1. What are Sepsis, cardiac defects (structural or functional), he-
some non-pul- molytic disease, CNS defects, exposure to cold, airway
monary caus- obstruction (atresia), intraventricular hemorrhage, hypo-
es of respira- glycemia, metabolic acidosis, acute blood loss and drugs.
tory distress in
neonates?
2. What appears to Surfactant deficiency.
be the princi-
ple factor in the
development of
Respiratory Dis-
tress Syndrome?
3. What are the 1.) Tachypnea (greater than or equal to 60 breaths/min)
clinical manifes- initially
tations of Res- 2.) Dyspnea
piratory Distress 3.) Pronounced intercostal or substernal retractions
Syndrome? 4.) Fine respiratory crackles
5.) Audible expiratory grunt
6.) Flaring of the external nares
7.) Cyanosis or pallor
8.) Apnea
9.) With progression of condition, deteriorating vital signs
including blood pressure, apnea, body temperature insta-
bility
4. In addition to Infants with meconium aspiration, infectious pneumo-
Respiratory Dis- nia, sepsis, persistent pulmonary hypertension, and pul-
tress Syndrome, monary hemorrhage.
what is surfac-
tant therapy also
being used in?
5. How is sur- Via an endotracheal (ET) tube directly into the infant's
factant adminis- trachea.
tered?
6.
, NUR 221 Final Exam
What is Acro- The bluish discoloration of the hands and feet that is a
cyanosis? normal finding within the first 24 hours after birth.
7. What are the 1.) Large for gestational age (>4g)
clinical manifes- 2.) Very plump and full faced
tations of Infants 3.) Abundant vernix caseosa
of Diabetic Moth- 4.) Plethora
ers (IDMs)? 5.) Listless and lethargic
6.) Possibly meconium stained at birth
7.) Hypotonia
8. What are the risk Hypoglycemia in IDMs is related to hypertrophy and hy-
factors for hypo- perplasia of the pancreatic islet cells and the transient
glycemia in the state of hyperinsulinism. High maternal blood glucose lev-
infant? els during fetal life provide a continual stimulus to the fetal
islet cells for insulin production (glucose easily passes
the placental barrier from maternal to fetal side, however,
insulin does not cross the placental barrier).
When the neonate's glucose supply is removed abruptly
at the time of birth, the continued production of insulin
soon depletes the blood of circulating glucose, creating
a state of hyperinsulinism and hypoglycemia within 0.5
to 4 hours, especially in infants of mothers with poorly
controlled diabetes.
9. What is the sin- The euglycemic status of the mother.
gle most impor-
tant factor that
influences fetal
well being in a di-
abetic mother?
10. What serum Above 40 mg/dL and as high as 55 to 65 mg/dL in other
glucose level infants.
should be main-
tained in an in-
fant with ab-
normal clinical
symptoms?
, NUR 221 Final Exam
11. What are the Jitteriness, lethargy, poor feeding, abnormal cry, hypo-
signs and symp- tonia, temperature instability (hypothermia), respiratory
toms of hypo- distress, apnea, and seizures.
glycemia in the
newborn?
12. What are It is green, and it is either thin (light) or thick (heavy),
the characteris- depending on the amount of meconium present.
tics of meconium
stained amniotic
fluid?
13. What are the 1.) It is a normal physiologic function that occurs with ma-
three possi- turity (meconium passage being infrequent before weeks
ble reasons for 23 or 24, with an increased incidence after 38 weeks) or
the passage of with a breech presentation.
meconium in the 2.) It is the result of hypoxia induced peristalsis and
amniotic fluid? sphincter relaxation.
3.) It can be a sequel to umbilical cord compression
induced vagal stimulation in mature fetuses.
14. SAFETY ALERT Every birth should be attended by at least one person
(pg. 454): whose only responsibility is the baby and who is capable
of initiating resuscitation. Either that person or someone
else who is immediately available should have the skills
required to perform a complete resuscitation, including
endotracheal suctioning to remove meconium, if neces-
sary.
15. What is the im- 1.) Assess the amniotic fluid for the presence of meconi-
mediate manage- um after rupture of membranes.
ment of the new- 2.) If the amniotic fluid is meconium stained, gather equip-
born with meco- ment and supplies that might be necessary for neonatal
nium stained am- resuscitation.
niotic fluid be- 3.) Have at least one person capable of performing endo-
fore birth? tracheal intubation on the baby present at the birth.
16. What is the im- 1.) Assess the baby's respiratory efforts, heart rate, and
mediate manage- muscle tone
ment of the new- 2.) Suction only the baby's mouth and nose, using either
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