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N421 - Peds Questions with correct answers
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N421 - Peds Questions with correct answers
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N421 - Peds Questions with correct answersTeratogens Correct Answer-Birth defect/appearance anomalies causing
agents that are present in prenatal environment; account for majority of
adverse INTRAUTERINE effect not related to genetic factors.
*most serious when structure is forming.
exp) Fetal Alcohol Syndrome, Zika Virus, Drugs (Dilantin, Coumadin,
Accutane), Chemicals (Cocaine, Lead), Infections (Rubella), Metabolic
Agents (Maternal PKU)
Pre-Term Infants & Problems Correct Answer-Occurs in about 1-8
pregnancies; leads to 75% of early neonatal mortality and morbidity.
Hard to tell if there even is an infection d/t immature immune system.
-Poor Thermoregulation: cannot keep stable temperatures due to
minimal subcutaenous fat deposits.
-Immature CNS (frequent apnea & hypoventilation & bradycardia)
-Immature immunity (infection)
-Intraventricular Hemorrhage (d/t trauma, asphyxia)
-Immature cardiopulmonary system
-Immature GI system (NEC)
-Jaundice
-Glucose Instability (HYPOGLYCEMIA)
-"Relaxed Limbs", Easily Folded Ears
-Partial Reflexes (sucking, swallowing, gagging, coughing)
,-Large head in relation to the body
Intraventricular Hemorrhage (IVH) Correct Answer-Bleeding into the
ventricles inside the brain.
Risk Factors:
-Extreme Prematurity
-Birth Asphyxia & Vigorous Resuscitation
-Mechanical Ventilation
-Sudden Change in BPs; result of rapid hypertonic volume expansion
Management:
-Identity and reduce risk factors!
Thermoregulation Correct Answer-Preterm babies have:
-Immature vasculature tone
-Disproportional body surface to body weight
-Immature, gelatinous skin with decreased subq fat
-Decreased fat = poor insulation & heat conservation
Management:
APPLY EXTERNAL WARMTH! ESSENTIAL TO SURVIVAL!
, Respiratory System Correct Answer--Surfactant Deficiency: Surfactant -
surface-active phospholipids secreted by alveoli. Reduces surface
tension of fluids that line alveoli and the respiratory system, resulting in
uniform expansion and maintenance of lung expansion. Deficient
surfactant production causes unequal inflation of alveoli on inspiration
and the collapse of alveoli on expiration.
-Respiratory Distress Syndrome (RDS) -
SYMPTOMS: Tachypnea then Dyspnea, Accessory Muscle Use, Fine
inspiratory crackles, Audible Expiratory grunt, flaring of the external
NARES, Cyanosis, or Pallor.
Management: Adequate Oxygenation, Ventilation, Supportive Care and
Measures required for any pre-term infant!
-Immature Neurological Control Center = Secondary Apnea
Management:
-Intubation & CPAP & O2
-Administration of Exogenous Surfactant (Surfactant Replacement
Therapy)
-Serial Chest X-Rays, Continuous Monitoring: Cardiorespiratory status,
Pulse Oximetry, BP, ABG
-Prevention of Preterm Delivery
-RDS & Surfactant Deficiency are SELF LIMITING; improved by 72
hours in the absence of complications.
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