Review Preterm birth

Newborn Complications > Maternal & Newborn

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Preterm birth

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Total Questions : 5

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Question 1:

A nurse is assessing a preterm infant who has necrotizing enterocolitis (NEC).

Which of the following findings should alert the nurse to a possible bowel perforation?

A. Bloody stools B. Abdominal distention C. Bilious vomitus D. All of the above.

Answer and Explanation

Choice A:

Bloody stools are not specific for bowel perforation.They can also be seen in mild cases of NEC or other causes of gastrointestinal bleeding.

Choice B:

Abdominal distension is a common sign of NEC, but not necessarily of bowel perforation.It can be caused by gas accumulation, fluid retention, or inflammation of the bowel wall.

Choice C:

Bilious vomitus is also a non-specific sign of NEC or other causes of bowel obstruction.It can indicate a problem with the passage of food or bile through the intestines.

Choice D:

All of these findings can indicate a possible bowel perforation in a preterm infant with necrotizing enterocolitis (NEC).NEC is a serious condition that causes inflammation and necrosis of the intestinal tissue, and can lead to a hole (perforation) in the bowel wall.Bacteria can leak through this hole and cause infection and sepsis.NEC usually develops within two to six weeks after birth, and mostly affects premature babies.

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Question 2:

A nurse is measuring the head circumference of a preterm infant.

Which of the following methods should the nurse use to ensure accuracy?

A. Place a tape measure around the widest part of the head. B. Place a tape measure around the forehead and occiput. C. Place a tape measure around the forehead and ears. D. Place a tape measure around the forehead and chin.

Answer and Explanation

Choice A:

This is the recommended method for measuring the head circumference of a preterm infant. It ensures accuracy by capturing the largest dimension of the head, which reflects the growth of the brain.

Choice B:

It does not measure the widest part of the head, which may be above or below the occiput.

Choice C:

It does not measure the widest part of the head, which may be above or below the ears.

Choice D:

It does not measure the widest part of the head, which may be above or below the chin.

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Question 3:

A nurse is educating the parents of a preterm infant who has retinopathy of prematurity (ROP).

Which of the following statements should the nurse include in the teaching?

A. “Your baby will need regular eye exams to monitor the condition.” B. “Your baby will need surgery to correct the abnormal blood vessels.” C. “Your baby will need oxygen therapy to prevent further damage.” D. “Your baby will need glasses to improve his or her vision.”.

Answer and Explanation

Choice A:

ROP is a condition that affects the blood vessels of the retina in premature infants. It can cause vision loss or blindness if not treated. The main treatment for ROP is laser therapy or cryotherapy to stop abnormal blood vessel growth. However, these treatments do not restore normal vision and may have complications. Therefore, regular eye exams are needed to monitor the condition and detect any changes or problems.

Choice B:

Surgery is not a common treatment for ROP. Surgery may be done in some cases to reattach the retina if it detaches from the eye wall, but this is a rare and serious complication of ROP.

Choice C:

Oxygen therapy can actually worsen ROP. High levels of oxygen can stimulate abnormal blood vessel growth in the retina. Oxygen therapy should be used with caution and only when necessary for premature infants.

Choice D:

Glasses do not improve vision in ROP. Glasses can correct refractive errors such as nearsightedness or farsightedness, but they cannot fix the damage to the retina caused by ROP.

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Question 4:

A nurse is providing developmental care for a preterm infant in the neonatal intensive care unit (NICU).

Which of the following interventions should the nurse implement?

A. Cluster care activities to allow for uninterrupted rest periods. B. Keep the lights and noise level high to stimulate brain development. C. Avoid touching or holding the infant to prevent overstimulation. D. Change the infant’s position frequently to promote muscle tone.

Answer and Explanation

Choice A:

This is because preterm infants are born before or during critical periods of brain development and need to reduce stress and promote neurological development. Cluster care means grouping care activities together and timing them according to the infant’s cues, such as alertness, hunger, and sleepiness. This way, the infant can have longer periods of undisturbed sleep, which is essential for brain maturation.

Choice B:

Keeping the lights and noise level high can cause sensory overload and stress for the preterm infant. The NICU environment should be dimmed and quiet to mimic the womb and support the infant’s circadian rhythm.

Choice C:

Avoiding touching or holding the infant can deprive the infant of human contact and bonding, which are important for emotional and social development. Preterm infants can benefit from gentle touch, massage, and kangaroo care, which is holding the baby with direct skin-to-skin contact. These interventions can help with body temperature, breastfeeding, weight gain, and attachment.

Choice D:

Changing the infant’s position frequently can disrupt the infant’s sleep and cause stress. Preterm infants should be positioned in a way that supports their posture and alignment, such as flexion, midline orientation, and containment. Positioning aids such as blankets, rolls, or nests can be used to provide boundaries and comfort for the infant.

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Question 5:

A nurse is evaluating a newborn who has hyperbilirubinemia and received phototherapy for 24 hours.

Which of the following outcomes indicates that phototherapy was effective?

A. The newborn has bronze discoloration of the skin. B. The newborn has decreased serum bilirubin level. C. The newborn has increased urine output and specific gravity. D. The newborn has normal vital signs and neurological status.

Answer and Explanation

Choice A:

Bronze discoloration of the skin is a side effect of phototherapy, not an outcome.

Choice B:

This indicates that phototherapy was effective because it lowers the level of bilirubin in the blood by converting it into a form that can be excreted in urine and stool.

Choice C:

Increased urine output and specific gravity are signs of dehydration, which can occur with phototherapy due to insensible water loss.

Choice D:

Normal vital signs and neurological status do not reflect the effectiveness of phototherapy on bilirubin levels. Normal ranges for serum bilirubin levels vary by age and risk factors, but generally they should be less than 15 mg/dL (257 μmol/L) for term newborns and less than 18 mg/dL (308 μmol/L) for preterm newborns.

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Preterm birth

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