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NeoNatal CH 4

Terms in this set (33)

What measures can the therapist take to prevent heat loss and cold stress before performing resuscitation on a preterm neonate?
I. Dry the infant's skin.
II. Wrap the infant in pre-warmed blankets.
III. Remove wet linens from around the infant.
IV. Measure the neonate's body temperature.
I, II, and III only
While stabilizing a preterm neonate before resuscitation, what should the therapist do to avert injury and atelectasis, and to avoid interfering with the infant's ability to establish adequate ventilation?
I. Use a bulb syringe.
II. Avoid excessive suctioning of clear fluid from the nasopharynx.
III. Use a suction catheter clearing the mouth first and then the nose.
IV. Suction using direct laryngoscopy.
I, II, and III only
As the head of a neonate contaminated with meconium emerges at birth, the heart rate monitor indicates 120 beats per minute, and the physician notices that the infant has good muscle tone and a strong respiratory effort. What should the physician do at this time to provide airway care?
Only routine monitoring of respiratory vital signs is needed at this time.
A newborn does not appear to respond to the extrauterine environment. Both the cry and respiratory effort are weak. Which of the following methods should the therapist use to stimulate the newborn?
Gently rub the back.
The therapist has completed a 1-minute Apgar score. The following evaluations were obtained.
(1) The infant is pale.
(2) The heart rate is 90 beats per minute.
(3) The respiratory effort is irregular.
(4) Some muscle tone is noted.
(5) No response to nasal suctioning is found.
On the basis of these findings, what Apgar score should be assigned to this neonate?
3
Which of the following parameters of the Apgar score provides the most important prognostic value?
Heart rate
Which of the following factors are taken into consideration when assessing the gestational age of a neonate?
I. Previous maternal pregnancies
II. Prenatal ultrasound evaluations
III. Postnatal findings based on physical and neurologic examinations
IV. Gestational duration based on the last menstrual cycle
II, III, and IV only
The gestational age of a newborn has been evaluated to be 34 weeks. The newborn's birth weight is greater than the 90th percentile. How should the therapist classify this infant?
Large for gestational age
An infant arrives in the newborn nursery with an axillary body temperature of 95.6°F. Which of the following events may be responsible for this infant's temperature?
The delivery room temperature was low.
A physical examination is being performed on a newborn, and the therapist notices that the infant's arms do not move symmetrically. Which of the following situations could account for this problem?
An injury to the infant's brachial plexus may have occurred during birth.
The therapist notices that an infant presents with irregular areas of dusky skin alternating with areas of pale skin. On the basis of this observation, which of the following conditions should the therapist anticipate this patient having?
Hypotension
Which of the following neonatal skin presentations at birth is associated with a high hematocrit value or polycythemia and neonatal hyperviscosity syndrome?
Reddish blue appearance
Why are chest retractions more prominent among neonates than among older children and adults?
Because newborns have relatively thin and weak musculature and a less rigid thorax
Why is it difficult to localize auscultation findings of the thorax of a newborn?
Because the neonate's chest is small and sounds are difficult to differentiate
While performing a physical examination on a newborn infant, the therapist notices that the point of maximal cardiac impulse is to the left of the sternal border. Which of the following conditions can cause this situation?
Right-sided pneumothorax
Which of the following statements refers to the diagnostic procedure called transillumination?
Direct a light source toward the ipsilateral surface of the patient's thorax.
A neonate is found to have a bounding pulse. Which of the following conditions may contribute to this finding?
Left-to-right shunt
What condition would be responsible for the therapist observing a pulse oximeter indicating decreased perfusion while central blood pressure remains normal?
Volume depletion with compensatory peripheral vasoconstriction
For the purpose of assessing right-to-left shunting, as in the case of persistent pulmonary hypertension, which of the following sites would render postductal blood?
I. Right arm
II. Left arm
III. Right leg
IV. Left leg
II, III, and IV only
The therapist is evaluating a newborn with an abdominal defect consisting of protrusion of the membranous sac that encloses abdominal contents through an opening in the abdominal wall into the umbilical cord. Which of the following conditions is consistent with this description?
Omphalocele
After the umbilical cord has been cut in the delivery room during the delivery of an infant who is large for gestational age, the therapist notices that the umbilical cord is large and fat. Which of the following maternal conditions is likely present?
Diabetes mellitus
The therapist notices that a preterm newborn has a grunting cry. Which of the following conditions is most consistent with this description?
Hypothyroidism
Which of the following pieces of information represent components of patient history for a new pediatric patient?
I. Chief complaint
II. History of present illness
III. Past medical history
IV. Occupational history
I, II, and III only
Which of the following components compose the history of present illness section of a patient's medical history?
Aggravating or alleviating factors
Which of the following components compose the past medical history section of the patient's medical history?
I. Birth weight
II. Previous mechanical ventilation
III. Recurrence of symptoms based on season
IV. Emergency department visits
I, II, and IV only
Which of the following components of a patient's medical history is intended to determine the presence of symptoms not identified in the history of present illness and may be related or contribute to the child's underlying condition?
Review of systems
Head bobbing, nasal flaring, and grunting are exhibiting signs of which of the following?
Respiratory distress
Which of the following are recommendations for infants with meconium staining?
I. No intrapartum suctioning should occur.
II. Infants who are vigorous at birth should not receive tracheal suctioning.
III. Infants who are not vigorous may receive direct laryngotracheal suctioning.
IV. Intrapartum suctioning should not occur.
I, II, and III only
During a physical examination of a child's chest, the therapist perceives increased tactile fremitus over the patient's right lower lobe. Which of the following conditions may cause this physical sign?
Pulmonary consolidation
While percussing the thorax of a child during a physical examination, the therapist hears a dull percussion note over the child's right lung. Which of the following conditions may cause this physical finding?
I. Atelectasis
II. Pneumothorax
III. Pleural effusion
IV. Consolidation
I, III, and IV only
After placing a stethoscope over a small child's trachea, the therapist hears expiratory stridor. Which of the following conditions is consistent with this finding?
Tracheomalacia
While auscultating a young child's thorax, the therapist hears bilateral fine crackles. Which of the following conditions can produce these adventitious sounds?
Pulmonary edema
Which of the following white blood cell counts constitutes the condition leukopenia?
Less than or equal to 3500/mm3
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