Nurs 651 Midterm Exam UPDATED
QUESTIONS AND CORRECT ANSWERS
Major concerns for preterm infants - CORRECT ANSWER 1. ABC- risk for apnea and HTN
-- typically need RSV prophylaxis
2. Feeding issues- under 34 weeks issues with suck
3. Jaundice
4. Temp instability
5. Hypoglycemia
6. Car seat safety test if born less than 37 weeks
Synagis (palivizumab) - CORRECT ANSWER RSV vaccine
- used for premature infants born btw 32-25 weeks or with CLD or CHD or need oxygen from birth
BPD - CORRECT ANSWER bronchopulmonary dysplasia
- form of CLD that affects newborns and infants due to damage to lungs caused by mechanical
ventilation or long term oxygen use
- common in low birth weight and premature infants using oxygen for over 28 days
- having inflammation and scarring of the lungs- damage alveoli then leads to increase presssure-
pulm HTN
- treatment: diuretics, steroids, inhaled bronchodilators and optimize nutrition
Apnea of prematurity - CORRECT ANSWER resp or bradycardic pause lasting for more than
20 secds
- treatment= caffeine
Pulmonary HTN in premie - CORRECT ANSWER -causes: oxygen toxicity, vent shear forces,
viral illness, and microaspiration
- treatment: post pyloric feeds, gentile ventilation, limit oxygen and trend BNP
- BNP levels will help to follow for heart function want less than 35
,- - 1st line medication= sildenafil
PDA - CORRECT ANSWER most common in preterm babies
- leads to wide BP, bounding pulsus, washer machine like murmur
- treatment: motrin
-- untreated can lead to pulm HTN and BPD
Common issues with premature infant - CORRECT ANSWER - correct for prematurity until 2-
3 years old- but vaccines based on age born
- use premature growth charts
- premature formula till 9 mos
- may need to go home with pulse ox and if on oxygen need follow up echos
- screening by corrected age! Milestones adjusted
- high risk for motor and cognitive issues- want EI and early screening
- higher risk for GERD and FTT
Neurological risk factors with prematurity - CORRECT ANSWER - major: CP, blindness,
hearing loss, MR
- minor: cognitive, learning, behavioral, language, and neuromotor deficits
- risk for IVH
IVH - CORRECT ANSWER intraventricular hemorrhage
- common in infants born < 35 weeks
- graded 1-4: higher the amount more at risk for CP and DD
- want HUS btw 7-10 days and repeat at 36-40 weeks
Periventricular Leukomalacia (PVL) - CORRECT ANSWER white matter injury in preterm
infants
- common in those <32 weeks
- US diagnosis: will have cystic changes
, -- can lead to MR, CP, DD, and visual impairments
CP - CORRECT ANSWER Cerebral palsy
- postural and movement disorder that manifests as spasticity & hypotonia
- typically diagnosed around 2 years old- need to screen regularly for tone, strength, DTR, and
coordination
- associated with motor involvement, epilepsy, speech problems, vision compromise, and cognitive
dysfunction
CP causes - CORRECT ANSWER trauma during delivery or after, HIE, premies< 32 weeks,
low birth weight< 2500 gs, infections (rubella, CMV, toxoplasmosis)
CP types - CORRECT ANSWER 1. Spastic- most common- muscle hypertonicity, postural
difficulty, impaired gross and fine motor skills, drooling and dysarthria
2. Dyskinetic- abnormal involuntary motion
3. Ataxic- poor coordination, balance, control of upper extremities, wide gait
CP manifestations - CORRECT ANSWER - delayed gross motor developement
- abnormal motor skills- asymmetric, early handedness (should not have before 5 yrs),
feeding/swallowing problems, persistent toe-walking, W sitting, bottom scooting
- altered muscle tone- hypotonia, hypertonia, scissoring
- persistence of premitive reflexes
CP treatment - CORRECT ANSWER - PT/OT/ST: work on ROM, functional skills and
feeding and talking
- orthopedic care: mobility, surgery to release tendons
-- may need tendon lengthening or to loosen
- medications: diazepam, phenytoin, amphetamines (behavioral and hyperkinesia), baclofen, botox
ROP - CORRECT ANSWER retinopathy of prematurity
-abnormal vascular proliferation of the retina
QUESTIONS AND CORRECT ANSWERS
Major concerns for preterm infants - CORRECT ANSWER 1. ABC- risk for apnea and HTN
-- typically need RSV prophylaxis
2. Feeding issues- under 34 weeks issues with suck
3. Jaundice
4. Temp instability
5. Hypoglycemia
6. Car seat safety test if born less than 37 weeks
Synagis (palivizumab) - CORRECT ANSWER RSV vaccine
- used for premature infants born btw 32-25 weeks or with CLD or CHD or need oxygen from birth
BPD - CORRECT ANSWER bronchopulmonary dysplasia
- form of CLD that affects newborns and infants due to damage to lungs caused by mechanical
ventilation or long term oxygen use
- common in low birth weight and premature infants using oxygen for over 28 days
- having inflammation and scarring of the lungs- damage alveoli then leads to increase presssure-
pulm HTN
- treatment: diuretics, steroids, inhaled bronchodilators and optimize nutrition
Apnea of prematurity - CORRECT ANSWER resp or bradycardic pause lasting for more than
20 secds
- treatment= caffeine
Pulmonary HTN in premie - CORRECT ANSWER -causes: oxygen toxicity, vent shear forces,
viral illness, and microaspiration
- treatment: post pyloric feeds, gentile ventilation, limit oxygen and trend BNP
- BNP levels will help to follow for heart function want less than 35
,- - 1st line medication= sildenafil
PDA - CORRECT ANSWER most common in preterm babies
- leads to wide BP, bounding pulsus, washer machine like murmur
- treatment: motrin
-- untreated can lead to pulm HTN and BPD
Common issues with premature infant - CORRECT ANSWER - correct for prematurity until 2-
3 years old- but vaccines based on age born
- use premature growth charts
- premature formula till 9 mos
- may need to go home with pulse ox and if on oxygen need follow up echos
- screening by corrected age! Milestones adjusted
- high risk for motor and cognitive issues- want EI and early screening
- higher risk for GERD and FTT
Neurological risk factors with prematurity - CORRECT ANSWER - major: CP, blindness,
hearing loss, MR
- minor: cognitive, learning, behavioral, language, and neuromotor deficits
- risk for IVH
IVH - CORRECT ANSWER intraventricular hemorrhage
- common in infants born < 35 weeks
- graded 1-4: higher the amount more at risk for CP and DD
- want HUS btw 7-10 days and repeat at 36-40 weeks
Periventricular Leukomalacia (PVL) - CORRECT ANSWER white matter injury in preterm
infants
- common in those <32 weeks
- US diagnosis: will have cystic changes
, -- can lead to MR, CP, DD, and visual impairments
CP - CORRECT ANSWER Cerebral palsy
- postural and movement disorder that manifests as spasticity & hypotonia
- typically diagnosed around 2 years old- need to screen regularly for tone, strength, DTR, and
coordination
- associated with motor involvement, epilepsy, speech problems, vision compromise, and cognitive
dysfunction
CP causes - CORRECT ANSWER trauma during delivery or after, HIE, premies< 32 weeks,
low birth weight< 2500 gs, infections (rubella, CMV, toxoplasmosis)
CP types - CORRECT ANSWER 1. Spastic- most common- muscle hypertonicity, postural
difficulty, impaired gross and fine motor skills, drooling and dysarthria
2. Dyskinetic- abnormal involuntary motion
3. Ataxic- poor coordination, balance, control of upper extremities, wide gait
CP manifestations - CORRECT ANSWER - delayed gross motor developement
- abnormal motor skills- asymmetric, early handedness (should not have before 5 yrs),
feeding/swallowing problems, persistent toe-walking, W sitting, bottom scooting
- altered muscle tone- hypotonia, hypertonia, scissoring
- persistence of premitive reflexes
CP treatment - CORRECT ANSWER - PT/OT/ST: work on ROM, functional skills and
feeding and talking
- orthopedic care: mobility, surgery to release tendons
-- may need tendon lengthening or to loosen
- medications: diazepam, phenytoin, amphetamines (behavioral and hyperkinesia), baclofen, botox
ROP - CORRECT ANSWER retinopathy of prematurity
-abnormal vascular proliferation of the retina
