For a newborn at greatest risk for developing hypoglycemia, what scenario should the nurse recognize related to the loss of heat?

The scenario that indicates a newborn at greatest risk for developing hypoglycemia related to the loss of heat is exposure to a cold environment after birth. Newborns are particularly vulnerable to hypothermia due to their relatively high surface area to volume ratio and limited subcutaneous fat, which is critical for thermal insulation. When exposed to a cold environment, a newborn may experience significant heat loss, leading to increased metabolism to generate heat. This process can deplete glucose stores more rapidly, as the body uses glucose for energy to maintain normal body temperature. Consequently, this heightened glucose demand can result in hypoglycemia if the newborn is unable to meet metabolic needs through adequate feeding.

In contrast, being delivered by cesarean section does not inherently lead to hypoglycemia through heat loss but rather may involve other risk factors related to feeding and recovery. Low birth weight due to maternal health issues can predispose a newborn to hypoglycemia, but it is not directly related to the immediate loss of heat. Experiencing delayed feeding is significant, as it can prevent the newborn from rapidly replenishing glucose stores; however, it is the exposure to a cold environment that primarily impacts temperature regulation and, subsequently, glucose metabolism.