A nurse is collecting data from a newborn who has respiratory distress syndrome and is experiencing respiratory acidosis. Which of the following risk factors predisposes the newborn to respiratory difficulties?
Small for gestational age.
Maternal history of asthma.
Ventricular septal defect.
Cesarean birth.
The Correct Answer is A
Choice A reason:
Small for gestational age (SGA) newborns are at risk for respiratory distress syndrome (RDS) and respiratory acidosis because they have immature lungs that produce less surfactant, which is needed to keep the alveoli open and prevent atelectasis. SGA newborns also have less glycogen stores, which can lead to hypoglycemia and impaired oxygen delivery to the tissues.
Choice B reason:
Maternal history of asthma is not a risk factor for RDS or respiratory acidosis in the newborn. Asthma is a chronic inflammatory disorder of the airways that affects the mother, not the fetus. Maternal asthma can cause complications such as preterm labor, preeclampsia, or intrauterine growth restriction, but it does not directly affect the fetal lung development or function.
Choice C reason:
Ventricular septal defect (VSD) is a congenital heart defect that causes a hole in the wall between the ventricles of the heart. This can result in increased pulmonary blood flow and pressure, which can lead to pulmonary edema and heart failure in the newborn. However, VSD does not cause RDS or respiratory acidosis, which are related to lung maturity and surfactant production.
Choice D reason:
Cesarean birth is not a risk factor for RDS or respiratory acidosis in the newborn. Cesarean birth can increase the risk of transient tachypnea of the newborn (TTN), which is caused by delayed absorption of fetal lung fluid. TTN usually resolves within 24 to 48 hours and does not cause a significant acid-base imbalance in the newborn.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is B
Explanation
Choice A reason:
This is incorrect because TTN usually resolves within 24 to 72 hours of birth and does not require a long stay in the NICU.
Choice B reason:
This is correct because TTN is more common in babies born by cesarean section without labor, as they do not have the hormonal changes that help clear the fetal lung fluid.
Choice C reason:
This is incorrect because breastfeeding is not contraindicated in babies with TTN, unless they have severe respiratory distress or need continuous positive airway pressure (CPAP) support.
Choice D reason:
This is incorrect because TTN does not cause chronic lung disease or require oxygen therapy at home. Most babies with TTN only need supplemental oxygen for a few days until their breathing improves.
Correct Answer is A
Explanation
Choice A reason:
Placental insufficiency is a condition in which the placenta does not deliver enough oxygen and nutrients to the developing baby, resulting in restricted growth and development. This is one of the most common causes of SGA babies.
Choice B reason:
Primipara means a woman who is pregnant for the first time or who has given birth to one child. Primipara is not a cause of SGA, although some studies have suggested that first-time mothers may have a slightly higher risk of having a low-birth-weight baby than multiparous women.
Choice C reason:
Maternal obesity is a condition in which the mother has a body mass index (BMI) of 30 or higher before or during pregnancy. Maternal obesity is not a cause of SGA, but rather a risk factor for having a large-for-gestational-age (LGA) baby, which can lead to complications such as macrosomia, shoulder dystocia, and birth trauma.
Choice D reason:
Perinatal asphyxia is a condition in which the baby does not receive enough oxygen before, during, or after birth, causing hypoxia and acidosis. Perinatal asphyxia is not a cause of SGA, but rather a possible complication of SGA, especially if the placental insufficiency is severe or prolonged. Perinatal asphyxia can damage the brain and other organs of the baby and lead to long-term neurological impairments.
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