NUR 221 Final Exam Questions With 100% Correct Answers

NUR 221 Final Exam Questions With 100% Correct Answers What are some non-pulmonary causes of respiratory distress in neonates? Sepsis, cardiac defects (structural or functional), hemolytic disease, CNS defects, exposure to cold, airway obstruction (atresia), intraventricular hemorrhage, hypoglycemia, metabolic acidosis, acute blood loss and drugs. What appears to be the principle factor in the development of Respiratory Distress Syndrome? Surfactant deficiency. What are the clinical manifestations of Respiratory Distress Syndrome? 1.) Tachypnea (greater than or equal to 60 breaths/min) initially 2.) Dyspnea 3.) Pronounced intercostal or substernal retractions 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 instability In addition to Respiratory Distress Syndrome, what is surfactant therapy also being used in? Infants with meconium aspiration, infectious pneumonia, sepsis, persistent pulmonary hypertension, and pulmonary hemorrhage. How is surfactant administered? Via an endotracheal (ET) tube directly into the infant's trachea. What is Acrocyanosis? The bluish discoloration of the hands and feet that is a normal finding within the first 24 hours after birth. What are the clinical manifestations of Infants of Diabetic Mothers (IDMs)? 1.) Large for gestational age (>4g) 2.) Very plump and full faced 3.) Abundant vernix caseosa 4.) Plethora 5.) Listless and lethargic 6.) Possibly meconium stained at birth 7.) Hypotonia What are the risk factors for hypoglycemia in the infant? Hypoglycemia in IDMs is related to hypertrophy and hyperplasia of the pancreatic islet cells and the transient state of hyperinsulinism. High maternal blood glucose levels 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. What is the single most important factor that influences fetal well being in a diabetic mother? The euglycemic status of the mother. What serum glucose level should be maintained in an infant with abnormal clinical symptoms? Above 40 mg/dL and as high as 55 to 65 mg/dL in other infants. What are the signs and symptoms of hypoglycemia in the newborn? Jitteriness, lethargy, poor feeding, abnormal cry, hypotonia, temperature instability (hypothermia), respiratory distress, apnea, and seizures. What are the characteristics of meconium stained amniotic fluid? It is green, and it is either thin (light) or thick (heavy), depending on the amount of meconium present. What are the three possible reasons for the passage of meconium in the amniotic fluid? 1.) It is a normal physiologic function that occurs with maturity (meconium passage being infrequent before weeks 23 or 24, with an increased incidence after 38 weeks) or with a breech presentation. 2.) It is the result of hypoxia induced peristalsis and sphincter relaxation. 3.) It can be a sequel to umbi