Unit 7 Exam
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Questions and Answers

What is a characteristic finding in a newborn that is Small for Gestational Age (SGA)?

  • Very high birth weight
  • Plump head (correct)
  • Abundant hair on scalp
  • Excess body flexion

    • Which symptom is indicative of hypoglycemia in a newborn?

  • Muscle rigidity
  • Hyperactivity
  • Tachypnea (correct)
  • Increased appetite

    • What is a key risk factor for a newborn being classified as Small for Gestational Age (SGA)?

  • Maternal hypertension
  • High protein intake during pregnancy
  • History of LGA babies (correct)
  • Low maternal stress levels

    • What is a primary concern for pre-term newborns due to their underdeveloped respiratory system?

    <p>Apnea and cyanosis</p> Signup and view all the answers

    Which nursing management intervention is crucial for post-term newborns at risk for hypoglycemia?

    <p>Frequent feedings</p> Signup and view all the answers

    Which physical finding is typically associated with a post-term newborn?

    <p>Dry, cracked skin</p> Signup and view all the answers

    What condition is a significant risk for pre-term infants due to their immature gastrointestinal system?

    <p>Insufficient calorie and fluid intake</p> Signup and view all the answers

    Which of the following is a common complication associated with the cardiovascular system in pre-term newborns?

    <p>Murmurs from an open shunt</p> Signup and view all the answers

    What aspect of care is essential for preventing infection in pre-term newborns?

    <p>Strict hand hygiene practices</p> Signup and view all the answers

    Which nursing assessment is important for evaluating a pre-term newborn’s growth and development?

    <p>Lack of creases on feet</p> Signup and view all the answers

    What is the primary cause of transient tachypnea of the newborn (TTN)?

    <p>Failure to clear lung fluid</p> Signup and view all the answers

    Which assessment finding is indicative of respiratory distress syndrome in a newborn?

    <p>Cyanosis and nasal flaring</p> Signup and view all the answers

    What complication can occur from meconium aspiration syndrome?

    <p>Mechanical obstruction of airways</p> Signup and view all the answers

    Which of the following is a critical component of managing respiratory distress syndrome?

    <p>Postnatal surfactant replacement therapy</p> Signup and view all the answers

    What is the main risk factor for retinopathy of prematurity?

    <p>Very low birth weight and supplemental oxygen use</p> Signup and view all the answers

    Which symptom might suggest necrotizing enterocolitis in a newborn?

    <p>Abdominal distension and tenderness</p> Signup and view all the answers

    What is a primary complication associated with an infant of a diabetic mother?

    <p>Excessive adipose tissue and high RBCs</p> Signup and view all the answers

    What is a potential consequence of hyperoxemia in newborns receiving supplemental oxygen?

    <p>Hemorrhaging of retinal vessels</p> Signup and view all the answers

    What should be monitored to prevent hypoglycemia in infants of diabetic mothers?

    <p>Blood glucose levels</p> Signup and view all the answers

    Which condition is most likely caused by bacterial invasion in preterm infants?

    <p>Necrotizing enterocolitis</p> Signup and view all the answers

    What potential issue can arise from the lack of maternal antibody transfer in pre-term newborns?

    <p>Higher susceptibility to infections</p> Signup and view all the answers

    Which observation might indicate the need for close monitoring in a post-term newborn?

    <p>Presence of meconium-stained skin</p> Signup and view all the answers

    Which factor could lead to ineffective feeding in a pre-term newborn?

    <p>Neuromuscular coordination issues</p> Signup and view all the answers

    What is a critical nursing management concern for a newborn classified as Small for Gestational Age (SGA)?

    <p>Ensuring adequate nutrition and preventing hypoglycemia</p> Signup and view all the answers

    What assessment finding could suggest an increased risk of thermal instability in a pre-term newborn?

    <p>Lack of flexion in limbs</p> Signup and view all the answers

    Which complication is associated with an at-risk gastrointestinal system in pre-term infants?

    <p>Necrotizing enterocolitis</p> Signup and view all the answers

    What characteristic finding is expected in a post-term newborn during assessment?

    <p>Thin umbilical cord</p> Signup and view all the answers

    What complication may result from the immature respiratory system of pre-term infants?

    <p>Apnea and respiratory distress</p> Signup and view all the answers

    Which finding is most likely to indicate a successful adaptation of the cardiovascular system in pre-term newborns?

    <p>Normal respiratory rate</p> Signup and view all the answers

    What is a significant risk for small for gestational age (SGA) infants during delivery?

    <p>Injury due to trauma</p> Signup and view all the answers

    What primary complication can arise from failed clearance of lung fluid in newborns?

    <p>Transient Tachypnea of newborn</p> Signup and view all the answers

    Which of the following assessments is critical in identifying respiratory distress syndrome in neonates?

    <p>Evaluating blood gas levels</p> Signup and view all the answers

    Which intervention is primarily aimed at preventing complications in infants of diabetic mothers?

    <p>Monitoring of blood glucose levels</p> Signup and view all the answers

    What characterizes the management approach for Necrotizing Enterocolitis in neonates?

    <p>Fluid and nutritional status assessment</p> Signup and view all the answers

    What is a key factor in the pathophysiology of Retinopathy of Prematurity?

    <p>Hyperoxemia due to supplemental oxygen</p> Signup and view all the answers

    Which nursing assessment finding is most indicative of Meconium Aspiration Syndrome?

    <p>Signs of fetal hypoxia</p> Signup and view all the answers

    What is the most serious risk associated with inadequate pulmonary surfactant production?

    <p>Increased oxygen consumption</p> Signup and view all the answers

    In managing infants with significant respiratory conditions, which diagnostic tool is essential for determining fluid in the lungs?

    <p>Chest X-ray</p> Signup and view all the answers

    What is an essential preventive measure for infants at risk of developing Retinopathy of Prematurity?

    <p>Decreasing oxygen exposure</p> Signup and view all the answers

    Which of the following describes a significant clinical manifestation of Necrotizing Enterocolitis?

    <p>Bloody stools</p> Signup and view all the answers

    Study Notes

    Birth Weight Variations

    • Small for Gestational Age (SGA): Babies born at term (40 weeks) with a weight less than 2500 grams (5.5 lbs) or below the 10th percentile on the growth chart.
    • Large for Gestational Age (LGA): Babies born at term (40 weeks) weighing more than 4000 grams (8.8 lbs) or above the 90th percentile on the growth chart.
    • Risk Factors for LGA: Diabetes mellitus, history of LGA babies, maternal obesity, high weight gain during pregnancy.
    • Characteristics of LGA babies: Large body size (proportionate), plump head, poor motor skills, less reactive, higher risk of birth injuries (fractured clavicle, shoulder issues, nerve paralysis), at risk for hypoglycemia.
    • Hypoglycemia in newborns: Anything less than 40 mg/dL is concerning. Look for symptoms like jitteriness, tachypnea, drowsiness, low tone, and temperature instability.
    • Nursing Management of LGA babies: Frequent blood sugar checks, monitor for birth injuries, and provide support with feeding difficulties due to poor motor skills.

    Pre-Term Newborn

    • Born before 37 weeks gestation.
    • Increased risk of mortality and morbidity due to immature body systems.
    • Typically weighs 2500 grams (5.5 lbs) or less.
    • Respiratory System: One of the last body systems to mature, making preterm infants at high risk for respiratory complications. Low surfactant production can lead to apnea, cyanosis, grunting, nasal flaring, and retractions.
    • Cardiovascular System: Preterm infants may still have a fetal shunt that needs to close after birth, potentially leading to a heart murmur.
    • Gastrointestinal System: Lack of neuromuscular coordination can cause difficulty sucking, swallowing, and breathing simultaneously, leading to insufficient calorie and fluid intake. Enteral feedings can help mature the intestines but require careful monitoring.
    • Immune System: Preterm infants have less of a chance to receive maternal antibodies as most transfer occurs at week 34.
    • Central Nervous System: Preterm infants at increased risk for temperature instability.
    • Nursing Assessment of Preterm Infants: Lack of flexion, limited rugae on scrotum, lack of creases on feet, covered in vernix, fused eyelids, and poor muscle tone.
    • Nursing Management of Preterm Infants: Promote oxygenation, maintain thermal regulation, prevent infection, and provide enteral or parenteral nutrition.

    Post-Term Newborn

    • Born beyond 42 weeks gestation.
    • Nursing Assessment: Dry, cracked, peeling skin, absence of vernix and lanugo, long and thin extremities, wide-eyed alert expression, abundant hair on scalp, thin umbilical cord, long fingernails, meconium-stained skin and fingernails.
    • Nursing Management: At risk for asphyxia due to an aged placenta and lack of amniotic fluid, hypoglycemia due to depleted stores, hypothermia due to less fat stores, and polycythemia (increased RBCs) leading to a higher risk of jaundice. Monitor for signs of respiratory distress, check glucose levels, maintain temperature, and provide frequent feedings.

    Acquired Disorders

    • Perinatal Asphyxia: Decreased ability for gas exchange. Causes can include maternal respiratory issues, placental insufficiency, and cord issues.
    • Rapid Newborn Assessment: Color, breathing effort, heart rate, and temperature.
    • Resuscitation Management: Effective ventilation is key.
    • Transient Tachypnea of Newborn: Self-limiting condition often associated with C-sections and the lack of "thoracic squeeze" during vaginal delivery.
    • Nursing Management: Monitor for respiratory distress, supplemental oxygen, and IV fluids.
    • Respiratory Distress Syndrome: Inadequate production of pulmonary surfactant, leading to difficulty keeping the lungs open and increased energy expenditure for breathing.
    • Nursing Management: Prevent preterm birth, maternal corticosteroids to enhance fetal lung development, surfactant replacement therapy, ventilation, and blood gas monitoring.
    • Meconium Aspiration Syndrome: Presence of meconium in the lungs, causing mechanical obstruction of airways, potential for pneumothorax and bacterial pneumonia.
    • Nursing Management: Maintain temperature, high oxygen, high-pressure ventilation, and prophylactic antibiotics.

    Retinopathy of Prematurity

    • Potentially blinding retina disorder. More common in preterm infants, especially those with very low birth weight.
    • Risk Factors: Prematurity, supplemental oxygen leading to hyperoxemia (elevated oxygen levels), hyperoxemia causing vasoconstriction and rupture of blood vessels in the retina.
    • Prevention: Avoiding prematurity.

    Necrotizing Enterocolitis

    • Bacterial invasion of the intestinal wall, leading to inflammation and cell death.
    • Risk Factors: Preterm infants.
    • Nursing Assessment: Cardiorespiratory changes, feeding intolerance, abdominal distension and tenderness, bloody stools, respiratory distress.
    • Nursing Management: Fluid and nutritional status, supportive care, antibiotics, and possible surgical resection.

    Infant of Diabetic Mother

    • Often LGA, ruddy (excessive red color), macrosomic, and have excessive adipose tissue.
    • Pathophysiology: Exposure to high levels of glucose in the mother, leading to increased insulin production by the fetus and increased glycogen storage.
    • Management: Prevent hypoglycemia (symptoms include slow mental development, vomiting, poor feeding, irritability, musty urine).
    • Preventive measures: Screen all newborns, dietary restrictions, regular monitoring of phenylalanine levels.

    Birth Weight Variations

    • Small for Gestational Age (SGA): infants weighing less than 4000 grams (at term) or below the 10th percentile on growth charts
      • Risk Factors: diabetes mellitus, history of LGA babies, maternal obesity, high weight gain during pregnancy
      • Common Characteristics: large body (proportionate), plump head, poor motor skills, less reactive, higher risk for birth injuries (e.g., fractured clavicle, shoulder issues, nerve paralysis)
      • Hypoglycemia Risk: frequent blood sugar checks are essential, signs include temp instability, jitteriness, tachypnea, drowsiness, low muscle tone
      • Hypoglycemia Threshold: anything less than 40 mg/dL in newborns
    • Pre-term Newborn: born before 37 weeks gestation
      • Higher risk for morbidity and mortality due to immature body systems
      • Typically weighs 2500 grams or less
      • Respiratory System: last body system to mature, prone to complications like apnea, cyanosis, grunting, nasal flaring, and retracting
      • Cardiovascular System: transition to extrauterine life requires a well-functioning respiratory system, PDA may remain open (heart murmur)
      • Gastrointestinal System: lack of neuromuscular coordination for suck, swallow, and breathe, leading to insufficient calorie and fluid intake, ischemia, and damage to the intestinal wall
      • Immune System: majority of maternal antibody transfer occurs at week 34
      • Central Nervous System: at higher risk for temperature instability
    • Post-Term Newborn: born after 42 weeks gestation
      • Characteristics: dry, cracked, and peeling skin, absence of vernix and lanugo, long and thin extremities, wide-eyed alert expression, abundant hair on scalp, thin umbilical cord, long fingernails, meconium-stained skin and fingernails
      • Risks: Asphyxia due to aged placenta and lack of amniotic fluid, hypoglycemia, hypothermia, polycythemia, and jaundice
      • Nursing Management: monitor for respiratory distress, check glucose levels, maintain temperature, frequent feedings

    Acquired Disorders

    • Perinatal Asphyxia: decreased ability for gas exchange
      • Risk Factors: maternal history of respiratory issues, placental insufficiency, cord issues
      • Nursing Management: rapid newborn assessment at birth (color, breathing effort, HR, temperature), resuscitation management, effective ventilation
    • Transient Tachypnea of Newborn (TTN): self-limiting respiratory distress
      • Cause: failure to clear lung fluids and debris, often associated with Cesarean deliveries without thoracic squeeze
      • Nursing Management: monitor for respiratory distress (tachypnea typically presents within 6 hours), chest x-ray, supplemental oxygen, fluid and electrolyte management with IV
    • Respiratory Distress Syndrome (RDS): inadequate production of pulmonary surfactant
      • Characteristics: cyanosis, nasal flaring, grunting
      • Nursing Management: prevention of preterm birth, maternal corticosteroids for enhanced fetal lung development, postnatal surfactant replacement therapy, ventilation, blood gas monitoring
    • Meconium Aspiration Syndrome (MAS): presence of meconium in the lungs
      • Complications: mechanical obstruction of airways, risk of pneumothorax, bacterial pneumonia, inactivation of surfactant, significant respiratory distress
      • Clinical Manifestations: hypotonia, low heart rate, fetal hypoxia, low APGAR scores (1-5)
      • Nursing Management: maintain temperature, high oxygen, high-pressure ventilation, prophylactic antibiotics

    Retinopathy of Prematurity

    • Possible cause of blindness
    • Retina disorder primarily associated with prematurity and very low birth weight
    • Also related to newborns receiving supplemental oxygen (can develop hyperoxemia - high oxygen in blood)
    • Prevention: avoiding prematurity

    Necrotizing Enterocolitis (NEC)

    • Bacterial invasion of the intestinal wall leading to inflammation and cell death
    • High risk in preterm infants
    • Nursing Assessment: cardiorespiratory baseline changes, feeding intolerance, abdominal distension and tenderness, bloody stools, respiratory distress, signs of sepsis
    • Nursing Management: fluid and nutritional support, supportive care, antibiotics, possible surgical resection

    Infant of Diabetic Mother (IDM)

    • Characteristics: LGA (Large for Gestational Age), ruddy complexion (excessive red color, high RBCs), macrosomic, excessive adipose tissue
    • Pathophysiology: fetus exposed to high levels of glucose, leading to increased insulin production and glycogen storage
    • Management: prevention of hypoglycemia (signs: slow mental development, vomiting, poor feedings, irritability, musty urine)
      • Screening: mandatory for all newborns
      • Dietary Restriction: phenylalanine levels must be monitored regularly

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    Description

    This quiz explores the concepts of birth weight variations such as Small for Gestational Age (SGA) and Large for Gestational Age (LGA). It covers definitions, risk factors, characteristics, and nursing management for these newborn conditions. Test your knowledge on the important aspects of birth weight and hypoglycemia in infants.

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