NURS 320 Exam 2 Questions with
Verified Answers
Autosomal dominant - ANSWER-One parent with abnormal gene (50% inheritance
takes place)
Males and females affected equally
ex. Marfan syndrome, dwarfism
Autosomal recessive - ANSWER-Need 2 parents w/abnormal gene
Inheritance:
-25% disease
-50% carrier
-25% normal
ex. PKU, Tay-Sachs disease, sickle cell
Sex-linked - ANSWER-Linked to X chromosome
ex. Duchenne muscular dystrophy, fragile X syndrome (usually to son)
Complications of prematurity: INTEGUMENT - ANSWER--Thin, transparent
(infection, wounds, heat loss, water loss)
-Keep warm, regulate temp
-Prevent skin breakdown
Complications of prematurity: MSK - ANSWER--Hypotonic (less flexion)
-Heat loss
-Abnormal muscle development
Nursing:
-Regulate temp (swaddling)
-Position in a flexed position
Complications of prematurity: GI - ANSWER--Immature - oftentimes get IV,
progressed to NG feedings
-At 34 weeks, can suck - starts with either breast or bottle
Complications of prematurity: IMMUNE - ANSWER--Increased risk for infection and
invasive procedures
-Increased risk if mom had infection
-Poor skin integrity
-Use/overuse of abx
-Prevention is key!
-Don't overuse abx
,Complications of prematurity: CARDIOVASCULAR - ANSWER--Bradycardia: reflux
-Periods of apnea
-Murmurs (congenital heart defect)
-Oral cyanosis
-Involve cardiologist, may need cardiac meds
Complications of prematurity: RESPIRATORY - ANSWER--Apnea (>20 sec)
-Cyanosis, bradycardia
-More premature = greater symptoms
-Try to wean off ventilator
-Treat apnea periods by shaking a little to startle/wake up
-May give a little caffeine
Transport of bilirubin - ANSWER-Albumin binds to unconjugated bilirubin
Conjugation of bilirubin - ANSWER-Liver enzymes
Converts bilirubin to excretable form
Excretion of bilirubin - ANSWER-Stools, if GI motility is decreased and baby not
passing stool, conjugated bilirubin can be reabsorbed and changed back into
unconjugated -> importance of noticing baby's stools
Physiologic jaundice - ANSWER-Normal process in the first week of life (after 24
hours)
45-60% of all full-term infants affected
Contributing factors:
-Shorter RBC lifespan
-Decreased albumin for transport
-Immature liver function
Usually self-resolves by 7-10 days
Normal bilirubin levels - ANSWER-Newborn 2-6 mg/mL
48 hours 6-7 mg/mL
5 days 4-12 mg/mL
Pathologic jaundice - ANSWER-*Occurs within 24 hours*
-Bilirubin increases by >5 mg/day
-Bilirubin >12 in term infant or >15 in preterm infant
-Jaundice > 10 days (term infant) or >two weeks (preterm)
Causes of pathologic jaundice - ANSWER-*Maternal-fetal or twin-to-twin
transfusion:* receives excess RBCs from placenta or twin
*Polycythemia:* hematocrit >60%
*Birth trauma/excessive bruising:* reabsorption of RBCs
*Sepsis:* affects liver function
*Blood incompatibilities*
, Rh incompatibility - ANSWER-15% of population is Rh negative
Rh- mom with Rh+ fetus
*Sensitization*: Rh+ fetal cells transfer to maternal circulation; mother develops anti-
Rh antibodies
No problem with first baby
Erythroblastosis fetalis - ANSWER-Hemolysis causing anemia and
hyperbilirubinemia
Problem with next pregnancy if fetus Rh+, anti-Rh antibodies cross placenta
Antibodies attack Rh+ fetal RBCs
Very uncommon in US, can be d/t no prenatal care
Hydrops fetalis - ANSWER-3+ children
More severe complication, extreme anemia, ascites/edema, death
When does transfer of the fetal blood into maternal circulation occur? - ANSWER-1.)
At delivery when placenta separates
2.) After spontaneous abortion of Rh positive fetus
RhoGAM - ANSWER-IM injection given to Rh- mother
Indication: given at 28 weeks gestation or after delivery of Rh+ baby or after abortion
Action: prevents anti-Rh antibody formation
Direct Coombs - ANSWER-Presence of anti-Rh antibodies in newborn blood
Indirect Coombs - ANSWER-Presence of anti-Rh antibodies in maternal blood
(sensitization)
ABO incompatibility - ANSWER-More common, less severe than Rh
Mother type O
Baby type A or B, AB
Anti-A, anti-B antibodies transfer to fetus
Causes hemolysis, jaundice
Photoisomerization - ANSWER-Light absorbed through skin
Photobilirubin - ANSWER-Unconjugated bilirubin converted to photobilirubin - can be
excreted without being conjugated by liver
Nursing care in phototherapy - ANSWER--Maximize skin exposure
-Maintain thermal neutral environment
Verified Answers
Autosomal dominant - ANSWER-One parent with abnormal gene (50% inheritance
takes place)
Males and females affected equally
ex. Marfan syndrome, dwarfism
Autosomal recessive - ANSWER-Need 2 parents w/abnormal gene
Inheritance:
-25% disease
-50% carrier
-25% normal
ex. PKU, Tay-Sachs disease, sickle cell
Sex-linked - ANSWER-Linked to X chromosome
ex. Duchenne muscular dystrophy, fragile X syndrome (usually to son)
Complications of prematurity: INTEGUMENT - ANSWER--Thin, transparent
(infection, wounds, heat loss, water loss)
-Keep warm, regulate temp
-Prevent skin breakdown
Complications of prematurity: MSK - ANSWER--Hypotonic (less flexion)
-Heat loss
-Abnormal muscle development
Nursing:
-Regulate temp (swaddling)
-Position in a flexed position
Complications of prematurity: GI - ANSWER--Immature - oftentimes get IV,
progressed to NG feedings
-At 34 weeks, can suck - starts with either breast or bottle
Complications of prematurity: IMMUNE - ANSWER--Increased risk for infection and
invasive procedures
-Increased risk if mom had infection
-Poor skin integrity
-Use/overuse of abx
-Prevention is key!
-Don't overuse abx
,Complications of prematurity: CARDIOVASCULAR - ANSWER--Bradycardia: reflux
-Periods of apnea
-Murmurs (congenital heart defect)
-Oral cyanosis
-Involve cardiologist, may need cardiac meds
Complications of prematurity: RESPIRATORY - ANSWER--Apnea (>20 sec)
-Cyanosis, bradycardia
-More premature = greater symptoms
-Try to wean off ventilator
-Treat apnea periods by shaking a little to startle/wake up
-May give a little caffeine
Transport of bilirubin - ANSWER-Albumin binds to unconjugated bilirubin
Conjugation of bilirubin - ANSWER-Liver enzymes
Converts bilirubin to excretable form
Excretion of bilirubin - ANSWER-Stools, if GI motility is decreased and baby not
passing stool, conjugated bilirubin can be reabsorbed and changed back into
unconjugated -> importance of noticing baby's stools
Physiologic jaundice - ANSWER-Normal process in the first week of life (after 24
hours)
45-60% of all full-term infants affected
Contributing factors:
-Shorter RBC lifespan
-Decreased albumin for transport
-Immature liver function
Usually self-resolves by 7-10 days
Normal bilirubin levels - ANSWER-Newborn 2-6 mg/mL
48 hours 6-7 mg/mL
5 days 4-12 mg/mL
Pathologic jaundice - ANSWER-*Occurs within 24 hours*
-Bilirubin increases by >5 mg/day
-Bilirubin >12 in term infant or >15 in preterm infant
-Jaundice > 10 days (term infant) or >two weeks (preterm)
Causes of pathologic jaundice - ANSWER-*Maternal-fetal or twin-to-twin
transfusion:* receives excess RBCs from placenta or twin
*Polycythemia:* hematocrit >60%
*Birth trauma/excessive bruising:* reabsorption of RBCs
*Sepsis:* affects liver function
*Blood incompatibilities*
, Rh incompatibility - ANSWER-15% of population is Rh negative
Rh- mom with Rh+ fetus
*Sensitization*: Rh+ fetal cells transfer to maternal circulation; mother develops anti-
Rh antibodies
No problem with first baby
Erythroblastosis fetalis - ANSWER-Hemolysis causing anemia and
hyperbilirubinemia
Problem with next pregnancy if fetus Rh+, anti-Rh antibodies cross placenta
Antibodies attack Rh+ fetal RBCs
Very uncommon in US, can be d/t no prenatal care
Hydrops fetalis - ANSWER-3+ children
More severe complication, extreme anemia, ascites/edema, death
When does transfer of the fetal blood into maternal circulation occur? - ANSWER-1.)
At delivery when placenta separates
2.) After spontaneous abortion of Rh positive fetus
RhoGAM - ANSWER-IM injection given to Rh- mother
Indication: given at 28 weeks gestation or after delivery of Rh+ baby or after abortion
Action: prevents anti-Rh antibody formation
Direct Coombs - ANSWER-Presence of anti-Rh antibodies in newborn blood
Indirect Coombs - ANSWER-Presence of anti-Rh antibodies in maternal blood
(sensitization)
ABO incompatibility - ANSWER-More common, less severe than Rh
Mother type O
Baby type A or B, AB
Anti-A, anti-B antibodies transfer to fetus
Causes hemolysis, jaundice
Photoisomerization - ANSWER-Light absorbed through skin
Photobilirubin - ANSWER-Unconjugated bilirubin converted to photobilirubin - can be
excreted without being conjugated by liver
Nursing care in phototherapy - ANSWER--Maximize skin exposure
-Maintain thermal neutral environment
