N355 Peds Final Questions with correct answers
High risk newborn Correct Answer-
neutral thermal environment Correct Answer-Neutral thermal
environment (NTE) one that permits the infant to maintain a normal core
temperature with minimum oxygen consumption and calorie expenditure
cold stress can cause Correct Answer--hypoxia
-hypoglycemia in the premature infant. -Increased metabolism
-increase in O2 and glucose consumption
signs of infection in newborn and preemie Correct Answer--may feed
poorly,
-lethargic,
-may have difficulties regulating temperature,
-may have a high temp but most likely decreased
hyperbilirubinemia Correct Answer-liver more immature, poor intestinal
motility
necrotizing enterocolitis Correct Answer--an acute inflammatory disease
of the bowel,
-occurs in infants whose GI tract has had a vascular compromise,
-believed to be related to severe hypoxic episodes where shunting of
blood away from GI tract from nonessential organs,
,-causes damage to the mucosal cells and bowel wall are attacked by
enzymes and bacteria invades
clinical manifestations of NEC Correct Answer-lethargy, vomiting,
distended abdomen, blood in stools, ↓ bowel sounds, air in submucosal
surfaces of colon (x-ray)
prevention of NEC Correct Answer--Feeding breast milk and non-
nutritive sucking during gavage feeding may decrease incidence.
-Feeding formula can be detrimental
treatment of NEC Correct Answer--NPO,
-NG tube for decompression, antibiotics,
-IV fluids or TPN,
-surgical resection sometimes necessary
Periventricular-intraventricular hemorrhage (PV-IVH) Correct Answer--
premie has fragile capillaries and a prolonged prothrombin time.
-Hemmorrhage can occur with increased blood flow and increased BP
ex. Suctioning, crying ,stressful procedures, hypotension followed by
rapid volume expansion, etc.
clinical manifestations of PV-IVH Correct Answer-apnea, bradycardia,
cyanosis, hypotonia, seizures, full fontanel bulging, hydrocephalus can
occur
,treatment of PV-IVH
grading system 1-4 Correct Answer-supportive care, ventricular
shunting, seizure medication
gading system: 1-4
Care of infant with PV-IVH Correct Answer-minimal
handling(increased handling can increase BP which increases bleeding),
position head in midline, elevated 20-30 degrees, avoid loud noises,
analgesics for painful procedures
Perinatal hypoxic-ischemic brain injury or hypoxic-ischemic
encephalopathy (HIE) Correct Answer-Related to asphyxia either
before, during or after delivery. Causes decreased cerebral blood flow.
clinical manifestations of HIE Correct Answer-hypotonia, apnea,
seizures, coma.
management of HIE Correct Answer-hypothermia in infant greater than
or equal to 36 weeks gestational age
outcome and treatment Correct Answer--Very hard to determine
outcome
-Treat seizures, prevention of HIE.
, Retinopathy of prematurity Correct Answer-Disease of the eyes that
causes vascular changes in the retina that can lead to retinal detachment,
scarring and blindness
vascular changes in the retina
main causes of retinopathy Correct Answer-O2 therapy and higher O2
concentration, ventilator use and longer time on, apnea, bradycardia,
infection, hypoxia, acidosis, shock all increase risk, premies under 28
weeks and 1500 g are the main cases
periodic apnea or apnea of prematurityy Correct Answer--related to
immature respiratory mechanism and regulatory of brain, laps of
brething 20 seconds or more
-usually grows out of it
treatment for periodic apnea Correct Answer--Tactile stimulation beings
baby out, if this doesn't work, baby needs to be bagged, if extremely
severe, ventilator is put on
-PO caffeine or IV to decrease frequency of spells, watch for s/e like
tachycardia, irritability, restlessness
respiratory distress syndrome RDS Correct Answer--Usually caused by
deficiency of surfactant in the lungs that causes lungs to collapse
completely
-Poor lung perfusion causes serfactant to decrease even more
-Fiborous membrane formed from blood product exudate form in infants
lung that lines alveoli