A nurse is providing health promotion teaching to the parents of an infant. Which of the following conditions should the nurse identify as the leading cause of death among this age group?

Congenital anomalies

Respiratory distress

Sudden infant death syndrome

Low birth weight

Answer and Explanation

The Correct Answer is A

Rationale:

A) Congenital anomalies: Congenital anomalies, also known as birth defects, are structural or functional abnormalities present at birth. They can affect any part of the body and may cause physical or developmental disabilities, as well as contribute to infant mortality. These anomalies can result from genetic factors, environmental exposures during pregnancy, or a combination of both. Preventive measures such as prenatal care, genetic counseling, and maternal health promotion play crucial roles in reducing the incidence and impact of congenital anomalies.

B) Respiratory distress: While respiratory distress can be a significant concern in newborns, especially those born prematurely or with certain medical conditions, it is not the leading cause of death among infants. Respiratory distress syndrome (RDS) occurs primarily in premature infants due to immature lung development and surfactant deficiency, requiring supportive care and sometimes mechanical ventilation to manage.

C) Sudden infant death syndrome (SIDS): SIDS is the sudden and unexplained death of an otherwise healthy infant, typically occurring during sleep. While SIDS is a devastating tragedy and a major public health concern, it is not the leading cause of death among infants. Strategies to reduce the risk of SIDS include placing infants on their backs to sleep, avoiding soft bedding and overheating, and promoting a safe sleep environment.

D) Low birth weight: Low birth weight, defined as a birth weight of less than 2,500 grams (5.5 pounds), is associated with an increased risk of neonatal complications and long-term health issues. While low birth weight infants may face various health challenges, including respiratory problems and developmental delays, low birth weight itself is not the leading cause of death among infants. Efforts to reduce low birth weight include prenatal care, nutrition support, and management of maternal risk factors such as smoking and substance abuse.

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Correct Answer is D

Explanation

A. Skin integrity: Skin integrity can be an indicator of dehydration, as dehydrated skin may appear dry and lack elasticity. However, skin turgor is not the most reliable indicator of fluid loss because it can be influenced by factors such as age and overall health. For example, infants and older adults may have decreased skin turgor due to a loss of skin elasticity, even if they are adequately hydrated.

B. Blood pressure: Blood pressure can decrease with significant fluid loss because there is less fluid volume to fill the arteries, leading to a drop in blood pressure. However, blood pressure is not the most reliable indicator of fluid loss because it can be influenced by many other factors, such as heart function and vascular resistance. Additionally, blood pressure may not change significantly until severe dehydration occurs.

C. Respiratory rate: An increased respiratory rate can be a sign of dehydration because the body may try to compensate for fluid loss by increasing the respiratory rate to deliver more oxygen to the tissues. However, an increased respiratory rate is a nonspecific symptom that can be associated with many other conditions, such as fever, pain, or lung disease. Therefore, it is not the most reliable indicator of fluid loss.

D. Body weight: Body weight is the most reliable indicator of fluid loss. This is because water makes up a significant portion of body weight, so a decrease in body weight is a direct indication of fluid loss. In infants, a rapid change in weight is often the first sign of fluid imbalance because they have a higher percentage of body water and a higher metabolic rate compared to adults. A 5% weight loss is considered mild dehydration, 10% is moderate, and 15% or more is severe. Therefore, regular monitoring of an infant’s weight is crucial when assessing for dehydration.

A. Withhold fluids until the client demonstrates a gag reflex. B. Suction the nasopharynx as needed. C. Perform chest physiotherapy. D. Place a bedside humidifier at the head of the client's bed

Correct Answer is B

Explanation

A. Withhold fluids until the client demonstrates a gag reflex: Withholding fluids until the gag reflex returns is not an appropriate intervention to prevent aspiration. The presence of a gag reflex does not guarantee the absence of aspiration risk. Additionally, depriving the client of fluids can lead to dehydration, which is not conducive to recovery.

B. Suction the nasopharynx as needed: This is the correct intervention to prevent aspiration in a client who is postoperative following anesthesia. Suctioning the nasopharynx helps remove secretions or blood that could obstruct the airway and lead to aspiration.

C. Perform chest physiotherapy: While chest physiotherapy may be beneficial for promoting lung expansion and clearing respiratory secretions, it is not specifically aimed at preventing aspiration. This intervention is more commonly used to manage conditions such as pneumonia or cystic fibrosis.

D. Place a bedside humidifier at the head of the client's bed: Using a bedside humidifier may help maintain airway moisture, but it does not directly address the risk of aspiration. While it can be a comfort measure, it is not a primary intervention for preventing aspiration in a postoperative client.

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