AWHONN Neonatal Modules
A deformation is a(n)
abnormality caused by unusual mechanical forces on normal tissue.
A low birth weight infant's temperature increases during skin-to-skin care. This is
an example of heat transfer by
conduction.
At the onset of labor the release of catecholamines stimulates
increased absorption of lung fluid.
An edematous, bruised lesion on the right anterior scalp where the vacuum was
applied. This lesion has clearly demarcated edges, is firm to touch, and does not
cross the suture line. This is best described as a
cephalohematoma.
An infant born at 40 5/7 weeks gestation and weighed 5 lbs 2oz (2,360 grams). In
completing a gestational age assessment on this infant, you would identify her as
term, small for gestational age.
During fetal life, the ductus arteriosus
diverts blood flow from the pulmonary artery to the descending aorta.
Expected findings in a neonate born to a mother who received magnesium sulfate
in labor include
hypotonia.
Eye prophylaxis with a single-use dose of sterile ophthalmic ointment containing
1% tetracycline or 0.5% erythromycin is usually administered within the first few
hours of birth to prevent an eye infection caused by
gonorrhea.
Following a birth complicated by shoulder dystocia, the neonate should be
assessed for
Erb's palsy.
Preeclampsia may result in all of the following fetal conditions
growth restriction, hypoxia/neurological injury, prematurity.
Hyperthermia is defined as an axillary temperature greater than 99.5ºF (37.5ºC).
The MOST common cause of hyperthermia in the newborn is
environmental.
In the immediate newborn transition period, the ability to maintain functional
residual lung capacity is most dependent upon
an adequate amount of alveolar surfactant.
Neonates at risk of hypoglycemia should have their glucose levels evaluated
within 2 hours of life because
blood glucose levels reach their lowest point within one to two hours after delivery.
Polycythemia in the immediate newborn period is often associated with
infant of a diabetic mother.
Symptoms of mild perinatal asphyxia include
hyperalert state and jitteriness.
The condition in which the newborn's immature hypothalamus does not regulate
peripheral blood vessels, resulting in a vasoconstriction on one side of the body
with a vasodilation on the opposite side of the body is called
harlequin phenomena.
,The following conditions may all lead to metabolic acidosis
loss of HCO3/excess acid load d/t prematurity, renal tubular necrosis, severe diarrhea,
hypoxia, hypoperfusion, inborn errors of metabolism, caloric deprivation, intolerance of
cow's milk protein.
The full newborn cardiovascular assessment includes auscultation, inspection,
and palpation. The point of maximum impulse is usually palpable and can be
auscultated in the
third to fourth intercostal space and left of the midclavicular line.
The neonate born to a mother with uncontrolled diabetes mellitus should be
evaluated for
congenital malformations.
You are the nurse caring for a 38 weeks gestation, female infant, who was born
one hour ago in the parking lot of the emergency room. On admission to the
nursery, the neonate's rectal temperature was 95ºF (35ºC). You recognize that
cold stress may predispose the infant to
increased oxygen consumption and hypoxia.
A full term neonate who presents at six hours of age with increasingly labile
oxygenation that appears disproportionate to the pulmonary disease should be
evaluated for
pulmonary hypertension of the newborn.
The development of pneumonia in chronically ventilated infants is most
commonly associated with which of the following organisms?
Ureaplasma urealyticum
Antenatal steroids enhance lung maturation by
increasing the number of type II pneumocytes in the lung.
Mean airway pressure is defined as the
pressure transmitted to the lung throughout the respiratory cycle.
Many infants with the diagnosis of persistent pulmonary hypertension (PPHN) will
have pharmacologic support. Identify the medication that is a direct-acting
vasodilator and acts by relaxing pulmonary vessel musculature.
Nitric oxide
The following arterial blood gas results: pH 7.28, PaO2 74, PaCO2 55, HCO3- 21
and base deficit -4 indicate
respiratory acidosis.
Nastassia is a one-hour-old neonate, born at 39 weeks gestation by primary
cesarean birth for fetal bradycardia. She was hypotonic at birth with gasping
respirations and a heart rate of 80. She was provided bulb suctioning and bag
mask ventilation and recovered by five minutes of life. On admission to the NICU,
her temperature was 36° C. After admission to the NICU, her arterial blood gas is
pH: 7.19, PCO2: 63, HCO3: 14. The correct interpretation of this blood gas is
mixed respiratory and metabolic acidosis.
Which statement is most accurate when identifying the pathophysiology of
transient tachypnea of the newborn (TTN)?
Labor enhances the process of fetal lung fluid absorption
During which phase of fetal pulmonary development do the type II pneumocytes
become numerous and begin to produce and store surfactant?
, Canalicular phase
An absence of air flow despite respiratory effort is an example of which apnea
classification?
Obstructive apnea
Continuous positive airway pressure (CPAP) improves oxygenation by
improving the ventilation-perfusion ratio.
The functional residual capacity in a newborn infant should be approximately
30 ml/kg.
A 29 week gestation infant who displays symptoms of a pulmonary hemorrhage
should be evaluated for
patent ductus arteriosus.
The most significant role of surfactant in neonatal lung development is to
maintain alveolar stability by decreasing surface tension.
Most respiratory disorders result in a ventilation-perfusion mismatch. Ideally, the
ventilation-perfusion ratio should be
1 to 1
A neonate at 12 hours of life with meconium aspiration syndrome who has been
intubated since birth suddenly develops severe respiratory distress, tachycardia,
and hypotension. Which diagnosis would be least likely to be in the differential?
Intraventricular hemorrhage
Which of the following conditions is not an air leak?
Pneumatosis intestinalis
The decision to intubate an infant born through thick meconium should be based
on the infant's
response to stimulation and bag and mask ventilation.
The type of patient-triggered ventilator that applies a constant pressure during
inspiration and terminates with a decrease in air flow, thereby decreasing the
work of breathing, is a(n)
pressure support ventilation.
Neonates receiving surfactant are at increased risk of developing
pulmonary hemorrhage.
A discrepancy greater than 10 mm Hg between the blood pressure in the upper
and lower extremities is indicative of which defect?
Coarctation of the aorta
In order to pass a pulse oximetry screening for critical congenital heart disease
(CCHD), which oxygenation and percentage of variance is required in the right
hand and foot?
Less than 95% O2 saturation and greater than 3% variance
A neonate at 10 hours of age is found to be cyanotic and without respiratory
distress symptoms. The EKG and chest x-ray are normal. The administration of
oxygen is not relieving the cyanosis. The healthcare provider should have a high
index of suspicion for which of the following defects?
Transposition of the great vessels
A right-to-left shunt will be seen with
pulmonary stenosis.
A deformation is a(n)
abnormality caused by unusual mechanical forces on normal tissue.
A low birth weight infant's temperature increases during skin-to-skin care. This is
an example of heat transfer by
conduction.
At the onset of labor the release of catecholamines stimulates
increased absorption of lung fluid.
An edematous, bruised lesion on the right anterior scalp where the vacuum was
applied. This lesion has clearly demarcated edges, is firm to touch, and does not
cross the suture line. This is best described as a
cephalohematoma.
An infant born at 40 5/7 weeks gestation and weighed 5 lbs 2oz (2,360 grams). In
completing a gestational age assessment on this infant, you would identify her as
term, small for gestational age.
During fetal life, the ductus arteriosus
diverts blood flow from the pulmonary artery to the descending aorta.
Expected findings in a neonate born to a mother who received magnesium sulfate
in labor include
hypotonia.
Eye prophylaxis with a single-use dose of sterile ophthalmic ointment containing
1% tetracycline or 0.5% erythromycin is usually administered within the first few
hours of birth to prevent an eye infection caused by
gonorrhea.
Following a birth complicated by shoulder dystocia, the neonate should be
assessed for
Erb's palsy.
Preeclampsia may result in all of the following fetal conditions
growth restriction, hypoxia/neurological injury, prematurity.
Hyperthermia is defined as an axillary temperature greater than 99.5ºF (37.5ºC).
The MOST common cause of hyperthermia in the newborn is
environmental.
In the immediate newborn transition period, the ability to maintain functional
residual lung capacity is most dependent upon
an adequate amount of alveolar surfactant.
Neonates at risk of hypoglycemia should have their glucose levels evaluated
within 2 hours of life because
blood glucose levels reach their lowest point within one to two hours after delivery.
Polycythemia in the immediate newborn period is often associated with
infant of a diabetic mother.
Symptoms of mild perinatal asphyxia include
hyperalert state and jitteriness.
The condition in which the newborn's immature hypothalamus does not regulate
peripheral blood vessels, resulting in a vasoconstriction on one side of the body
with a vasodilation on the opposite side of the body is called
harlequin phenomena.
,The following conditions may all lead to metabolic acidosis
loss of HCO3/excess acid load d/t prematurity, renal tubular necrosis, severe diarrhea,
hypoxia, hypoperfusion, inborn errors of metabolism, caloric deprivation, intolerance of
cow's milk protein.
The full newborn cardiovascular assessment includes auscultation, inspection,
and palpation. The point of maximum impulse is usually palpable and can be
auscultated in the
third to fourth intercostal space and left of the midclavicular line.
The neonate born to a mother with uncontrolled diabetes mellitus should be
evaluated for
congenital malformations.
You are the nurse caring for a 38 weeks gestation, female infant, who was born
one hour ago in the parking lot of the emergency room. On admission to the
nursery, the neonate's rectal temperature was 95ºF (35ºC). You recognize that
cold stress may predispose the infant to
increased oxygen consumption and hypoxia.
A full term neonate who presents at six hours of age with increasingly labile
oxygenation that appears disproportionate to the pulmonary disease should be
evaluated for
pulmonary hypertension of the newborn.
The development of pneumonia in chronically ventilated infants is most
commonly associated with which of the following organisms?
Ureaplasma urealyticum
Antenatal steroids enhance lung maturation by
increasing the number of type II pneumocytes in the lung.
Mean airway pressure is defined as the
pressure transmitted to the lung throughout the respiratory cycle.
Many infants with the diagnosis of persistent pulmonary hypertension (PPHN) will
have pharmacologic support. Identify the medication that is a direct-acting
vasodilator and acts by relaxing pulmonary vessel musculature.
Nitric oxide
The following arterial blood gas results: pH 7.28, PaO2 74, PaCO2 55, HCO3- 21
and base deficit -4 indicate
respiratory acidosis.
Nastassia is a one-hour-old neonate, born at 39 weeks gestation by primary
cesarean birth for fetal bradycardia. She was hypotonic at birth with gasping
respirations and a heart rate of 80. She was provided bulb suctioning and bag
mask ventilation and recovered by five minutes of life. On admission to the NICU,
her temperature was 36° C. After admission to the NICU, her arterial blood gas is
pH: 7.19, PCO2: 63, HCO3: 14. The correct interpretation of this blood gas is
mixed respiratory and metabolic acidosis.
Which statement is most accurate when identifying the pathophysiology of
transient tachypnea of the newborn (TTN)?
Labor enhances the process of fetal lung fluid absorption
During which phase of fetal pulmonary development do the type II pneumocytes
become numerous and begin to produce and store surfactant?
, Canalicular phase
An absence of air flow despite respiratory effort is an example of which apnea
classification?
Obstructive apnea
Continuous positive airway pressure (CPAP) improves oxygenation by
improving the ventilation-perfusion ratio.
The functional residual capacity in a newborn infant should be approximately
30 ml/kg.
A 29 week gestation infant who displays symptoms of a pulmonary hemorrhage
should be evaluated for
patent ductus arteriosus.
The most significant role of surfactant in neonatal lung development is to
maintain alveolar stability by decreasing surface tension.
Most respiratory disorders result in a ventilation-perfusion mismatch. Ideally, the
ventilation-perfusion ratio should be
1 to 1
A neonate at 12 hours of life with meconium aspiration syndrome who has been
intubated since birth suddenly develops severe respiratory distress, tachycardia,
and hypotension. Which diagnosis would be least likely to be in the differential?
Intraventricular hemorrhage
Which of the following conditions is not an air leak?
Pneumatosis intestinalis
The decision to intubate an infant born through thick meconium should be based
on the infant's
response to stimulation and bag and mask ventilation.
The type of patient-triggered ventilator that applies a constant pressure during
inspiration and terminates with a decrease in air flow, thereby decreasing the
work of breathing, is a(n)
pressure support ventilation.
Neonates receiving surfactant are at increased risk of developing
pulmonary hemorrhage.
A discrepancy greater than 10 mm Hg between the blood pressure in the upper
and lower extremities is indicative of which defect?
Coarctation of the aorta
In order to pass a pulse oximetry screening for critical congenital heart disease
(CCHD), which oxygenation and percentage of variance is required in the right
hand and foot?
Less than 95% O2 saturation and greater than 3% variance
A neonate at 10 hours of age is found to be cyanotic and without respiratory
distress symptoms. The EKG and chest x-ray are normal. The administration of
oxygen is not relieving the cyanosis. The healthcare provider should have a high
index of suspicion for which of the following defects?
Transposition of the great vessels
A right-to-left shunt will be seen with
pulmonary stenosis.
