NSNE 7200 FINAL EXAM QUESTIONS AND ANSWERS ALREADY PASSED LATEST UPDATE

NSNE 7200 FINAL EXAM QUESTIONS AND ANSWERS ALREADY PASSED LATEST UPDATE health challenges that affect PREMATURE infants - Answers - F&E imbalance - RDS - hyperoxia - poor suck & swallow reflex - BPD - PDA - NEC - AOP - IVH - PVL - pneumonia health challenges that affect TERM/POST-TERM infants - Answers - intrapartum asphyxia - MAS - PPHN - HIE lactogenesis vs. galactopoeisis - Answers lactogensis = initiation of milk production triggered by drop in estrogen, lactogen, progesterone which allows prolactin levels to rise galactopoeisis = ongoing milk production what affects galactopoeisis? - Answers - sensory stimulation, i.e., infant suckling - breast emptying - supply & demand - milk-ejection reflex common health challenges that increase vulnerability associated with early discharge of TERM infants - Answers - difficulty with BF - jaundice - dehydration CCHD screening (3 points) - Answers - pulse ox measurement of R hand + either foot - O2 sats must be above 95% and difference b/w hand & foot should be 3% or less - infant immediately fails if O2 sats <90% or after 3 tries whey in breast milk - Answers - smooth & easily digestible - higher in content in early lactation (90%) casein in breast milk - Answers - less digestible; requires more enr to breakdown - enhances absorption of iron to prevent iron-dependent bacteria from proliferating in GI important factors in milk transfer (3 points) - Answers - compression - suction - tongue action feeding cues (3 points) - Answers - bringing hands to mouth - rooting - mouthing & sucking motions preparing for a feed (3 points) - Answers - help mom get into a comfortable position with back, head, and arms supported - position baby belly-to-belly, STS - prop baby up so body is aligned with breasts - infant's head & body aligned basic BF positions (3 points) - Answers - cradle - side-lying - football promoting good latch when breasts are large & soft (4 points) - Answers - support breast by using C-hold - wait until baby's mouth is wide-open; jaw to be as far back as possible - lead latch with chin - draw baby firmly towards breast with nipple centred b/w tongue & baby's upper lip; bodies close signs of good latch (6 points) - Answers - tugging sensation on nipple (not pain) - mouth wide open - lips flanged outward - tongue cupped beneath breast - tip of nose & chin are touching breast - cheeks are rounded (not sucked in or dimpled) signs of good suck (6 points) - Answers - begins with quick sucking to stimulate let down, then becomes deep & rhythmical - regular audible swallowing - observable "wiggle" at junction of ear & temple - no audible smacking or clicking - BF is comfortable for mom - baby ends feed on own how often & long to BF? (4 points) - Answers - feed as often & as long as baby wants - q2-3h during day, q3-4 during night - at least 8x in 24h - feeds apprx 20-30 min signs that baby is getting enough milk (3 points) - Answers - looks content after feeds - feeding at least 8x in 24h + at least 15-20 min per breast - 6-8 wet diapers + 3 stools q24h by day 4 nature of milk relating to frequency & duration of feeds (4 points) - Answers - always exist in a state of change - fat content changes from feed-to-feed - the longer the feed & the effectiveness of milk removal = the higher the fat content - longer interval b/w feeds = lower fat concentration for next feed supporting the BF experience (8 points) - Answers - aware of factors that influence feeding choices - ongoing education, esp. during antenatal period - feeding cues, positioning, good latch - providing support for common BF challenges = unpreparedness, lack of confidence - encourage frequent feedings & assure cluster feeding is normal - not a sign of inadequate milk supply - provide family with support resources - provide positive feedback - promote fully-informed infant feeding decisions - involve partners