Sudden Infant Death Syndrome (SID)

• Rationale: (D) Only factual questions should be asked during the initial history in the emergency department. The other questions imply blame, guilt, or neglect.

3. An infant is brought to the emergency department (ED) and pronounced dead with the preliminary finding of sudden infant death syndrome (SIDS). Which question to the parents is appropriate? a) Did you hear the infant cry out? b) Was the infant's head buried in a blanket? c) Were any of the siblings jealous of the new baby? d) How did the infant look when you found him?

• Rationale: (A) Premature infants, especially those with low birth weight, have an increased risk for SIDS. Hospitalization for fever is insignificant. Infants with apnea, central nervous system disorders, or respiratory disorders have a higher risk of SIDS. Peak age for SIDS is 2 to 4 months. There's an increase risk for SIDS in subsequent siblings of two or more SIDS victims.

1. Which of the following children has an increased risk of sudden infant death syndrome (SIDS) a) Premature infant with low birth weight b) A healthy 2-year-old c) Infant hospitalized for fever d) Firstborn child.

• Rationale: (A) Autopsies reveal consistent pathological findings, such as pulmonary edema and intrathoracic hemorrhages that confirm the diagnosis of SIDS. Chest X-rays are used to diagnose respiratory complications. Skeletal surveys are used with cases of suspected child abuse. Laboratory analysis will show no characteristics to confirm the diagnosis of SIDS.

4. Sudden infant death syndrome (SIDS) is confirmed by which of the following procedures? a) Autopsy b) Chest X-ray c) Skeletal survey d) Laboratory analysis

• Rationale: (C) SIDS can best be defined as the sudden death of an infant under age 1 that remains unexplained after autopsy. Apnea of prematurity occurs in infants less then 32 weeks' gestation who have periodic breathing lapses for 20 seconds or more. Apparent life-threatening events usually have some combination of apnea, color change, marked in muscle tone, choking, or gagging.

5. Which of the following definitions best describe the etiology of sudden infant death syndrome (SIDS)? a) Cardiac arrhythmias b) Apnea of prematurity c) Unexplained death of an infant d) Apparent life-threatening event

• Rationale: (C) The parents need time with their infant to assist with the grieving process. Calling their pastor and collection the infant's belongings are also important steps in the plan of care but aren't priorities. The parents will be too upset to understand an explanation of SIDS at this time.

6. A 6-week-old infant is brought to the emergency department no breathing. A preliminary finding of sudden infant death syndrome (SIDS) is made to the parents. Which of the following interventions should the nurse take initially? a) Call their spiritual advisor b) Explain the etiology of SIDS c) Allow them to see their infant d) Collect the infant's belongings and give them to the parents

• Rationale: (A) Research has demonstrated that placing an infant on hi back to sleep reduces the incidence of sudden infant death syndrome (SIDS). To decrease the risk of suffocation, pillows, stuffed animals, and loose blankets should be placed in the crib with the infant.

7. The nurse is teaching a family with a newborn about infant safety during sleep. What information is the most important for the family to understand? a) The infant should be placed on his back to sleep b) Small pillows should be used to support the infant c) The infant should be covered loosely with a blanket d) A stuffed animal may be placed in the crib for comfort

• Rationale: (B) It's important for the nurse to stress that death from SIDS isn't predictable or preventable and that it isn't the parents' fault. Although it's important to inform the parents that an autopsy is necessary, that's secondary. Instructing the parents to place other infants on their backs to sleep implies that the parents did something wrong to cause the infant's death. Stressing that the parents are still young and can have other children minimizes their grief.

8. When communication with the grieving family after a death from sudden infant death syndrome (SIDS), the nurse should: a) Instruct the parents to place other infants on their backs to sleep b) Stress that the death isn't the parent's fault c) Stress that an autopsy must be done to confirm diagnosis d) Stress that the parents are still young and can have more children

• Rationale: (C) Children who are diagnosed with SIDS are typically described as healthy with no previous medical problems. They are usually found dead sometime after being put down to sleep. Depending on how long the infant has been dead, the infant may have a mottled complexion with extreme cyanosis of the lips, fingertips, or pooling of blood in the legs and feet that may be mistaken for bruising.

9. Which of the following client histories is most consistent with the diagnosis of sudden infant death syndrome (SIDS)? a) The child was physically abused in the past b) The infant had a history of many medical problems c) The infant was healthy and was found shortly after being put down to sleep d) The infant was described as lethargic, irritable, and feeding poorly before being put down to sleep

• Rationale: (D) Prematurity, low birth weight, and multiple births are important risk factors associated with SIDS. Immunizations have been disapproved to be associated with the disorder. Feeding habits and gestational age of 42 weeks aren't significant.

2. Which of the following risk factors is related to sudden infant death syndrome (SIDS)? a) Feeding habits b) Gestational age of 42 weeks c) Immunizations d) Low birth weight