An infant who is cold-stressed is at risk for developing which metabolic disturbance?

• A. Hyperglycemia
• B. Metabolic acidosis
• C. Respiratory acidosis
• D. Hypoglycemia

Answer: (B)

Cold stress makes the newborn’s body work harder to generate heat, increasing metabolic rate and oxygen use. When oxygen delivery doesn’t meet this higher demand, tissues shift toward anaerobic metabolism and produce lactic acid. The buildup of lactic acid lowers the blood pH, causing metabolic acidosis—the typical metabolic disturbance seen with cold-stressed infants. While hypoglycemia can also occur due to increased glucose utilization, the acid-base change most directly tied to cold stress is the lactic acidosis. Respiratory acidosis would come from CO2 retention related to ventilation issues, not the heat-generation challenge in cold stress, and hyperglycemia is not the characteristic disturbance here.