NUR 221 Final Exam Liberty University Question and answers verified to pass 2024/2025 NUR 221 Final Exam
What are some non-pulmonary causes of respiratory distress in neonates? - correct answer Sepsis, cardiac defects (structural or functional), hemolytic disease, CNS defects, exposure to ...
NUR 221 Final Exam
What are some non-pulmonary causes of respiratory distress in neonates? -
correct answer ✔Sepsis, cardiac defects (structural or functional), hemolytic
disease, CNS defects, exposure to cold, airway obstruction (atresia),
intraventricular hemorrhage, hypoglycemia, metabolic acidosis, acute blood
loss and drugs.
What appears to be the principle factor in the development of Respiratory
Distress Syndrome? - correct answer ✔Surfactant deficiency.
What are the clinical manifestations of Respiratory Distress Syndrome? -
correct answer ✔1.) Tachypnea (greater than or equal to 60 breaths/min)
initially
2.) Dyspnea
3.) Pronounced intercostal or substernal retractions
4.) Fine respiratory crackles
5.) Audible expiratory grunt
6.) Flaring of the external nares
7.) Cyanosis or pallor
8.) Apnea
9.) With progression of condition, deteriorating vital signs including blood
pressure, apnea, body temperature instability
In addition to Respiratory Distress Syndrome, what is surfactant therapy also
being used in? - correct answer ✔Infants with meconium aspiration,
infectious pneumonia, sepsis, persistent pulmonary hypertension, and
pulmonary hemorrhage.
,How is surfactant administered? - correct answer ✔Via an endotracheal (ET)
tube directly into the infant's trachea.
What is Acrocyanosis? - correct answer ✔The bluish discoloration of the
hands and feet that is a normal finding within the first 24 hours after birth.
What are the clinical manifestations of Infants of Diabetic Mothers (IDMs)? -
correct answer ✔1.) Large for gestational age (>4g)
2.) Very plump and full faced
3.) Abundant vernix caseosa
4.) Plethora
5.) Listless and lethargic
6.) Possibly meconium stained at birth
7.) Hypotonia
What are the risk factors for hypoglycemia in the infant? - correct answer
✔Hypoglycemia in IDMs is related to hypertrophy and hyperplasia of the
pancreatic islet cells and the transient state of hyperinsulinism. High maternal
blood glucose levels during fetal life provide a continual stimulus to the fetal
islet cells for insulin production (glucose easily passes the placental barrier
from maternal to fetal side, however, insulin does not cross the placental
barrier).
When the neonate's glucose supply is removed abruptly at the time of birth,
the continued production of insulin soon depletes the blood of circulating
glucose, creating a state of hyperinsulinism and hypoglycemia within 0.5 to 4
hours, especially in infants of mothers with poorly controlled diabetes.
What is the single most important factor that influences fetal well being in a
diabetic mother? - correct answer ✔The euglycemic status of the mother.
, What serum glucose level should be maintained in an infant with abnormal
clinical symptoms? - correct answer ✔Above 40 mg/dL and as high as 55 to
65 mg/dL in other infants.
What are the signs and symptoms of hypoglycemia in the newborn? - correct
answer ✔Jitteriness, lethargy, poor feeding, abnormal cry, hypotonia,
temperature instability (hypothermia), respiratory distress, apnea, and
seizures.
What are the characteristics of meconium stained amniotic fluid? - correct
answer ✔It is green, and it is either thin (light) or thick (heavy), depending on
the amount of meconium present.
What are the three possible reasons for the passage of meconium in the
amniotic fluid? - correct answer ✔1.) It is a normal physiologic function that
occurs with maturity (meconium passage being infrequent before weeks 23 or
24, with an increased incidence after 38 weeks) or with a breech presentation.
2.) It is the result of hypoxia induced peristalsis and sphincter relaxation.
3.) It can be a sequel to umbilical cord compression induced vagal stimulation
in mature fetuses.
SAFETY ALERT (pg. 454): - correct answer ✔Every birth should be attended
by at least one person whose only responsibility is the baby and who is
capable of initiating resuscitation. Either that person or someone else who is
immediately available should have the skills required to perform a complete
resuscitation, including endotracheal suctioning to remove meconium, if
necessary.
What is the immediate management of the newborn with meconium stained
amniotic fluid before birth? - correct answer ✔1.) Assess the amniotic fluid
for the presence of meconium after rupture of membranes.
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