vasoconstriction of retinal capillaries, which can lead to blindness; there are no data to indicate that this infant was preterm, severely compromised, or received oxygen. A chemical conjunctivitis occurs within the first 48 hours and is not purulent.
A preterm infant with respiratory distress syndrome (RDS) has blood drawn for an arterial blood gas analysis. Which test result should the nurse anticipate for this infant? Increased Po 2 Lowered HCO 3 Decreased Pco 2 Decreased blood pH
Decreased blood pH In addition to increased Pco 2, hypoxia from inadequate oxygen/carbon dioxide exchange leads to anaerobic metabolism with an accumulation of acid by-products; both lower blood pH. Po 2 is decreased, because inadequate lung surface area is available for diffusion of gases. Acidosis, not alkalosis, is present; bicarbonate will be normal or increased in the body's attempt to compensate. Pco 2 increases, because inadequate lung surface area is available for the diffusion of gases.
A primipara has just given birth at 37 weeks' gestation. What should the nurse do to assist the attachment process between the mother and her newborn? Encourage continuous rooming-in Assign one nurse to care for both of them Allow extra visiting privileges in the nursery Teach the client how to breast-feed the baby
Encourage continuous rooming-in Rooming-in provides time for the mother and newborn to be together; the mother can become acquainted with the infant more quickly. It is possible that the client does not want to breast-feed; attachment can be furthered by means of a variety of methods. Assigning one nurse to care for both client and infant will not promote bonding and attachment. Although visiting in the nursery is unlimited for the parents, rooming-in is preferable.
A newborn is circumcised prior to discharge from the hospital. What should the immediate postoperative care include? Keeping the infant NPO for 4 hours to prevent vomiting Encouraging the intake of alkaline fluids to reduce urine acidity Changing the dressing using dry, sterile gauze to maintain cleanliness Encouraging the mother to cuddle her baby to provide emotional support
Encouraging the mother to cuddle her baby to provide emotional support Cuddling is comforting for the mother and baby and provides an opportunity to teach the mother how to take care of the circumcision. There is no contraindication to feeding the infant after the circumcision; nutrition may be withheld before, not after, the procedure. Providing alkaline fluids is inappropriate and could lead to fluid and electrolyte imbalance. Removal of dry gauze will cause bleeding; sterile petrolatum gauze is used and replaced with each diaper change. Test-Taking Tip: Identifying content and what is being asked about that content is critical to your choosing the correct response. Be alert for words in the stem of the item that are the same or similar in nature to those in one or two of the options . Example: If the item relates to and identifies stroke rehabilitation as its focus and only one of the options contains the word stroke in relation to rehabilitation, you are safe in identifying this choice as the correct response.
Neonates have difficulty maintaining their body temperature; however, their bodies have several mechanisms to help them do so. Which ones should a nurse remember when caring for the newborn? Flexed fetal position Hepatic insulin stores Brown fat metabolism Peripheral vasoconstriction Parasympathetic nervous system
Flexed fetal position Brown fat metabolism Peripheral vasoconstriction Full-term neonates maintain a flexed fetal position, which conserves heat. Deposition of brown fat begins at 28 weeks' gestation and continues for the rest of the pregnancy; when the newborn's body becomes cool, the sympathetic nervous system stimulates the breakdown of brown fat, which releases heat as a by-product. Peripheral vasoconstriction helps conserve heat by keeping the central core warm and preventing heat from dissipating. Insulin is not stored in the liver and is not involved with maintenance of neonatal body temperature. The sympathetic, not parasympathetic, nervous system is involved in thermoregulation.
The nurse assessing a newborn suspects Down syndrome. Which characteristics support this conclusion? Hypotonia High-pitched cry Rocker-bottom feet Epicanthal eye folds Singe transverse palmar crease
Hypotonia Epicanthal eye folds Singe transverse palmar crease Hypotonia is typical of newborns with Down syndrome. Their muscle tone is flaccid; they have less control of the head than a healthy newborn does because of their weak muscles. The single crease across the palm of the hand is typical of newborns with Down syndrome. Epicanthal eye folds give the newborn with Down syndrome the typical slant-eyed appearance. A high-pitched cry is characteristic of newborns with brain damage, cerebral irritability (opioid withdrawal), and cerebral edema (hydrocephaly). Rocker-bottom feet are found in newborns with trisomy 18.
A nurse performing a newborn assessment elicits the Babinski reflex. What does the nurse conclude that this finding indicates? Hypoxia during labor Neurological injury during birth Hyperreflexia of the muscular system Immaturity of the central nervous system (CNS)
Immaturity of the central nervous system (CNS) Stimulation of the newborn's immature neuromuscular system causes dorsiflexion of the big toe and fanning of the remaining toes ( Babinski sign). CNS damage resulting from hypoxia may manifest as a lack of Babinski sign. The newborn would not elicit the Babinski reflex if there were neurological injury during birth. Hyperreflexia is an abnormal increase in reflexes; it is not related to the Babinski reflex.
A nurse suspects that a newborn has toxoplasmosis, one of the TORCH infections. How and when may it have been transmitted to the newborn? In utero through the placenta In the postpartum period through breast milk During birth through contact with the maternal vagina After the birth through a blood transfusion given to the mother
In utero through the placenta Toxoplasmosis is caused by a parasitic protozoon that is acquired from inadequately cooked contaminated food or through handling of infected cat feces; the most common form of transmission to the newborn is by way of placental perfusion when in utero. There is no evidence that toxoplasmosis is transmitted in breast milk. The newborn does not contract toxoplasmosis from the maternal genital tract during the birth process. There is no evidence that toxoplasmosis is transmitted in blood transfused into the mother.
A newborn has small, whitish, pinpoint spots over the nose that are caused by retained sebaceous secretions. When documenting this observation, how does the nurse identify them? Milia Lanugo Whiteheads Mongolian spots
Milia Milia are common, they are not indicative of illness, and they eventually disappear. Lanugo is fine, downy hair. Whiteheads are a lay term for milia; the term is not used in documentation. Mongolian spots are bluish-black areas on the buttocks that may be present on dark-skinned infants.
What is the optimal area for the nurse to assess adequate tissue oxygenation in a neonate born of African-American parents? Heels and buttocks Upper tips of the ears Nailbeds on the hands and feet Mucous membranes of the mouth
Mucous membranes of the mouth Lack of skin pigmentation on the surfaces of the mucous membranes makes this the best area in which to assess this neonate's tissue oxygenation. Heels and buttocks are usually highly pigmented areas, and the buttocks often have Mongolian spots. The tips of the ears will indicate skin color later in life. Because most neonates' hands and feet exhibit acrocyanosis, the nailbeds may be cyanotic as well.
A primipara tells the nurse that her baby is breathing very rapidly and that the breaths are irregular. She expresses fear that her baby may be sick and will have to remain in the hospital. What is the nurse's initial action? Assessing the infant and telling the mother that her baby is fine Picking up the infant and telling the mother that the nurses will watch her baby closely Observing the infant's respirations and telling the mother that these respirations are expected Taking the infant to the nursery and returning to tell the mother that the health care provider has been notified
Observing the infant's respirations and telling the mother that these respirations are expected Newborns' respirations are rapid and irregular; this is not a sign of respiratory distress. More explanation than just telling the mother the baby is fine is needed; also, communication is shut off with this statement. Picking up the infant and telling the mother that the nurses will watch her baby closely implies that something may be wrong. Taking the infant to the nursery and notifying the health care provider are not necessary because these respirations are within the norm, and further assessment is unnecessary.
In specific situations gloves are used to handle newborns whether or not they are positive for human immunodeficiency virus (HIV). When is it unnecessary for the nurse to wear gloves while caring for a newborn? Offering a feeding Changing the diaper Giving an admission bath Suctioning the nasopharynx
Offering a feeding Standard precautions do not include the use of gloves for feeding. Wearing clean gloves for diaper changes of newborns is standard protocol. Clean gloves should be worn for all admission baths, because the nurse will be exposed to blood and amniotic fluid. Clean gloves should also be worn while the nurse suctions an infant.
After a difficult birth, a neonate has an Apgar score of 8 after 5 minutes. Which signs met the criteria of 2 points? Reflex irritability: cry Heart rate: 110 beats/min Respiratory rate: good cry Color: body pink, extremities blue Muscle tone: some flexion of extremities
Reflex irritability: cry Heart rate: 110 beats/min Respiratory rate: good cry A cry for reflex irritability rates a score of 2. A good cry for respiratory rate scores a 2. A heart rate of 100 beats/min or more rates a 2. A pink body with blue extremities rates a 1. Some flexion of extremities rates a 1 for muscle tone.
During the second reactive period a newborn becomes more alert and responsive and there is an increase in mucus production and gagging. What should the nurse's initial intervention be? Report this finding Administer nasal oxygen Lower the head of the bassinette Remove secretions from the pharynx
Remove secretions from the pharynx An increase in mucus production is expected during the second reactive period; mucus should be removed either by swiping the oral cavity with a gloved finger or with the use of an aspiration device. Reporting this finding is unnecessary; identifying and treating human responses is within the scope of nursing practice. Oxygen administration is useless if mucus is blocking the respiratory passages. Although lowering the head of the bassinette may help secretions drain, the newborn cannot remove secretions that block respirations.
Which intervention will be delayed until the newborn is 36 to 48 hours old? Vitamin K injection Test for blood glucose level Screening for phenylketonuria Test for necrotizing enterocolitis
Screening for phenylketonuria In 36 to 48 hours the newborn will have ingested an ample amount of the amino acid phenylalanine, which, if not metabolized because of a lack of a specific liver enzyme, can result in excessive levels of phenylalanine in the bloodstream and brain, resulting in cognitive impairment; early detection is essential to prevent this. The infant will have a vitamin K injection soon after birth to prevent bleeding problems. Blood is withdrawn from the heel soon after birth to test for hypoglycemia. Necrotizing enterocolitis is a disorder that can affect preterm infants. It is not identified with the use of a test.
The nurse is caring for a 1-hour-old newborn. Which assessment characteristics represent a preterm gestational age? Skin: thin, veins visible; breasts: flat areolae, no buds; plantar creases: absent; lanugo: abundant Skin: parchment/wrinkled; breasts: flat areolae, no buds; plantar creases: cover entire sole; lanugo: absent Skin: thin, veins visible; breasts: flat areolae, no buds; plantar creases: covering the entire sole; lanugo: abundant Skin: cracking/few veins; breasts: raised areolae (3- to 4-mm buds); plantar creases: covering the anterior two thirds of the sole; lanugo: thinning
Skin: thin, veins visible; breasts: flat areolae, no buds; plantar creases: absent; lanugo: abundant The characteristics of preterm, term, and postterm gestational age are based on assessments of physical maturity such as the Ballard or Dubowitz assessment. A preterm infant's skin is translucent, with many visible veins. A term infant has some cracking of the skin and some visible veins, depending on gestational age. Term is any gestation after 38 weeks; veins are less visible at 40 weeks' gestation. The postterm infant typically has dry, leathery, parchmentlike skin with numerous deep wrinkles. The areolae of a preterm infant are flat, without buds, and they become more raised during development, averaging 3 to 4 mm at term and 5 to 10 mm in the postterm infant. The plantar creases develop on the foot during gestation, beginning smooth, then covering two thirds at term, and finally covering the entire sole after term. Lanugo is the fine downy hair that diminishes as the infant develops gestationally.
The nurse assessing a newborn identifies several characteristics of Turner syndrome. Which features did the nurse observe? Hypotonia Webbed neck Female sex organs Rocker-bottom feet Widely spaced nipples
Webbed neck Female sex organs Widely spaced nipples The broad, webbed neck is an outstanding characteristic of the newborn with Turner syndrome. All infants with Turner syndrome are female because their one sex chromosome is the X chromosome; although they have female sex organs, the organs are underdeveloped, and affected individuals are infertile. Widely spaced nipples are also a characteristic of Turner syndrome. Hypotonia is typical of newborns with Down syndrome and trisomy 18. Rocker-bottom feet are found in infants with trisomy 18.