The nurse notes irritability, microcephaly, and short palpebral fissures in a newborn in the nursery. The nurse suspects which diagnosis for this infant?

  1. syphilis
  2. TORCH syndrome
  3. brachial plexus injury
  4. fetal alcohol syndrome (FAS)
Number 4 is correct.
Rationale: FAS is characterized by microcephaly, small eyes or short palpebral fissures, thin upper lip, and flat midface. Syphilis presents with maculopapular dermal rash on palms and soles. TORCH syndrome is a group of infections that produce various congenital malformations. The acronym stands for toxoplasmosis, other infections, rubella, cytomegalovirus, and herpes simplex. Brachial plexus injury describes a type of paralysis associated with a difficult birth.