Nurs 221 Final Exam – Practice Questions &
Answers | Correct Study Guide With Solutions
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Terms in this set (101)
What are some non-pulmonary causes Sepsis, cardiac defects (structural or functional),
of respiratory distress in neonates? 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 Surfactant deficiency.
factor in the development of
Respiratory Distress Syndrome?
What are the clinical manifestations of 1.) Tachypnea (greater than or equal to 60
Respiratory Distress Syndrome? 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 Infants with meconium aspiration, infectious
Syndrome, what is surfactant therapy pneumonia, sepsis, persistent pulmonary
also being used in? hypertension, and pulmonary hemorrhage.
How is surfactant administered? Via an endotracheal (ET) tube directly into the infant's
trachea.
,What is Acrocyanosis? 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 1.) Large for gestational age (>4g)
Infants of Diabetic Mothers (IDMs)? 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 IDMs is related to hypertrophy and
hypoglycemia in the infant? 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 The euglycemic status of the mother.
factor that influences fetal well being
in a diabetic mother?
What serum glucose level should be Above 40 mg/dL and as high as 55 to 65 mg/dL in
maintained in an infant with abnormal other infants.
clinical symptoms?
What are the signs and symptoms of Jitteriness, lethargy, poor feeding, abnormal cry,
hypoglycemia in the newborn? hypotonia, temperature instability (hypothermia),
respiratory distress, apnea, and seizures.
, What are the characteristics of It is green, and it is either thin (light) or thick (heavy),
meconium stained amniotic fluid? depending on the amount of meconium present.
What are the three possible reasons 1.) It is a normal physiologic function that occurs with
for the passage of meconium in the maturity (meconium passage being infrequent before
amniotic fluid? 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): 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 1.) Assess the amniotic fluid for the presence of
the newborn with meconium stained meconium after rupture of membranes.
amniotic fluid before birth? 2.) If the amniotic fluid is meconium stained, gather
equipment and supplies that might be necessary for
neonatal resuscitation.
3.) Have at least one person capable of performing
endotracheal intubation on the baby present at the
birth.
Answers | Correct Study Guide With Solutions
Save
Terms in this set (101)
What are some non-pulmonary causes Sepsis, cardiac defects (structural or functional),
of respiratory distress in neonates? 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 Surfactant deficiency.
factor in the development of
Respiratory Distress Syndrome?
What are the clinical manifestations of 1.) Tachypnea (greater than or equal to 60
Respiratory Distress Syndrome? 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 Infants with meconium aspiration, infectious
Syndrome, what is surfactant therapy pneumonia, sepsis, persistent pulmonary
also being used in? hypertension, and pulmonary hemorrhage.
How is surfactant administered? Via an endotracheal (ET) tube directly into the infant's
trachea.
,What is Acrocyanosis? 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 1.) Large for gestational age (>4g)
Infants of Diabetic Mothers (IDMs)? 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 IDMs is related to hypertrophy and
hypoglycemia in the infant? 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 The euglycemic status of the mother.
factor that influences fetal well being
in a diabetic mother?
What serum glucose level should be Above 40 mg/dL and as high as 55 to 65 mg/dL in
maintained in an infant with abnormal other infants.
clinical symptoms?
What are the signs and symptoms of Jitteriness, lethargy, poor feeding, abnormal cry,
hypoglycemia in the newborn? hypotonia, temperature instability (hypothermia),
respiratory distress, apnea, and seizures.
, What are the characteristics of It is green, and it is either thin (light) or thick (heavy),
meconium stained amniotic fluid? depending on the amount of meconium present.
What are the three possible reasons 1.) It is a normal physiologic function that occurs with
for the passage of meconium in the maturity (meconium passage being infrequent before
amniotic fluid? 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): 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 1.) Assess the amniotic fluid for the presence of
the newborn with meconium stained meconium after rupture of membranes.
amniotic fluid before birth? 2.) If the amniotic fluid is meconium stained, gather
equipment and supplies that might be necessary for
neonatal resuscitation.
3.) Have at least one person capable of performing
endotracheal intubation on the baby present at the
birth.
