NICU RN A V1 STUDY CORRECT QUESTIONS AND
ANSWERS SURE A+
✔✔What do we do for the management of a PDA - ✔✔-fluid restriction; still need
enough to maintain hydration, but do not want to keep PDA open
-positive end expiratory pressure- keeps lungs open
-indomethacin - vasconstrictor
-ibuprofen- drug of choice - constricts the vessel
-surgical ligation: when ibuprofen wont work
✔✔What medications do we give for PDA - ✔✔Indomethacin (vasoconstrictor)
Ibuprofen (vasoconstrictor)
✔✔What are the neonate gastrointestinal disorders - ✔✔-necrotizing enterocolitis
-abdominal wall defects
-tracheoesophageal fistula (TEF)
-intestinal atresia or stenosis
-meconium ileus
-imperforate anus
-diaphragmatic hernia
✔✔What are the types of abdominal wall defects? - ✔✔-gastroschisis
-omphalocele
✔✔What is gastroschisis - ✔✔-bowel is outside of the body, not covered by a sac
contact w/ amniotic fluid makes it edematous and swollen
-may include stomach, small and large intestine
-not usually associated with other anomalies
✔✔What is omphalocele - ✔✔-herniation of abdominal viscera into umbilical cord and
usually covered with peritoneal sac
-may include stomach, liver, spleen and intestine
-are associated with multiple anomalies
, ✔✔What is an omphalocele associated with? - ✔✔Multiple Anomalies!
-cardiac
-neurologic
-GU
-Skeletal
-chromosomal
✔✔What is necrotizing enterocolitis - ✔✔-disease process leading to bowel necrosis
✔✔What is the pathogenesis of necrotizing enterocolitis - ✔✔pathogenesis remains
unclear, but a common pathway appears to be mucosal injury
✔✔What are the risk factors for necrotizing enterocolitis? - ✔✔-perinatal hypoxemia
-polycythemia
-prematurity
-formula or hyperosmolar feeds
-abnormal bacterial colonization (giving antibiotics)
-congenital heart defect
✔✔What are the symptoms of necrotizing enterocolitis (NEC) - ✔✔-apnea
-lethargy
-*abdominal distention* hallmark*
-feeding intolerance
-emesis
-*bloody stools*- can be a first sign
-abdominal wall erythema
-hypotension
-metabolic acidosis
-DIC
✔✔What is the medical management for the neonate with necrotizing enterocolitis? -
✔✔-NPO
-abdominal decompression
--ng to suction
-antibiotics
-bowel rest
-TPN- won't eat for a while- bowel has to be back to 100%
-treatment of pain- want sedated
✔✔What is the surgical management for the neonate with necrotizing enterocolitis -
✔✔-35-50% need surgery
-penrose drain placement
-exploratory laparotomy with bowel resection
-enterostomy
ANSWERS SURE A+
✔✔What do we do for the management of a PDA - ✔✔-fluid restriction; still need
enough to maintain hydration, but do not want to keep PDA open
-positive end expiratory pressure- keeps lungs open
-indomethacin - vasconstrictor
-ibuprofen- drug of choice - constricts the vessel
-surgical ligation: when ibuprofen wont work
✔✔What medications do we give for PDA - ✔✔Indomethacin (vasoconstrictor)
Ibuprofen (vasoconstrictor)
✔✔What are the neonate gastrointestinal disorders - ✔✔-necrotizing enterocolitis
-abdominal wall defects
-tracheoesophageal fistula (TEF)
-intestinal atresia or stenosis
-meconium ileus
-imperforate anus
-diaphragmatic hernia
✔✔What are the types of abdominal wall defects? - ✔✔-gastroschisis
-omphalocele
✔✔What is gastroschisis - ✔✔-bowel is outside of the body, not covered by a sac
contact w/ amniotic fluid makes it edematous and swollen
-may include stomach, small and large intestine
-not usually associated with other anomalies
✔✔What is omphalocele - ✔✔-herniation of abdominal viscera into umbilical cord and
usually covered with peritoneal sac
-may include stomach, liver, spleen and intestine
-are associated with multiple anomalies
, ✔✔What is an omphalocele associated with? - ✔✔Multiple Anomalies!
-cardiac
-neurologic
-GU
-Skeletal
-chromosomal
✔✔What is necrotizing enterocolitis - ✔✔-disease process leading to bowel necrosis
✔✔What is the pathogenesis of necrotizing enterocolitis - ✔✔pathogenesis remains
unclear, but a common pathway appears to be mucosal injury
✔✔What are the risk factors for necrotizing enterocolitis? - ✔✔-perinatal hypoxemia
-polycythemia
-prematurity
-formula or hyperosmolar feeds
-abnormal bacterial colonization (giving antibiotics)
-congenital heart defect
✔✔What are the symptoms of necrotizing enterocolitis (NEC) - ✔✔-apnea
-lethargy
-*abdominal distention* hallmark*
-feeding intolerance
-emesis
-*bloody stools*- can be a first sign
-abdominal wall erythema
-hypotension
-metabolic acidosis
-DIC
✔✔What is the medical management for the neonate with necrotizing enterocolitis? -
✔✔-NPO
-abdominal decompression
--ng to suction
-antibiotics
-bowel rest
-TPN- won't eat for a while- bowel has to be back to 100%
-treatment of pain- want sedated
✔✔What is the surgical management for the neonate with necrotizing enterocolitis -
✔✔-35-50% need surgery
-penrose drain placement
-exploratory laparotomy with bowel resection
-enterostomy
