peds hour 9
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Questions and Answers

Which characteristic is commonly associated with Bronchopulmonary Dysplasia (BPD)?

  • Improved air sac structure
  • Rapid recovery of lung function
  • Tissue destruction in the lungs (correct)
  • Normal alveoli size

What is a common sign of respiratory distress in infants with BPD?

  • Decreased muscle tone (correct)
  • Reduced oxygen need
  • Normal chest expansion
  • Stable breathing rate

What imaging finding is typical in infants with respiratory distress syndrome?

  • Fluid-filled cavities
  • Ground glass appearance (correct)
  • Solid lung mass
  • Normal lung appearance

Which treatment option is most effective for retinopathy of prematurity (ROP) in its early stages?

<p>Laser therapy (C)</p> Signup and view all the answers

Which of the following symptoms is indicative of retinopathy of prematurity?

<p>Presence of opaque retrolental membrane (A)</p> Signup and view all the answers

What is the primary focus of treatment for bronchopulmonary dysplasia (BPD)?

<p>Minimizing lung damage (A)</p> Signup and view all the answers

Which is NOT a typical symptom of pneumothorax in neonates?

<p>Normal respiratory effort (C)</p> Signup and view all the answers

What diagnostic method would likely reveal signs of infection in a neonate with respiratory issues?

<p>Blood tests (D)</p> Signup and view all the answers

What is a common sign of Retinopathy of Prematurity?

<p>Eyes do not follow objects (B)</p> Signup and view all the answers

Which factor is associated with a lower risk of Necrotizing Enterocolitis (NEC)?

<p>Breast milk feeding (B)</p> Signup and view all the answers

What is one of the interventions used in treating Necrotizing Enterocolitis?

<p>Inserting a nasogastric tube (A)</p> Signup and view all the answers

Which symptom is indicative of serious complications from Necrotizing Enterocolitis?

<p>Green vomit containing bile (C)</p> Signup and view all the answers

Which of the following is NOT a sign of respiratory distress?

<p>Frequent crying (B)</p> Signup and view all the answers

Which treatment option for necrotizing enterocolitis may be required in severe cases?

<p>Surgical bowel resection (A)</p> Signup and view all the answers

What is a likely outcome if retinal detachment is left untreated in infants?

<p>Permanent blindness (B)</p> Signup and view all the answers

Which of the following is NOT a common symptom of Necrotizing Enterocolitis?

<p>Jaundice (A)</p> Signup and view all the answers

What is the most common gestational age for babies affected by Respiratory Distress Syndrome (RDS)?

<p>Before 28 weeks (C)</p> Signup and view all the answers

Which of the following is NOT a common sign of respiratory distress in newborns?

<p>Elevated blood pressure (A)</p> Signup and view all the answers

What is the primary cause of Bronchopulmonary Dysplasia (BPD)?

<p>Premature birth (B)</p> Signup and view all the answers

What condition can result from prolonged oxygen therapy in premature infants?

<p>Retinopathy of Prematurity (B)</p> Signup and view all the answers

Which of the following interventions is NOT typically used to treat Respiratory Distress Syndrome?

<p>Increased exposure to bright light (A)</p> Signup and view all the answers

What is a potential complication associated with premature infants in relation to their eyes?

<p>Retinopathy of Prematurity (A)</p> Signup and view all the answers

Which of the following treatments is used to manage Bronchopulmonary Dysplasia?

<p>Oxygen therapy (D)</p> Signup and view all the answers

What method is specifically recommended to monitor premature infants for potential respiratory issues?

<p>Continuous pulse oximetry (A)</p> Signup and view all the answers

What is the primary reason a baby may need to go to a Neonatal Intensive Care Unit (NICU)?

<p>Late preterm birth (B)</p> Signup and view all the answers

Which maternal health condition is NOT commonly associated with preterm birth?

<p>Hypertension (C)</p> Signup and view all the answers

What does the diagnosis of Bronchopulmonary Dysplasia (BPD) typically reveal in chest X-rays?

<p>A spongy appearance in the lungs (D)</p> Signup and view all the answers

What is the highest level of care in a Neonatal Intensive Care Unit?

<p>Level 4 (C)</p> Signup and view all the answers

What symptom involves changes in the eye's response to objects in infants?

<p>Inability to follow objects (C)</p> Signup and view all the answers

Which symptom is a common indicator of retinopathy of prematurity (ROP) in preterm infants?

<p>Dilated or twisted eye vessels (B)</p> Signup and view all the answers

What is a common potential problem associated with babies needing tube feeding?

<p>Feeding difficulties (C)</p> Signup and view all the answers

What is a common sign of Respiratory Distress Syndrome (RDS) in neonates?

<p>Grunting (A)</p> Signup and view all the answers

What is a typical treatment approach for Bronchopulmonary Dysplasia?

<p>Continuous monitoring and oxygen therapy (D)</p> Signup and view all the answers

Which condition can lead to blindness if not treated?

<p>Lazy eye (B)</p> Signup and view all the answers

What is a serious consequence of untreated retinopathy of prematurity?

<p>Potential blindness (C)</p> Signup and view all the answers

Which of the following conditions is a potential complication of oxygen therapy in premature infants?

<p>Retinopathy of Prematurity (C)</p> Signup and view all the answers

Which factor is associated with an increased risk of Necrotizing Enterocolitis (NEC)?

<p>Premature birth (A)</p> Signup and view all the answers

Which sign indicates possible Necrotizing Enterocolitis (NEC) in infants?

<p>Visible abdominal swelling (C)</p> Signup and view all the answers

Which of the following signs indicates that a child might require continued oxygen therapy?

<p>Rapid breathing exceeding 60-70 breaths per minute (C)</p> Signup and view all the answers

Which intervention is NOT typically utilized in the management of Respiratory Distress Syndrome?

<p>Initiate phototherapy (D)</p> Signup and view all the answers

What problem can arise from elevated bilirubin levels in newborns?

<p>Kernicterus (A)</p> Signup and view all the answers

What is an abnormal finding in blood tests for infants with respiratory distress syndrome?

<p>Low oxygen levels in the bloodstream (D)</p> Signup and view all the answers

What is a common treatment intervention for an infant diagnosed with NEC?

<p>Inserting a nasogastric tube (A)</p> Signup and view all the answers

What diagnostic method can be used to identify retinopathy of prematurity?

<p>Optometrist examination of the retina (C)</p> Signup and view all the answers

Which symptom is associated with severe cases of NEC?

<p>Bradycardia (C)</p> Signup and view all the answers

Which treatment is considered most effective for early stages of retinopathy of prematurity?

<p>Laser treatment (D)</p> Signup and view all the answers

Which treatment might be necessary for infants with severe NEC?

<p>Bowel resection surgery (C)</p> Signup and view all the answers

What is a notable sign of respiratory distress in infants that differs from symptoms of NEC?

<p>Cyanosis or bluish skin (D)</p> Signup and view all the answers

Flashcards

Late Preterm Birth

A baby born between 35 and 37 weeks gestation.

Neonatal Intensive Care Unit (NICU)

A specialized hospital unit for premature or ill newborns.

Respiratory Distress Syndrome (RDS)

A lung condition common in premature babies, affecting their ability to breathe.

Surfactant

A substance in the lungs, needed to keep them inflated.

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Bronchopulmonary Dysplasia (BPD)

A chronic lung disease that can occur in premature babies due to lung damage.

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Gestational Age at Birth

The measure of how far along a pregnancy is at the moment of birth.

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Premature birth causes

A premature birth can be due to health conditions such as preeclampsia, diabetes, heart and kidney problems, multiple births, cervical or other delivery complications, or drug use.

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Feeding difficulties

Premature babies can face feeding issues, sometimes needing to be tube-fed at first.

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Signs of BPD

Rapid breathing (60-70 breaths/minute), labored breathing, wheezing, and needing continuous oxygen.

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BPD Diagnosis

Diagnosis is often made through chest X-rays (showing spongy or ground-glass appearance) and blood tests (to check oxygen levels and infections).

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BPD Treatment

No cure, but treatment focuses on minimizing lung damage and supporting lung growth through monitoring and care in a hospital setting.

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Retinopathy of Prematurity (ROP)

A disease affecting the blood vessels in the eyes of premature babies, potentially leading to vision problems.

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ROP Signs

Visual disturbance, retinal detachment, absent pupil reflexes, dilated/twisted blood vessels, and potentially blindness or opaque membranes.

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ROP Diagnosis

Diagnosis is made by an optometrist using an eye exam.

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ROP Treatment

Treatment options include laser therapy (early stage), vitrectomy, and lensectomy, depending on the severity.

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Retinal Detachment Distortion

A condition causing the retina to detach, resulting in vision problems like difficulty recognizing faces.

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Lazy Eye (Amblyopia)

A condition where one eye doesn't develop proper vision, potentially leading to blindness.

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Necrotizing Enterocolitis (NEC)

A serious condition in premature babies where the intestine becomes inflamed and damaged.

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NEC Cause

NEC is caused by various factors, including underdeveloped intestines, insufficient oxygen to the intestines, injury, and bacterial infection.

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NEC Symptoms (Swollen Belly)

Babies with NEC may have a swollen, tender belly, which can appear discolored (red, blue, or gray).

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NEC Symptoms (Feeding Issues)

Babies with NEC often have trouble feeding, with food staying in their stomach longer than normal, and may experience constipation or diarrhea.

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NEC Treatment (Interventions)

NEC treatment may involve stopping feedings, IV fluids for nutrition, antibiotics to combat infection, and possibly surgery to repair damaged areas of the intestines.

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NEC Monitoring

NEC cases often require frequent monitoring via X-rays to track the condition's progression and response to treatment.

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What is the gestational age range for late preterm birth?

Late preterm birth occurs between 35 and 37 weeks of pregnancy.

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What are some potential health conditions of the mother that can contribute to premature birth?

Preeclampsia, diabetes, heart disease, kidney disease, multiple births, cervical complications, and drug use can all increase the risk of preterm birth.

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What are the levels of NICU care?

NICU care levels range from Level 1, the most basic, to Level 4, the most advanced, with higher levels offering specialized care for more complex needs.

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What is Kernicterus?

Kernicterus is a serious condition caused by a buildup of bilirubin, a yellow pigment, in the brain, which can lead to brain damage.

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What is Retinopathy of Prematurity (ROP)?

ROP is a disorder that affects the blood vessels in the eyes of premature babies, potentially leading to vision problems.

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What is respiratory distress syndrome (RDS)?

RDS is a lung condition common in premature babies, affecting their ability to breathe due to underdeveloped lungs and insufficient surfactant.

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What is surfactant?

Surfactant is a substance in the lungs that helps to keep them inflated and prevents them from collapsing.

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What is Bronchopulmonary Dysplasia (BPD)?

BPD is a chronic lung disease that can occur in premature babies, often as a complication of RDS, caused by lung damage and inflammation.

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What happens in BPD?

The tiny air sacs in the lungs (alveoli) are damaged, causing tissue destruction and making it hard for the lungs to function properly.

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What is the biggest challenge for babies with BPD?

Babies with BPD often need continuous oxygen therapy, especially after reaching 36 weeks of gestational age.

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How does BPD affect breathing?

Babies with BPD experience rapid breathing, labored breathing, wheezing, and may have repeated lung infections.

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What does BPD look like on an X-ray?

Chest X-rays of babies with BPD often show a 'spongy' appearance, indicating lung damage.

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What is ROP?

Retinopathy of Prematurity (ROP) is a condition affecting the blood vessels in the eyes of premature babies.

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What can ROP lead to?

ROP can cause visual disturbances, retinal detachment, and even potential blindness in premature babies.

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What are some signs of ROP?

Babies with ROP might show dilated or twisted blood vessels in the eye, have absent pupil reflexes, and experience visual problems.

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How is ROP treated?

Early treatment for ROP includes laser therapy. In severe cases, vitrectomy or lensectomy may be necessary.

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What is Necrotizing Enterocolitis (NEC)?

A serious condition in premature babies where the intestine becomes inflamed and damaged, potentially leading to life-threatening complications.

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What causes Necrotizing Enterocolitis (NEC)?

NEC can be caused by various factors, including an underdeveloped intestine, insufficient oxygen flow to the intestines, injury to the intestinal lining, and bacterial infection.

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What are some NEC symptoms?

Symptoms of NEC can include a swollen and tender belly, discoloration of the belly, trouble feeding, constipation or diarrhea, and lethargy.

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Why is NEC monitoring important?

Regular monitoring with X-rays helps track the progression of NEC and the effectiveness of treatment.

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What is an ostomy opening?

In some severe cases of NEC, part of the intestine may need to be removed, leading to the creation of an ostomy opening on the abdomen to allow waste to pass out of the body.

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Study Notes

Premature Infant

  • A birth that occurs before the 37th week of pregnancy
  • Late preterm birth (35th to 37th weeks) may not require NICU admission
  • Maternal health conditions (preeclampsia, diabetes, heart disease, kidney disease, multiples, cervical complications, drug use, premature rupture of membranes) can contribute to preterm birth
  • Often, the cause of premature birth is unknown

Neonatal Intensive Care Unit (NICU)

  • Level of care is determined by gestational age
  • Level 1: lowest, basic care
  • Level 4: highest, most advanced care
  • Patient names are typically listed as last name, male/female (baby A/baby B for twins)
  • Babies do not have a legal name until birth certificate is received

Potential Problems of Premature Infants

  • Breathing issues: Immature lungs, poor perfusion
  • Feeding difficulties: Tube-feeding, then breast/bottle-feeding
  • Developmental delay: Bilirubin buildup, kernicterus, phototherapy
  • Vision problems: Premature eyes, retinopathy of prematurity; proper vision may not develop right away at 40 weeks gestation
  • Hearing problems
  • Respiratory distress syndrome (RDS)

Respiratory Distress Syndrome (RDS)

  • A breathing disorder affecting newborns, mostly those born prematurely
  • RDS is usually more common in very premature babies
  • Occurs before 28 weeks, sometimes in full-term babies
  • RDS is more common in NICU babies
  • Premature lung tissue
    • Surfactant missing; needs to be given
    • Immature muscles and ribs
    • Lung compliance: Alveoli cannot support proper shape to exchange oxygen and carbon dioxide

RDS Symptoms and Treatment

  • Inspection: Tachycardia, retractions, grunting, flaring, pale/purplish or red color of nares
  • Auscultation: Diminished breath sounds, crackles
  • Treatment/Interventions
    • Positioning: HOB elevated or side lying
    • Environment: Adjust stimuli
    • Feeding
    • Bathing: Stimulates breathing process
    • Monitor: CPAP (ET tube), O2 levels, ABGs
  • Potential problems: Bronchopulmonary dysplasia (BPD)
  • Preventing BPD involves monitoring ABGs and O2 levels

Bronchopulmonary Dysplasia (BPD)

  • A chronic lung disease affecting newborns, most often those born prematurely and needing oxygen therapy
  • Damage occurs to the lungs and airways (bronchi), causing tissue destruction (dysplasia) in the alveoli (tiny air sacs in the lungs)
  • Alveoli do not return to normal size
  • Often those born prematurely and needing oxygen therapy develop BPD
  • BPD causes damage to airways, causing tissue destruction
  • Signs and symptoms:
    • Rapid breathing (60-70 breaths/min)
    • Labored breathing
    • Chest wall drawing in during inspiration
    • Wheezing
    • Need for continued oxygen therapy after 36 weeks gestation
    • Difficulty breathing
    • Repeated lung infections
    • Ineffective breathing
  • Diagnosis: Chest X-rays of the lungs of babies with respiratory distress syndrome (often looks like ground glass; babies with BPD often look spongy)

Treatment for BPD

  • Administering oxygen therapy
  • Keeping the stomach empty
  • Intravenous fluids for nutrition and fluid replacement
  • Antibiotic treatment for infections
  • Frequent X-rays to monitor disease progression
  • Extra oxygen or mechanical assisted breathing
  • Isolation procedures to prevent infection spread
  • Surgery (in severe cases) to remove diseased intestine or bowel (bowel resection), with connecting part of the intestine or bowel to an ostomy opening on the abdomen

Retrolental Fibroplasia

  • Vasculature in the eyes is growing abnormally
  • A disease entity (initially referred to as retrolental fibroplasia (RLF)) describing a disorder occurring in premature, low-birth-weight infants
  • The blood vessel development in the retina is abnormal
  • Abnormal vessel development in the retinal periphery, increasing risk of retinal tear/detachment or vision problems

Retrolental Fibroplasia Signs and Symptoms

  • Visual disturbances
  • Retinal detachment
  • Absent pupillary light reflexes
  • Potential blindness
  • Dilated or twisted eye vessels
  • Opaque retrolental eye membrane
  • Retinal edema
  • Retinal hemorrhages

Retrolental Fibroplasia Diagnosis and Treatment

  • Diagnosis: Optometrist makes the diagnosis
  • Treatments:
    • Laser treatments are most effective during early stages
    • Vitrectomy: Removal of vitreous layer
    • Lensectomy: Removal of the lens
    • Left untreated, eyes of the baby may wander, shake, or have other abnormal movements

Necrotizing Enterocolitis (NEC)

  • Necrosis (dying) of the bowel (colon)
  • Cause: Underdeveloped (premature) intestine; too little oxygen or blood flow to the intestine at birth or later; injury to the intestinal lining; heavy growth of bacteria in the intestine that erodes the intestinal wall; viral or bacterial intestinal infection; formula feeding (babies who get breast milk have a lower risk of NEC)
  • Signs and symptoms
    • Swollen/tender belly
    • Pale/blue/gray discoloration of the belly
    • Trouble feeding
    • Food stays in stomach longer than expected, no BM's
    • Constipation
    • Diarrhea and/or bloody stools
    • Lethargy/less active
    • Low/unstable body temperature
    • Green vomit (containing bile)
    • Apnea (pauses in breathing)
    • Bradycardia (slowed heart rate)
    • Hypotension (low blood pressure)
    • Fecal matter/blood flow and dead colon may need to be removed

Necrotizing Enterocolitis (NEC) Interventions/Treatments

  • Stopping feedings (priority intervention)
  • Inserting a nasogastric (NG) tube into stomach to keep it empty
  • Intravenous fluids for nutrition and fluid replacement
  • Antibiotics for infection
  • Frequent X-rays to monitor progress of the disease
  • Extra oxygen or mechanical assistance for breathing
  • Isolation procedures to prevent infection spread
  • Surgery (in severe cases) to remove diseased intestine or bowel (bowel resection), with connecting part of the intestine or bowel to an ostomy opening on the abdomen

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Description

This quiz covers essential information about premature infants, specifically focusing on their care, the levels of the Neonatal Intensive Care Unit (NICU), and potential problems they may face. Test your knowledge on gestational age impacts, feeding challenges, and developmental concerns in preterm infants.

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