Premature Infants and Respiratory Issues

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Questions and Answers

What is the primary respiratory issue that premature infants commonly face?

Alveoli expansion.

Insufficient surfactant production. (correct)

Excessive surfactant production.

Increased airway clearance.

What happens when a premature infant does not have enough surfactant?

The alveoli develop normally.

The alveoli over-inflate with each breath.

The alveoli collapse with each breath. (correct)

The alveoli remain consistently expanded.

What physiological response occurs as a result of the alveoli collapsing in premature infants?

Increased oxygen exchange.

Healthy tissue growth in the airways.

Improved lung function.

Collection of damaged cells in the airways. (correct)

What is the primary purpose of administering a tocolytic?

To delay premature delivery. Signup and view all the answers

What medication is given to the mother to promote fetal lung maturity?

Glucocorticoids Signup and view all the answers

Which medication is associated with uterine relaxation?

Magnesium Sulfate Signup and view all the answers

What is the gestational age of an infant considered extremely premature?

Less than 28 weeks. Signup and view all the answers

Besides premature rupture of membranes, what is another cause of premature labor and delivery according to the text?

Unknown etiology. Signup and view all the answers

Which of the following is a potential cause of Small for Gestational Age (SGA) infants?

Fetal exposure to opioids, cocaine, alcohol, or tobacco Signup and view all the answers

What is a primary characteristic of infants with Symmetric Growth Restriction?

A fetal pattern problem that begins early in pregnancy Signup and view all the answers

What is the main cause of hypoglycemia in SGA infants immediately after birth?

Sudden termination of maternal glucose when the umbilical cord is cut Signup and view all the answers

Why are SGA infants at risk for polycythemia?

Elevated insulin levels increasing fetal metabolism and thus oxygen need Signup and view all the answers

What is Perinatal Asphyxia defined as in the context of a newborn?

Failure to establish breathing at birth Signup and view all the answers

Why might SGA infants have decreased tolerance for oral feedings?

The state of being polycythemic, which can increase the bilirubin load, leading to decreased tolerance Signup and view all the answers

What is the underlying cause of hyperbilirubinemia in newborns?

The break down of red blood cells resulting in a large amount of bilirubin that the baby can't easily discard Signup and view all the answers

Which of these is a direct consequence of elevated insulin levels in a fetus?

Decreased surfactant production Signup and view all the answers

What is the primary purpose of the Ballard scoring system?

To estimate the gestational age of a newborn. Signup and view all the answers

Which of the following describes the appearance of a preterm infant?

Thin, pink skin with visible veins and lesser subcutaneous fat. Signup and view all the answers

What is Anemia of Prematurity primarily characterized by?

A deficiency in red blood cells in premature infants. Signup and view all the answers

What is the main cause of acute bilirubin encephalopathy in a newborn?

A severe hyperbilirubinemia. Signup and view all the answers

What does Persistent Patent Ductus Arteriosus refer to in a premature infant?

A persistent opening between two major blood vessels leading from the heart. Signup and view all the answers

What is the characteristic feature of periventricular hemorrhage?

Bleeding into the ventricular system due to the rupture of microvessels within the germinal matrix. Signup and view all the answers

What is the most accurate description of Asphyxia during the birth process?

A condition where the body is deprived of oxygen. Signup and view all the answers

What is the hallmark of Meconium Aspiration Syndrome?

A mixture of meconium and amniotic fluid being inhaled to the lungs during delivery. Signup and view all the answers

What is the primary mechanism by which G6PD deficiency leads to increased bilirubin levels in infants?

Increased breakdown of red blood cells. Signup and view all the answers

In the context of Rh incompatibility, when does the passive Rh antibody (RhoGAM) ideally need to be administered to the mother?

Within 72 hours after birth of an Rh-positive child Signup and view all the answers

Why does ABO incompatibility typically cause less severe hemolytic disease compared to Rh incompatibility in the fetus?

ABO antibodies are of the IgM class and do not cross the placenta. Signup and view all the answers

What is the consequence of untreated severe jaundice in infants?

Kernicterus and permanent brain damage Signup and view all the answers

During an Rh incompatibility scenario, what is the primary target of the maternal antibodies?

Fetal red blood cells Signup and view all the answers

According to the information provided, which of the statements concerning an infant born with ABO incompatibility is most accurate?

Is typically born non-anemic. Signup and view all the answers

What condition can significantly exacerbate the effects of G6PD deficiency on red blood cells?

A decrease in red blood cell lifespan Signup and view all the answers

Which of the following best describes the sequence of events in a second Rh incompatibility pregnancy scenario?

Fetal RBC destruction occurs early in pregnancy by maternal antibodies Signup and view all the answers

What is the primary purpose of phototherapy in the treatment of newborn jaundice?

To facilitate the breakdown and removal of bilirubin by the liver. Signup and view all the answers

Which of the following is a crucial nursing consideration during phototherapy for a neonate?

Protecting the infant's eyes with appropriate coverings. Signup and view all the answers

What is the main function of pulmonary surfactant in the lungs?

To prevent the collapse of the alveoli. Signup and view all the answers

Respiratory Distress Syndrome (RDS) is primarily caused by:

A deficiency in pulmonary surfactant due to fetal lung immaturity. Signup and view all the answers

What is the purpose of an exchange transfusion (ET) in neonates?

To remove blood with high levels of bilirubin or antibody-coated RBCs and replace it with fresh donor blood. Signup and view all the answers

Which condition is likely to result from a severe deficiency of surfactant in a neonate's lungs?

Hyperinflation of the lungs and increased pulmonary resistance. Signup and view all the answers

A neonate displays signs of labored grunting respiration, sternal retractions, and flaring of nasal alae. These are typical symptoms of:

Respiratory Distress Syndrome (RDS) due to surfactant deficiency. Signup and view all the answers

At what gestational age is sufficient surfactant typically available in a fetus to prevent Respiratory Distress Syndrome?

37 weeks Signup and view all the answers

What is the main cause of Respiratory Distress Syndrome (RDS) in neonates?

Pulmonary surfactant deficiency leading to alveolar collapse Signup and view all the answers

Which of the following physiological responses is NOT typically associated with hypoxia in an infant?

Decreased lactic acid production Signup and view all the answers

What is the relationship between prematurity and the severity of Respiratory Distress Syndrome (RDS)?

RDS severity worsens with increasing prematurity Signup and view all the answers

Which of the following is a definitive treatment for elevated bilirubin levels in infants?

Phototherapy and exchange transfusion Signup and view all the answers

What is the primary consequence of pulmonary vasoconstriction in the context of RDS?

Alveolar collapse Signup and view all the answers

What is the significance of ‘seesaw respiration’ in an infant with RDS?

It is a manifestation of respiratory distress and chest wall instability Signup and view all the answers

What effect does the release of lactic acid have on an infant experiencing hypoxia?

It leads to further limitation of pulmonary function Signup and view all the answers

Which of these findings would be expected in an infant with Respiratory Distress Syndrome (RDS)?

Fine rales and diminished breath sounds Signup and view all the answers

Study Notes

Pediatrics - Prematurity

Premature infants (born before 37 weeks) often have respiratory problems due to insufficient surfactant, a substance that prevents the alveoli from collapsing.
Lack of surfactant can cause the tiny alveoli to collapse with each breath, leading to damaged cells and affecting breathing.

Preterm Birth Subcategories

< 37 weeks: Late preterm
< 34 weeks: Moderate preterm
< 32 weeks: Very premature
< 28 weeks: Extremely premature
38 weeks: Full Term
38-42 weeks (in some sources) is considered full term.

Surfactant

Surfactant is a mixture of proteins that reduce surface tension in the alveoli.
It is essential for breathing outside the womb.
The development of surfactant occurs between 25-34 weeks of gestation.

Prematurity - Etiology

The cause of premature labor and delivery is unknown.
Premature labor can be preceded by premature rupture of the membrane.
Premature birth can be elective or spontaneous, often due to conditions such as multiple gestation or complications.

Prematurity - Interventions

Delay delivery
Administer tocolytic (Example: Epinephrine, Magnesium Sulfate)
Effects within 48 hours for uterine relaxation
Administer glucocorticoids to the mother to promote surfactant production.
Example: Betamethasone to accelerate lung maturity.

Postmaturity

Postmaturity is defined as gestation beyond 40 weeks.
Complications are associated with postmaturity infants, which may include high risk mothers with conditions like diabetes and high blood pressure.
Symptoms may include thin, cracked skin, and decreased subcutaneous fat; as well as possible complications involving the lungs.

Complications for Preterm Infants

Anemia of Prematurity (low red blood cell count)
Acute Bilirubin Encephalopathy (a severe illness from hyperbilirubinemia)
Persistent Patent Ductus Arteriosus (a persistent opening between blood vessels)
periventricular hemorrhage (bleeding in the brain)
Hypoglycemia, Hypothermia

Neonatal Sepsis

Sepsis in newborns is a significant concern, especially in infants that are low birth weight.
Early onset sepsis involves symptoms within 3 days of birth.
Infections that cause sepsis may be associated with maternal conditions, prolonged stays in hospital or infections associated with prolonged equipment use.

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Description

This quiz explores the common respiratory challenges faced by premature infants, including the role of surfactant and the physiological responses related to their development. It also covers important medications and causes of premature labor and delivery. Test your knowledge on these critical topics in neonatal care.