The newborn you are caring for has developed early onset sepsis shortly after birth.

He is ordered gentamicin 5 mg/kg qh.

With a weight of 7 Ib, how many mg would you give for one dose?

Choice A rationale

Pelvic pain is a very common symptom of endometriosis. This pain often originates from the presence of endometrial-like tissue outside the uterus, which responds to hormonal fluctuations, leading to inflammation, bleeding, and nerve irritation within the peritoneal cavity. This can result in chronic pelvic pain.

Choice B rationale

Endometriosis can indeed be asymptomatic in some individuals. The severity of symptoms does not always correlate with the extent or location of the endometrial implants. Some women may have significant endometriosis without experiencing any pain or other noticeable symptoms, making diagnosis challenging in these cases.

Choice C rationale

Food cravings are not a recognized symptom directly associated with endometriosis. While hormonal fluctuations can influence appetite or mood, food cravings are not a specific or characteristic symptom of the disease process itself, which primarily involves the abnormal growth and behavior of endometrial-like tissue outside the uterus.

Choice D rationale

Dysmenorrhea, or painful menstruation, is a hallmark symptom of endometriosis. The ectopic endometrial tissue responds to cyclic hormonal changes, leading to bleeding and inflammation within the pelvic cavity during menstruation, which can cause severe cramping and pain beyond typical menstrual discomfort.

Choice A rationale

At 22 weeks of gestation, a fetus's lungs are still immature and typically lack sufficient amounts of surfactant. Surfactant is a crucial lipoprotein that reduces surface tension within the alveoli, preventing their collapse upon exhalation and facilitating gas exchange. Without adequate surfactant, the lungs struggle to remain open, leading to severe respiratory distress syndrome and making extrauterine survival highly challenging.

Choice B rationale

Lung damage at 22 weeks gestation is primarily due to immaturity, specifically the lack of surfactant and incompletely developed alveolar structures. Surgical intervention is not the primary treatment for this developmental immaturity. Medical management, such as surfactant administration and respiratory support, is the standard approach to support lung function in premature infants, not surgical repair.

Choice C rationale

Infants at 22 weeks gestation are far from fully formed and are considered extremely premature. Their organ systems, particularly the respiratory, neurological, and gastrointestinal systems, are significantly immature. They require extensive medical assistance, including respiratory support, nutritional support, and often specialized care in a neonatal intensive care unit (NICU) to survive, contradicting the idea of minimal assistance.

Choice D rationale

While survival rates for infants born at 22 weeks are very low, stating that a 22-week-old baby would *never* survive is an absolute and inaccurate statement. With advances in neonatal intensive care, including improved respiratory support, surfactant therapy, and nutritional strategies, some infants born at this gestational age do survive, although they often face significant long-term health challenges.