NSNE 7200 - Module 4 Exam Questions with Correct Answers Graded A+
Small for gestational age (SGA) infants are those in the lower x percentile for weight based on
gestational age. SGA infants can be genetically small but they can also suffer from y - Answers
10th, intrauterine growth restriction (IUGR)
Differentiate SGA and IUGR - Answers SGA—infant is below the 10th percentile on a standard
growth chart
IUGR—refers to the deviation and reduction in expected fetal growth pattern
The term IUGR should be used when there is evidence of abnormal x or y influences affecting
growth - Answers genetic, environmental
Infants can be SGA without IUGR, and infants can suffer from IUGR and not be SGA. T/F? -
Answers T
How is prenatal growth related to neurodevelopment? - Answers Prenatal growth can seriously
affect neurodevelopmental outcomes of infants. The neurodevelopmental outcomes of IUGR
infants are strongly associated with the cause of IUGR
What are some underlying causes of IUGR? - Answers Early, severe IUGR often reflects a
chromosomal abnormality, another severe genetic disorder, or a congenital infection that
occurred early in gestation.
Uteroplacental insufficiency is one of the most common causes of IUGR. The fetus will respond
to a lack of oxygen supply and nutrients first by decreasing subcutaneous tissue, then by
decreasing in length, lastly the head and brain growth will be affected
What is symmetrical IUGR? - Answers -This type of growth restriction occurs early in pregnancy
and is associated with a decreased number of fetal cells.
-It is marked by inadequate growth of the head, body, and extremities.
-Infants are born with fewer brain cells and tend to have poorer outcomes.
What are some etiologies of symmetrical IUGR? - Answers Etiologies include genetic or
chromosomal causes, early gestational intrauterine infections (TORCH), and maternal alcohol
use.
What is asymmetrical IUGR? - Answers This type of growth restriction usually occurs early in the
third trimester and is associated with impaired growth of the body, with normal growth of the
head and extremities
,It is the result of failure of the cells to increase in size, resulting in less fat and smaller
abdominal organs.
What are some etiologies of asymmetrical IUGR? - Answers This is due to extrinsic influences
that affect the fetus later in gestation, such as preeclampsia, chronic hypertension, and uterine
anomalies.
How does IUGR affect long-term outcomes? Prematurity and IUGR? - Answers IUGR infants at
full term show more language problems, learning disabilities, neuromotor dysfunction,
hyperactivity, and attention and behaviour problems than full-term infants of an average size.
Preterm infants who are also IUGR demonstrate the disadvantages of both prematurity and
IUGR, showing higher rates of major disability and learning disability
What is apnea? - Answers Apnea is defined as a non-breathing episode lasting longer than 20
seconds and accompanied with cyanosis and/or bradycardia
How does neonatal response to hypoxemia and CO2 retention differ from an adult's? - Answers
Neonates have a unique response to hypoxemia and CO2 retention. Adults will have a sustained
increase in ventilation, but infants will have a brief period of increased ventilation followed by
respiratory depression
What are the 2 types of apnea? - Answers primary apnea—refers to apnea that is not associated
with any other diseases (for example, apnea of prematurity)
secondary apnea—may be associated with a particular disease or in response to a procedure
What do the 2 types of apnea respond to? - Answers When referring to apnea in the context of
neonatal resuscitation, primary apnea responds to the initial steps of Neonatal Resuscitation
Program (NRP), whereas secondary apnea does not respond to stimulation, drying, or
suctioning and requires initiation of intermittent positive pressure ventilation (IPPV).
What causes apnea of prematurity? - Answers The exact causes of apnea of prematurity are still
not known. Immaturity and/or depression of the central respiratory drive to the muscles of
respiration have been accepted as key factors in the pathogenesis of apnea of prematurity.
The severity of apnea attacks in premature infants correlates with x. The more y an infant is, the
more likely he or she is to have frequent, severe apneic spells. - Answers gestational age,
premature
Which sleep-wake state are infants more likely to have apnea? - Answers Studies have shown
that apnea occurs most frequently during the sleep state and is especially prevalent during
active sleep. Active sleep, or REM sleep, is the predominant sleep state of premature infants,
and infants less than 32 weeks spend 80% of their time asleep. These two characteristics of the
, sleep states of premature infants puts them at significantly higher risk for developing apnea.
Which hormones have been implicated in apnea and why is this especially problematic for
preterm infants? - Answers Premature infants have a decreased amount of peripheral
catecholamines (epinephrine and norepinephrine), and this has also been implicated as a cause
of apnea. When infection is present, catecholamine stores are further depleted, putting infected
premature infants at a very high risk for developing apnea.
Respiratory muscle fatigue may also be a contributing factor in apnea of prematurity. Premature
infants have very compliant x and less compliant y than full-term infants, and this means
increased z for premature infants - Answers chest cages, lungs, work of breathing
What does apnea in the first 24 hours indicate? - Answers Apnea seldom occurs in first 24
hours of life, even in premature infants. Therefore, the appearance of apneic spells in the first
24 hours is usually a sign of an underlying disorder. Rather than being due to prematurity, apnea
may be the first sign of an underlying disorder.
Apnea is rare beyond what GA? - Answers Apnea is rare in infants of greater than 34 weeks
gestation and needs to be promptly investigated.
Apnea can be fairly benign, if managed appropriately. Or apnea can progress to x, terminal y,
and z failure. - Answers bradycardia, apnea, respiratory
What is one of the most important nursing interventions when it comes to apnea? - Answers
Responding quickly and appropriately to an infant who is apneic
What are some factors implicated with apnea of prematurity? - Answers Immaturity and/or
depression of the central respiratory drive to the muscles of respiration, hypoxemia, sleep,
decreased amount of peripheral catecholamines, respiratory muscle fatigue
Assessment and intervention should proceed in an orderly sequence. How would you assess
apnea? - Answers Look at the infant, check breathing, check HR, and check color and saturation
What to look for when looking at the infant with apnea? - Answers Often, we are first alerted to
an infant's apnea when the infant's cardiorespiratory monitor alarm rings. When the monitor
alarm rings, it is important to first look at the infant. The infant may be fine: breathing, with a
normal heart rate, and satisfactory colour. The problem may be the monitor, the leads, etc. If the
infant is not fine, proceed with assessment and intervention, following the sequence: breathing,
heart rate, and colour.
What to look for when checking breathing of the infant with apnea? - Answers If an infant is
apneic, provide gentle stimulation by rubbing the infant's back or foot. Often, this stimulation is
all that is required for the infant to resume breathing.
Small for gestational age (SGA) infants are those in the lower x percentile for weight based on
gestational age. SGA infants can be genetically small but they can also suffer from y - Answers
10th, intrauterine growth restriction (IUGR)
Differentiate SGA and IUGR - Answers SGA—infant is below the 10th percentile on a standard
growth chart
IUGR—refers to the deviation and reduction in expected fetal growth pattern
The term IUGR should be used when there is evidence of abnormal x or y influences affecting
growth - Answers genetic, environmental
Infants can be SGA without IUGR, and infants can suffer from IUGR and not be SGA. T/F? -
Answers T
How is prenatal growth related to neurodevelopment? - Answers Prenatal growth can seriously
affect neurodevelopmental outcomes of infants. The neurodevelopmental outcomes of IUGR
infants are strongly associated with the cause of IUGR
What are some underlying causes of IUGR? - Answers Early, severe IUGR often reflects a
chromosomal abnormality, another severe genetic disorder, or a congenital infection that
occurred early in gestation.
Uteroplacental insufficiency is one of the most common causes of IUGR. The fetus will respond
to a lack of oxygen supply and nutrients first by decreasing subcutaneous tissue, then by
decreasing in length, lastly the head and brain growth will be affected
What is symmetrical IUGR? - Answers -This type of growth restriction occurs early in pregnancy
and is associated with a decreased number of fetal cells.
-It is marked by inadequate growth of the head, body, and extremities.
-Infants are born with fewer brain cells and tend to have poorer outcomes.
What are some etiologies of symmetrical IUGR? - Answers Etiologies include genetic or
chromosomal causes, early gestational intrauterine infections (TORCH), and maternal alcohol
use.
What is asymmetrical IUGR? - Answers This type of growth restriction usually occurs early in the
third trimester and is associated with impaired growth of the body, with normal growth of the
head and extremities
,It is the result of failure of the cells to increase in size, resulting in less fat and smaller
abdominal organs.
What are some etiologies of asymmetrical IUGR? - Answers This is due to extrinsic influences
that affect the fetus later in gestation, such as preeclampsia, chronic hypertension, and uterine
anomalies.
How does IUGR affect long-term outcomes? Prematurity and IUGR? - Answers IUGR infants at
full term show more language problems, learning disabilities, neuromotor dysfunction,
hyperactivity, and attention and behaviour problems than full-term infants of an average size.
Preterm infants who are also IUGR demonstrate the disadvantages of both prematurity and
IUGR, showing higher rates of major disability and learning disability
What is apnea? - Answers Apnea is defined as a non-breathing episode lasting longer than 20
seconds and accompanied with cyanosis and/or bradycardia
How does neonatal response to hypoxemia and CO2 retention differ from an adult's? - Answers
Neonates have a unique response to hypoxemia and CO2 retention. Adults will have a sustained
increase in ventilation, but infants will have a brief period of increased ventilation followed by
respiratory depression
What are the 2 types of apnea? - Answers primary apnea—refers to apnea that is not associated
with any other diseases (for example, apnea of prematurity)
secondary apnea—may be associated with a particular disease or in response to a procedure
What do the 2 types of apnea respond to? - Answers When referring to apnea in the context of
neonatal resuscitation, primary apnea responds to the initial steps of Neonatal Resuscitation
Program (NRP), whereas secondary apnea does not respond to stimulation, drying, or
suctioning and requires initiation of intermittent positive pressure ventilation (IPPV).
What causes apnea of prematurity? - Answers The exact causes of apnea of prematurity are still
not known. Immaturity and/or depression of the central respiratory drive to the muscles of
respiration have been accepted as key factors in the pathogenesis of apnea of prematurity.
The severity of apnea attacks in premature infants correlates with x. The more y an infant is, the
more likely he or she is to have frequent, severe apneic spells. - Answers gestational age,
premature
Which sleep-wake state are infants more likely to have apnea? - Answers Studies have shown
that apnea occurs most frequently during the sleep state and is especially prevalent during
active sleep. Active sleep, or REM sleep, is the predominant sleep state of premature infants,
and infants less than 32 weeks spend 80% of their time asleep. These two characteristics of the
, sleep states of premature infants puts them at significantly higher risk for developing apnea.
Which hormones have been implicated in apnea and why is this especially problematic for
preterm infants? - Answers Premature infants have a decreased amount of peripheral
catecholamines (epinephrine and norepinephrine), and this has also been implicated as a cause
of apnea. When infection is present, catecholamine stores are further depleted, putting infected
premature infants at a very high risk for developing apnea.
Respiratory muscle fatigue may also be a contributing factor in apnea of prematurity. Premature
infants have very compliant x and less compliant y than full-term infants, and this means
increased z for premature infants - Answers chest cages, lungs, work of breathing
What does apnea in the first 24 hours indicate? - Answers Apnea seldom occurs in first 24
hours of life, even in premature infants. Therefore, the appearance of apneic spells in the first
24 hours is usually a sign of an underlying disorder. Rather than being due to prematurity, apnea
may be the first sign of an underlying disorder.
Apnea is rare beyond what GA? - Answers Apnea is rare in infants of greater than 34 weeks
gestation and needs to be promptly investigated.
Apnea can be fairly benign, if managed appropriately. Or apnea can progress to x, terminal y,
and z failure. - Answers bradycardia, apnea, respiratory
What is one of the most important nursing interventions when it comes to apnea? - Answers
Responding quickly and appropriately to an infant who is apneic
What are some factors implicated with apnea of prematurity? - Answers Immaturity and/or
depression of the central respiratory drive to the muscles of respiration, hypoxemia, sleep,
decreased amount of peripheral catecholamines, respiratory muscle fatigue
Assessment and intervention should proceed in an orderly sequence. How would you assess
apnea? - Answers Look at the infant, check breathing, check HR, and check color and saturation
What to look for when looking at the infant with apnea? - Answers Often, we are first alerted to
an infant's apnea when the infant's cardiorespiratory monitor alarm rings. When the monitor
alarm rings, it is important to first look at the infant. The infant may be fine: breathing, with a
normal heart rate, and satisfactory colour. The problem may be the monitor, the leads, etc. If the
infant is not fine, proceed with assessment and intervention, following the sequence: breathing,
heart rate, and colour.
What to look for when checking breathing of the infant with apnea? - Answers If an infant is
apneic, provide gentle stimulation by rubbing the infant's back or foot. Often, this stimulation is
all that is required for the infant to resume breathing.
