High-risk Newborn Part 2

Question 1

indicates insufficient weight gain or
inappropriate weight loss. in children, it is usually defined in terms
of weight and can be evaluated either by a low weight for the child’s age or by a low rate of increase in weight.

Answer 1

failure to thrive

Question 2

meaning of endogenous

Answer 2

organic

Question 3

meaning of exogenous

Answer 3

non-organic

Question 4

main endogenous causes of ftt

Answer 4

physical and mental issues

Question 5

7 endogenous causes of ftt

Answer 5

inborn errors of metabolism
gastrointestinal problems such as excessive gas and acid reflux
cystic fibrosi, diarrhea, liver disease, anemia, or iron deficiency
physical deformities such as cleft palate and tounge tie
milk allergies
fetal alcohol syndrome
increased metabolism due to infections, asthma, hyperthyroidism, or congenital heart disease

Question 6

type of cause that is due to physical or mental issues with the child itself

Answer 6

endogenous

Question 7

type of cause that is caused by a caregiver’s action

Answer 7

exogenous

Question 8

give the 3 exogenous causes of ftt

Answer 8

chronic food security
lack of nutritional awareness
sleepy baby syndrome (failure to recognize hunger cues)

Question 9

2 other mixed causes of ftt

Answer 9

a child who is not getting sufficient nutrition may appear content, leading caregivers to not offer feedings of sufficient frequency or volume.

a child with severe acid reflux may experience pain while eating, making caregivers hesitant to offer feedings.

Question 10

5 diagnosis for ftt

Answer 10

patient and diet history
abnormal breathing sounds
signs of specific vitamin and mineral deficiencies
signs of possible child neglect or abuse
additional tests such as blood work, x-ray, or other diagnostic procedures may be conducted

Question 11

8 signs and symptoms of ftt

Answer 11

poor weight gain or failur to meet expected growth milestones
concerns from parents about picky eating habits or smaller size relative to peers
physicians may identify it during routine office visits when a child’s growth parameters do not track appropriately on growth curves
scaling skin
spoon-shaped nails
neuropathy indicating potential vitamin and mineral deficiencies
wasting
stunting

Question 12

deceleration in stature >2 standard deviations from median weight-for-height

Answer 12

wasting

Question 13

drop of >2 standard deviations from median height-for-age

Answer 13

stunting

Question 14

5 treatments for ftt

Answer 14

encouraging self-feeding in children who have developed reluctance to eat due to unpleasant eating experience
positive reinforcement during meals to promote enjoyable feeding habits
if behavioral issues persist, a psychologist may be consulted
treatment directed towards any underlying condition (e.g. inflammatory bowel disease)
special care should be taken to avoid refeeding syndrome when initiating feeds in a malnourished patient

Question 15

a potentially fatal condition caused by a shift in fluid and electrolytes in a malnourished person as they receive
artificial refeeding. it can occur with both enteral (oral/feeding tube) and parenteral (IV nutrition) feeding.

Answer 15

refeeding syndrome

Question 16

also known as “crib death”, it refers to the sudden, unexplained death of an infant under 1 year of age that remains unexplained after a thorough postmortem investigation.

Answer 16

sudden infant death syndrome

Question 17

sids remain unexplained after a thorough postmortem investigation, including (3)

Answer 17

autopsy
examination of the death scene
review of case history

Question 18

sids is not

Answer 18

caused by immunizations
contagious or hereditary
caused by lack of love or child abuse
due to external suffocation or overlaying
caused by allergy to cow’s milk
caused by vomiting or choking

Question 19

the leading cause of death in infants after the first month of life

Answer 19

sids

Question 20

sudden and silent death in an apparently healthy infant

Answer 20

sids

Question 21

t/f: sids is predictable and preventable

Answer 21

f

Question 22

typically occurs during sleep without signs of suffering

Answer 22

sids

Question 23

sids most often occur in what season of the months?

Answer 23

colder months

Question 24

sids is mor common in babies of mothers that are ages?

Answer 24

younger than 20 years old

Question 25

is sids more common in males or females?

Answer 25

more common in males (60%) than females (40%)

Question 26

babies exposed to _ are more at risk for having sids

Answer 26

secondhand smoke or mother smoked during pregnancy

Question 27

is sids more common in term or preterm? low or high birth weight?

Answer 27

preterm, low birth weight

Question 28

sids is often associated with _ in the weeks prior.

Answer 28

upper respiratory infections

Question 29

is a condition in which an otherwise healthy baby cries for extended periods, typically more than 3 hours a day, more than 3 days a week, for at least 3 weeks. the cause of it is unknown but may be linked to digestive issues, overstimulation, or an immature nervous system.

Answer 29

colic

Question 30

diagnosed after potential causes of crying are excluded.

Answer 30

colic

Question 31

colic is typically diagnosed via a _ and _, and in most cases tests such as x-rays o blood tests are not needed.

Answer 31

history, physical exam

Question 32

babies who cry may simply be _, _, or _.

Answer 32

hungry, uncomfortable, or ill

Question 33

how many percent of babies would meet the definition of colic based on the amount of they cry have an identifiable underlying disease

Answer 33

less than 10%

Question 34

3 causes for concern for colic

Answer 34

elevated temperature history of breathing problems child who is not appropriately gaining weight

Question 35

5 conditions in where a baby should be evaluated for other illnesses aside from colic?

Answer 35

poor weight gain vomiting more than 5 times a day uti intestinal obstruction acid reflux

Question 36

infants normally cry an average of _ hours a day, with the duration peaking at _ weeks.

Answer 36

2, 6

Question 37

at what period of the day does colic mostly happen?

Answer 37

evening for no obvious reasons

Question 38

5 signs and symptoms of colic

Answer 38

high pitched cry (piercing) legs pulled up to the stomach flushed face clenched hands wrinkled brow

Question 39

4 calming measure treatments for colic pt

Answer 39

swaddling with the legs flexed holding the baby on its side or stomach swinging the baby side to side or back and forth while supporting the head making a sushing sound and breastfeeding

Question 40

a genetic disorder caused by the presence of all or part of a third copy of chromosome 21

Answer 40

trisomy 21 or down syndrome

Question 41

3 associations of ds

Answer 41

physical growth delays mild to moderate intellectual disability characteristic facial features

Question 42

the average iq of a young adult with ds is _, equivalent to the mental ability of an _ year-old child, but this can vary widely.

Answer 42

50, 8 or 9

Question 43

trisomy 21 is caused by a failure of the 21st chromosome to separate during egg or sperm development (_)

Answer 43

nondisjunction

Question 44

as a result, a sperm or egg cell i produced with an extra copy of chromosome 21; this cell thus has _ chromosomes.

Answer 44

trisomy 21; 24

Question 45

in trisomy 21, when combined with a normal cell from the other parent, the baby has _ chromosome, with three copies of chromosome 21.

Answer 45

47

Question 46

about _% of cases of trisomy 21 result from nonseparation of the chromosomes in the mother, _% from nonseparation in the father, and _% after the egg and sperm have merged.

Answer 46

88%, 8%, and 3%

Question 47

two more invasive diagnostic test that is used as screening tests for predicting a high risk of down syndrome before birth.

Answer 47

amniocentesis chorionic villus sampling

Question 48

diagnosis of trisomy 21 after birth is done through

Answer 48

suspected based on the child's appearance at birth

Question 49

signs and symptoms, physical characteristics of people with ds (6)

Answer 49

small chin slanted eyes poor muscle tone flat nasal bridge single crease of the palm protruding tongue

Question 50

ds children has this feature because of their small mouth and relatively large tongue.

Answer 50

protruding tongue

Question 51

ds children with airway changes lead to

Answer 51

obstructive sleep apnea in around half of those with ds

Question 52

other common features of ds (9)

Answer 52

flat and wide face short neck, excessive joint flexibility extra space between big toe and second toe abnormal patterns on the fingertips and short fingers instability of atlantoaxial joint occurs in about 20% and may lead to spinal cord injury in 1-2% hip dislocations may occur without trauma in up to a third of people with ds growth in height is slower, resulting to a short stature -- the average height for men is 154 cm (5 ft 1 in) and for women is 142 cm (4 ft 8 in) at risk for obesity growth charts have been developed specifically for children with down syndrome

Question 53

instability of _ joint in ds occurs about 20% and may lead to spinal cord injury in 1-2%.

Answer 53

atlantoaxial

Question 54

2 delayed developmental milestones for children with ds

Answer 54

ability to crawl ability to walk independently

Question 55

children with ds' ability to crawl typically occurs on the _ month, rather than the 5th month

Answer 55

8th

Question 56

children with ds' ability to walk independently typically occurs on the _ month, rather than the 14th month.

Answer 56

21st

Question 57

in children with ds, do they have better language understanding or better ability to speak?

Answer 57

better language understanding than ability to speak

Question 58

ds cause about a _ of cases of intellectual disability.

Answer 58

third

Question 59

in children with ds, _% and _% have either stutter or rapid and irregular speech, making it difficult to understand. some, after _ years of age, may lose the ability to speak.

Answer 59

10%, 45%, 30 years of age

Question 60

t/f: ds people do fairly well with social skills

Answer 60

t

Question 61

t/f: people with ds do not experience a wide range of emotions

Answer 61

f

Question 62

t/f: while people with ds are generally happy, symptoms of depression and anxiety may develop in early adulthood

Answer 62

t

Question 63

children with ds has an increased risk of a specific type of seizure called _

Answer 63

infantile spasms

Question 64

children and adults with ds are at increased risk of _, which occurs in 5-10% of children and up to 50% of adults.

Answer 64

epileptic seizures

Question 65

t/f: hearing and vision disorders occur in more than half of people with ds.

Answer 65

t

Question 66

the rate of congenital heart disease in newborns with ds is _%.

Answer 66

40%

Question 67

in people with ds, risk of _ cancer and certain _ cancer, including _ is increased, while the risk of other _ cancer are decreased.

Answer 67

in people with ds, risk of testicular cancer and certain blood cancer, including **acute lymphoblastic anemia (ALL)** is increased, while the risk of other non-blood cancers are decreased.

Question 68

individual with ds tend to be more susceptible to _ as well as early, _, _ and early _, especially in the_.

Answer 68

individual with ds tend to be more susceptible to **gingivitis** as well as early, **severe periodontal disease**, **necrotizing ulcerative gingivitis** and early **tooth loss**, especially in the **lower front teeth**

Question 69

contributing factors to periodontal diseases that people with ds are prone to (2), but the severity of these periodontal diseases cannot solely be explained by external factors

Answer 69

plaque poor oral hygiene

Question 70

_ with ds usually do not father children, while _ have lower rates of fertility relative to those unaffected.

Answer 70

**male** with ds usually do not father children, while **females** have lower rates of fertility relative to those unaffected.

Question 71

t/f: in people with ds, menopause typically occurs at an earlier age.

Answer 71

t

Question 72

in people with ds, the poor fertility in males is thought to be due to problems with _; however, it may also be related to not being sexually active.

Answer 72

in people with ds, the poor fertility in males is thought to be due to problems with **sperm development**; however, it may also be related to not being sexually active.

Question 73

7 managements for raising children with ds.

Answer 73

early childhood intervention screening for common problems medical treatment where indicated good family environment work-related training education proper care