The most important reason to protect the preterm infant from cold stress is that:

It could make respiratory distress syndrome worse.

Shivering to produce heat may use up too many calories.

A low temperature may make the infant less able to digest nutrients.

Cold decreases circulation to the extremities.

Answer and Explanation

The Correct Answer is A

A) It could make respiratory distress syndrome worse:
The most critical reason to protect a preterm infant from cold stress is that hypothermia can exacerbate respiratory distress syndrome (RDS). Cold stress leads to an increased oxygen demand, which can worsen the infant’s already compromised respiratory function. In preterm infants, the immature lungs and underdeveloped surfactant production contribute to RDS, and hypothermia worsens the situation by increasing metabolic demands and impairing pulmonary function. Maintaining a stable body temperature is crucial for minimizing respiratory complications.

B) Shivering to produce heat may use up too many calories:
While it is true that preterm infants may not have the metabolic reserves to generate heat via shivering (as they lack significant brown fat), the primary concern is not shivering. Preterm infants generally do not shiver, and cold stress does not trigger this response. Instead, their body tries to conserve heat through vasoconstriction and increased metabolism, which can lead to hypoxia and worsening respiratory distress.

C) A low temperature may make the infant less able to digest nutrients:
Cold stress can affect a preterm infant’s gastrointestinal function by reducing blood flow to the digestive organs, which can impair nutrient absorption and digestion. However, the most immediate and serious consequence of cold stress is the increased metabolic demand and worsening of respiratory distress, rather than a direct impact on digestion. Protecting the infant from hypothermia helps prevent these secondary complications.

D) Cold decreases circulation to the extremities:
While cold stress can indeed lead to vasoconstriction and decreased circulation to the extremities, this is not the most significant concern. The primary issue with cold stress in preterm infants is the overall increase in metabolic demands, oxygen consumption, and exacerbation of respiratory problems, which can lead to more severe respiratory distress syndrome. The loss of peripheral circulation is a secondary concern.

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Correct Answer is A

Explanation

A) "Babies usually breathe in and out through their noses so they can feed without choking.":
Newborns are obligate nasal breathers, meaning they primarily breathe through their noses rather than their mouths, which helps coordinate breathing with feeding. This nasal breathing mechanism helps prevent aspiration and ensures that babies can feed while still breathing. It is perfectly normal for a baby to primarily use their nose for breathing, especially in the early days of life, and no cause for concern should be raised about small nasal openings unless the baby is showing signs of respiratory distress.

B) "You are right. I will report the baby's small nasal openings to the pediatrician right away.":
A small nasal opening is common in newborns and is not usually a cause for alarm unless it interferes with breathing, feeding, or shows signs of a more significant anatomical issue. There is no immediate need to report it unless the baby is having trouble breathing or feeding. The nurse should offer reassurance instead.

C) "Everything about babies is small. It truly is amazing how everything works so well.":
While this response may seem comforting, it is not very informative. It dismisses the mother’s concern rather than providing a clear and educational explanation. Reassuring the mother with factual information about why babies breathe through their noses and how this works effectively for them would be more helpful.

D) "The baby does rarely open his mouth but you can see that he isn't in any distress.":
This response minimizes the importance of the mother’s question and doesn’t fully address her concern. While it’s true that babies rarely open their mouths to breathe, the explanation needs to focus on the physiological reasoning behind it. The nurse should also reassure the mother that nasal breathing is normal in newborns and not typically a concern unless signs of distress are present.

A. Abdominal with synchronous chest movements. B. Chest breathing with nasal flaring. C. Diaphragmatic with chest retraction. D. Deep with a regular rhythm.

Correct Answer is A

Explanation

A) Abdominal with synchronous chest movements:
Newborns primarily exhibit abdominal breathing, meaning that the diaphragm does most of the work while the chest movements are less pronounced. This is normal for full-term neonates, and the chest and abdomen move in a synchronous manner as the baby breathes. This pattern is indicative of an immature respiratory system that is still developing, but it is completely normal in the early stages of life.

B) Chest breathing with nasal flaring:
While some chest movement is observed in newborns, the primary pattern of breathing is abdominal. Nasal flaring is generally an abnormal sign in newborns and may indicate respiratory distress, such as when there is an obstruction in the airway or a need for increased oxygen intake. It is not considered a normal, healthy breathing pattern in newborns.

C) Diaphragmatic with chest retraction:
Diaphragmatic breathing is normal, but chest retraction is not. Retractions occur when there is increased effort to breathe, and they typically indicate respiratory distress or obstruction. In a healthy, full-term newborn, retractions should not be present. This type of breathing would require further investigation to rule out conditions like respiratory distress syndrome or infection.

D) Deep with a regular rhythm:
Newborns may have irregular breathing patterns, including periods of apnea (a few seconds without breathing) and slight irregularity in rhythm, especially during sleep. Deep, regular breathing without any irregularities is not typical in a newborn, and any consistent deep breathing would require further observation to rule out any potential underlying issues.

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The most important reason to protect the preterm infant from cold stress is that:

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

Part of the health assessment of a newborn includes observation of the neonate's breathing pattern. A full-term newborn's breathing pattern is predominantly:

Correct Answer is A

Explanation

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