Neo/Peds ch 22

What is the incidence of respiratory distress syndrome (RDS) among infants born at less than 28 weeks of gestation?

60% to 80%

When neonatal pneumonia is suspected, how long does an infant generally receive broad-spectrum antibiotics?

72 hours

A neonate diagnosed with a pneumothorax was treated with a chest tube. After 36 hours, the therapist noticed that bubbling is present in the chest tube system. What should the therapist do at this time?

Keep the chest tube until bubbling stops

Which of the following blood gas parameters should the therapist target when managing patients with PPHN? I. SaO2 > 95% II. PaCO2 35-45 mm Hg III. pH 7.35-7.45 IV. PaO2 > 95 mm Hg

1,2,3

Which of the following conditions increase the risk for developing RDS? I. Maternal diabetes II. Cesarean delivery III. Multiple births IV. Premature rupture of membranes

1,2,3

When should a therapist consider intubation and mechanical ventilation for a newborn with respiratory distress? I. FiO2 > 40% to 70% II. SpO2 < 85% III. CPAP of 5-10 cm H2O IV. pH < 7.20

1,2,3,4

Which of the following risk factors contribute to the pathogenesis of BPD? I. Lung immaturity II. Respiratory failure III. Oxygen supplementation IV. Positive-pressure ventilation

1,2,3,4

What ventilator settings should a therapist select for a newborn with respiratory distress syndrome? I. PIP 25-30 cm H2O II. PEEP 3-6 cm H2O III. VT 5-6 mL/kg IV. Frequency 60 breaths per minute

2

Which of the following therapeutic interventions is generally needed to treat transient tachypnea of the newborn (TTN)?

40% oxygen hood

What is the significance of an infant with RDS demonstrating a grunt during each exhalation?

An effort to maintain its functional residual capacity (FRC)

What is the typical type of airway obstruction that occurs with MAS?

Ball valve

Why does meconium staining occur predominantly in infants older than 36 weeks of gestational age?

Because these infants demonstrate strong peristalsis

In addition to Group B Streptococcus, which of the following microorganisms are responsible for nosocomial pneumonia acquired after delivery?

E. coli

When should a therapist consider CPAP for a newborn with respiratory distress?

FiO2 > 40% to 70% and SpO2 < 85%

The therapist is contemplating the possibility of intubating and suctioning a nonvigorous newborn with MAS. Which of the following clinical parameters confirms the indication for the procedure?

Heart rate < 100 beats per minute

A newborn suspected of having a pneumothorax is rapidly deteriorating. What should the therapist suggest at this time?

Needle aspiration

Blood samples are simultaneously obtained from both the right radial artery and the umbilical artery, and the arterial partial pressure of oxygen (PaO2) value from the right radial artery is 20 mm Hg greater than that analyzed from the umbilical artery sample. On the basis of this finding, which of the following conditions does the neonate likely have?

PPHN

Eight hours after being born, a baby presents with cyanosis despite administration of adequate ventilation, tachypnea, and retractions. Which of the following conditions should the therapist suspect is affecting this newborn?

PPHN

What radiographic features is the therapist likely to see on a typical chest X-ray of an infant with MAS?

Patchy areas of atelectasis

While reviewing the chest X-ray of a newborn, the therapist observes the following features: continuous diaphragm sign and linear bands of air paralleling the left side of the heart and the descending aorta with extension superiorly along the great vessels into the neck. Which of the following conditions does this patient likely have?

Pneumomediastinum

The therapist is reviewing the chest radiograph of a newborn, preterm infant and observes diffuse, fine, reticulogranular densities, which provide a ground-glass appearance. On the basis of these radiographic findings, which of the following conditions should the therapist suspect is present?

Respiratory distress syndrome

The therapist is assessing a newborn on the mechanical ventilator. The neonate shows clear signs of respiratory distress, and lung auscultation reveals shifting of the PMI towards the left and breath sounds decreased on the right. What should the therapist suspect this newborn developed?

Right-sided pneumothorax

How should the therapist interpret the lack of supernatant foam appearing during the shake test?

The infant's lungs are immature.

How should the therapist interpret a lecithin-to-sphingomyelin (L:S) ratio of 2:1?

The presence of lung maturity

While reviewing the chest X-ray of a newborn, the therapist observes the following features: Pulmonary vascular congestion Prominent perihilar streaking Fluid in the interlobular fissures Hyperexpansion Flat diaphragm Which of the following conditions does this patient likely have?

Transient tachypnea of the newborn

Which of the following medications should the therapist recommend for an infant with apnea of prematurity experiencing episodes of apnea?

caffeine