AWHONN Neonatal Modules

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.