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test #1 Flashcards

1
Q

Major RF for the development of chronic lung disease (BPD) include?

A

Prematurity, Resp Failure

Mechanical ventilation and O2 supplements

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2
Q

Risk of long term diuretic use in infants with chronic lung disease include?

A

nephrocalcinosis and hypokalemia

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3
Q

The rationale for prescribing methlxanthines in infants with chronic lung disease is to

A

stabilizing the diaphragm

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4
Q

Which of the following abnormalities may persist for years in infants with BPD

A

wheezing

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5
Q

Factors significantly associated with increased neurodevelopmental morbidity in infants with BPD include?

A

postnatal steroid treatment for BPD

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6
Q

The new definition for BPD differs from the classic 4 stages of BPD described by Northway since it considers the infant’s?

A

gestational age

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7
Q

60 yr old former 28 weeker with CLD has pH 7.36/61/55/30

A

compensated resp acidosis

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8
Q

What is pathologic apnea?

A

> 20 sec pause in breathing with a drop in the pulse ox.

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9
Q

a pause in alveolar ventilation cause by lack of diaphragmatic activity is known as

A

Central apnea

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10
Q

Methylzanthines work to prevent apnea by blocking?

A

adenosine receptors

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11
Q

Actions of methylxanthines include>

A

reduced diaphragmatic fatigue

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12
Q

The Diff Dx for apnea includes?

A

hyperthermia

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13
Q

Assessment of a FULL TERM infant reveals a pattern of minimal periodic breathing you should

A

close observation

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14
Q

Advantage of caffeine over theophylline for treatment of apnea of prematurity

A

slower elimination and improved safety

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15
Q

CPAP may improve apnea by

A

Stimulating the central resp center

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16
Q

the purpose of home apnea monitoring is to

A

recognize prolonged apnea

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17
Q

In VLBW infants with symptomatic GE reflux, which may be a presenting sign?

A

apnea and bradycardia

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18
Q

Which of the following is a H2 receptor antagonist is used for tx of GE reflux isn infants

A

famotidine (zantac)

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19
Q

an expected rate of weight gain for term infants in the first 3 months of life is

A

20-30gm/day

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20
Q

which increases in length per is is expected in preterm infants?

A

1 cm

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21
Q

What is considered a suspicious increase in Head circum?

A

1.25cm/week

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22
Q

Current AAP recommendations for feeding the per-term infant in the post-discharge periods is

A

nutrients enriched formula until 9 months old

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23
Q

The primary goal of nutritional management for the neonate with BPD is

A

support growth and maintain fluid and sodium balance

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24
Q

Perterm infants are at higher risk for GE reflux than term infants d/t

A

lower esophageal motility

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25
Q

Mediating factors in the development of anemia or prematurity include

A

decreased iron store, RBC mass and survival time, higher level of fetal hgb and lower EPO

NOT: low caloric intake and poor growth

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26
Q

A lab sign of anemia of prematurity is

A

metabolic acidosis

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27
Q

RBC on a peripheral blood smear of a 3 month old perterm infant with anemia will appear

A

hypochromic and microcytic

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28
Q

BF perterm infant with anemia of prematurity requires initial iron therapy of?

A

3-6 mg/kg/day for 4 weeks then recheck

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29
Q

The purpose of irradiating rRBC prior to tranfusing into a neonate is to

A

reduce the risk of graft vs host disease

30
Q

Mgnt of anemic infant receiving recombinant human erythropoietin therapy should include

A

therapeutic dose of iron

31
Q

An expected result of recombinant human erythropoietin therapy in VLBW anemic noenoate is

A

increased reticulocyte count

32
Q

a neonate receives a transfusion of blood from an adult donor. an expected physiologic response in the neonate is

A

more oxygen will be released to the tissues

33
Q

the mom of a 750 gram 25 week female asks about eye problems in her infant. the NNP should say

A

the majority of infants her size and age will develop ROP

34
Q

A perterm has been diagnosed with ROP-Plus disease. what is the consequence of this disease?

A

the infant will require more frequent exams

35
Q

ROP is screening should

A

be recommend for all infants with BW

36
Q

the most common occurring long term complication of ROP is

A

nearsightedness

37
Q

The mother of 25 week infant asks you about the future prognosis for her infant with ROP. What is the most accurate response

A

some knowledge of visual outcome may be apparent by 3months

38
Q

a perterm infant with a histroy of fdg intolerance has been receiving supplemental TPN. Albumin =6 and pre-albumin

A

protein intake is insufficient to meet needs

39
Q

What is an elemental infant formula?

A

nutramingen

40
Q

indicators of pathologic GE reflux in preterm infant is

A

occult blood in stools

41
Q

Medications which increase GE reflux in neonates is

A

Xanthines

42
Q

which PPI is effective in tx of GE reflux in preterm infants?

A

omerprozole

43
Q

Microaspiration is suspected in a neonate with GE reflux and recurrent pneumonia. what diagnostic test would be most helpful?

A

Milk scan

44
Q

The latest recommendations for use of palivizumab for RSV prevention are based on the

A

decreasing incidence of disease in infants 34-37 weeks or optimal balance of benefit and cost

45
Q

Neonatal infectsion are classified as early or late onset based on the timing of the presenting symptoms and the…

A

causative organism

46
Q

Mortality rates in neonatal sepsis are highest when onset of infection is

A
47
Q

A blood culture is reported positive for Staphlococcus epi at 5 days. this shows

A

probable contaminant

48
Q

Common causative organisms for late onset infection in the noenatal population include

A

CON serratia

49
Q

One indication for use of surveillance cultures in the NICU population is to

A

Identify colonization patterns in a unit

50
Q

Tx for nenoatal pneumonia should be continued for a minimum of ___days

A

7 days

51
Q

UTI infections in the neonate are most caused by

A

klebsiella

52
Q

Tx for neonatal meningitis includes

A

21 days of therapy when a gram (-) organism is identified

53
Q

A neonate with documented UTI requires

A

renal US

54
Q

Antibiotic coverage for infants with meningitis includes?

A

use of cephalosporins when gram (-) organisms invade

55
Q

Oral antibx are indicated for use in infants with

A

chlamydia eye infections

56
Q

RF for hearing loss in the VLBW infants include

A

aminoglycosides, hypoxia, and constant background noise, cytomegalovirus, hyperbili, loop diuretics

57
Q

Neonatal hearing loss has long term effects on

A

cognitive and emotional development

58
Q

Osteopenia of prematurity is defined as

A

decrease bone matrix

59
Q

Lab findings in osteopenia inculdes

A

hypophosphatemia and elevated alkaline phosphatase level

60
Q

Evidence supports which intervention for NICU infants with osteopenia?

A

physical therapy during periods of immobilization

61
Q

Classic x-ray findings in infants with osteomalacia includes

A

wide growth plates on long bones

62
Q

What finding would alert the NNP to suspect hypothyroidism in a term Noenate

A

lg posterior fontanel

63
Q

A common lab finding in a sick preterm at 28 weeks gestation si

A

low T4 and normal TSH

64
Q

A preterm infant is receiving treatment for hypothyroidism. the mother should be informed that

A

treatment will beed to be continued for 2-3 years

65
Q

AAP recommends the use of soy formula for

A

infants with allergy to cows milk

66
Q

administration for aminoglycoside antibx in neonates can result in

A

permanent damage to hair cells affecting high-frequency hearing

67
Q

Ototoxicity cause by loop diuretic is

A

hearing loss accelerated when administered with aminoglycosides

68
Q

Typical chest x-ray findings in an infant with RSV include?

A

semental atelectasis and increase interstitial markings

69
Q

the most appropriate specimen for RSV testing is

A

nasopharyngeal aspirate

70
Q

RSV is currently recommended for which

A

32 weeker with congenital heart disease now 42 weeks corrected age

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