NCM 109 UNIT 3 Quiz: The Newborn at Risk

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Questions and Answers

What defines a preterm infant?

Born after the end of week 37 of gestation

Born before the end of week 37 of gestation (correct)

Born between 24 and 34 weeks of gestation

Born between 34 and 37 weeks of gestation

What is a common factor associated with preterm birth?

High socioeconomic level

Stress-free environment

Alcohol and smoking cessation

Low socioeconomic level (correct)

Which neonatal condition are preterm infants more prone to?

Respiratory distress syndrome (correct)

Hypertension

Hypothyroidism

Diabetes mellitus

What is a characteristic of the skin of preterm infants?

Unusually ruddy with little subcutaneous fat Signup and view all the answers

What indicates a late preterm infant?

Born between 34 and 37 weeks of gestation Signup and view all the answers

What is a common iatrogenic issue associated with preterm birth?

Elective caesarian section Signup and view all the answers

What is the most common cause of ABO incompatibility?

The maternal blood type is O and the fetal blood type is A or B Signup and view all the answers

What is the primary cause of hemolysis in a first pregnancy with ABO incompatibility?

Naturally occurring antibodies to A and B cell types Signup and view all the answers

Which of the following is NOT a common complication of ABO incompatibility?

Increased intracranial pressure Signup and view all the answers

What is the primary risk associated with a total serum bilirubin level above 20 mg/dl in a term infant with ABO incompatibility?

Bilirubin-induced neurologic dysfunction Signup and view all the answers

Which of the following is the primary therapeutic management for ABO incompatibility in a newborn?

Phototherapy and exchange transfusion Signup and view all the answers

What is the underlying cause of twin-to-twin transfusion syndrome?

Abnormal arteriovenous shunts between the twins Signup and view all the answers

Which factor tends to contribute to sudden unexplained death in infants according to the text?

Exposure to secondary smoke Signup and view all the answers

What is recommended as a safe sleeping position for newborns based on the text?

Sleeping supine Signup and view all the answers

Which of the following is NOT a recommended measure to reduce the risk of sudden infant death syndrome?

Exposing newborns to tobacco smoke Signup and view all the answers

What is a common autopsy finding related to sudden unexplained death in infants according to the text?

Petechiae in the lungs Signup and view all the answers

Which prenatal factor tends to be associated with a higher rate of sudden unexplained death in infants based on the text?

Infants of adolescent mothers Signup and view all the answers

What is the most common causative agent of ophthalmia neonatorum?

Neisseria gonorrhoeae and Chlamydia trachomatis Signup and view all the answers

What is the more serious form of ophthalmia neonatorum?

Gonococcal conjunctivitis Signup and view all the answers

What is the purpose of prophylactic instillation of erythromycin ointment into the eyes of newborns?

To prevent both gonococcal and chlamydial conjunctivitis Signup and view all the answers

What is the therapeutic management for gonococcal conjunctivitis?

All of the above Signup and view all the answers

What is the purpose of treating the sexual contacts of the mother?

To prevent the spread of the disease Signup and view all the answers

What is the prognosis for normal eyesight with early diagnosis and treatment of ophthalmia neonatorum?

Good Signup and view all the answers

What is the primary concern for infants born after the 41st week of pregnancy?

The placenta loses its ability to effectively carry nutrients to the fetus. Signup and view all the answers

Which of the following is NOT a characteristic of a post-term infant?

Decreased alertness compared to a 2-week-old baby. Signup and view all the answers

What test may be performed to assess placental functioning in a post-term pregnancy?

Nonstress test or complete biophysical profile. Signup and view all the answers

Which of the following is a potential complication for a post-term infant?

All of the above. Signup and view all the answers

What is a potential reason for a Caesarean birth in a post-term pregnancy?

If a nonstress test reveals compromised placental functioning. Signup and view all the answers

Which of the following is a potential risk factor for a post-term infant?

Hypothermia due to low subcutaneous fat level. Signup and view all the answers

Study Notes

Ophthalmia Neonatorum

Eye infection occurring at birth or during the first month of life
Most common causative agents: Neisseria gonorrhoeae and Chlamydia trachomatis
These agents are contracted through vaginal secretions
N. gonorrhoeae causes a more serious form, leading to corneal ulceration and destruction if left untreated
Resulting in opacity of the cornea and severe vision impairment
Prophylactic instillation of erythromycin ointment into the eyes of newborns prevents both gonococcal and chlamydial conjunctivitis

Therapeutic Management

Treatment depends on the organism cultured from the exudate
If gonococci, erythromycin is used
Sterile saline solution lavage is used to clear discharge from the eyes
Ophthalmic solution is used to treat the mother of the infant if she has gonorrhea or chlamydia
Sexual contacts of the mother should be treated to prevent the spread of disease
With early diagnosis and treatment, prognosis for normal eyesight is good

Post-term Infant

Born after the 41st week of pregnancy
Infants who stay in utero past week 41 are at special risk due to placenta dysfunction
Characteristics: dry, cracked skin, absence of vernix, meconium staining, and fingernails that have grown beyond the fingertips
Demonstrate alertness like a 2-week-old baby
May have difficulty establishing respiration if meconium stained
Polycythemia may develop due to decreased oxygenation in the final weeks
Hypoglycemia may develop due to low subcutaneous fat levels
Prone to hypothermia

Preterm Infant

Born before the end of week 37 of gestation
Occurs in approximately 11% of live births worldwide
At least 50% of neonatal deaths are preterm
Most preterm births need intensive care
Prone to hypoglycemia, intracranial hemorrhage, and respiratory distress syndrome
Late preterm: born between 34 and 37 weeks
Early preterm: born between 24 and 34 weeks

Neonatal Assessment

Inspection for sole creases
Skull firmness
Ear cartilage
Neurologic development
LMP of the mother

Contrast between Small for Gestational Age and Preterm Infants

Common factors associated with preterm birth: low socioeconomic level, poor nutritional status, smoking, and alcohol use
Multiple pregnancy, lack of prenatal care, previous early birth, race, and age of mother
Abnormalities of the mother's reproductive system, infections, and pregnancy complications
Iatrogenic issues: early induction of labor and elective caesarian section

ABO Incompatibility

In most instances, the maternal blood is O and the fetal blood type is either A or B
Hemolysis can become a problem with a first pregnancy
Assessment: indirect Coombs test, detecting antibodies on the fetal erythrocytes in cord blood
Enlargement of the liver and spleen, edema, severe anemia leading to heart failure, and hydrops fetalis
Progressive jaundice usually occurring within the first 24 hours of life

Therapeutic Management of ABO Incompatibility

Early breastfeeding
Phototherapy
Exchange transfusion
Blood transfusion
Erythropoietin therapy

Twin to Twin Transfusion

Phenomenon that occurs if twins are monozygotic and abnormal arteriovenous shunts occur
Directing more blood to one twin than the other

Sudden Infant Death Syndrome (SIDS)

Sudden unexplained death in infancy
Tends to occur at a higher rate in infants of adolescent mothers, infants of closely spaced pregnancies, and underweight and preterm infants
Contributing factors: sleeping prone, viral respiratory or botulism infection, exposure to secondary smoke, pulmonary edema, brainstem abnormalities, and neurotransmitter deficiencies
Autopsy reveals: petechiae in the lungs and mild inflammation and congestion in the respiratory tract
Recommendations: put newborn to sleep on their back, use firm sleep surface, breastfeeding, room sharing without bed sharing, routine immunization, using a pacifier, and avoidance of soft bedding, overheating, and exposure to tobacco smoke, alcohol, and illicit drugs.

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Description

Test your knowledge on the topic of newborns at risk due to altered gestational age, birth weight, maternal infection, and physical or developmental challenges. Learn about preterm infants, their characteristics, and the care they require, including risks like hypoglycemia and respiratory distress syndrome.

NCM 109 - UNIT 3: The Newborn at Risk Quiz

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