Generalized edema of the newborn may occur in the following conditions EXCEPT

Correct Answer: D

Rationale: In this question, the correct answer is D) Hurler syndrome. Generalized edema of the newborn can occur due to various conditions, but Hurler syndrome is not typically associated with this specific symptom. Prematurity (Option A) can lead to generalized edema in newborns due to immature renal function and increased capillary permeability. Nonimmune hydrops (Option B) is characterized by excessive fluid accumulation in fetal compartments, leading to edema. Turner syndrome (Option C) can present with lymphedema or swelling of the hands and feet due to lymphatic system abnormalities. Educationally, understanding the causes of generalized edema in newborns is crucial for pediatric nurses. Recognizing these conditions helps in early identification, appropriate interventions, and providing optimal care for newborns. By differentiating between conditions like prematurity, nonimmune hydrops, and genetic syndromes like Turner syndrome, nurses can contribute effectively to the multidisciplinary team caring for neonates with edema. Knowing that Hurler syndrome does not typically present with generalized edema is a key point in clinical assessment and differential diagnosis.

Correct Answer: B

Rationale: Intraventricular hemorrhage (IVH) of prematurity is a common concern in neonatal care. The correct answer, B, states that MRI is the preferred imaging technique for screening IVH, is incorrect. The gold standard for diagnosing IVH is cranial ultrasound due to its accessibility, portability, and accuracy in detecting hemorrhages in premature infants. MRI is not commonly used for routine screening due to its high cost, limited availability in neonatal units, and the need for sedation, making it less practical for this purpose. Option A states that IVH usually develops spontaneously, which is true as it is often associated with fragile blood vessels in the germinal matrix of preterm infants. Option C mentions prophylactic administration of low-dose indomethacin reducing the incidence of severe IVH, which is accurate as indomethacin helps in closing the ductus arteriosus, reducing the risk of IVH. Option D, stating that the majority of patients with IVH have no clinical symptoms, is also correct since symptoms may not be apparent until the hemorrhage progresses or causes complications. Educationally, understanding the nuances of IVH diagnosis and management is crucial for healthcare providers working in neonatal care. By recognizing the importance of appropriate imaging modalities, such as cranial ultrasound over MRI for IVH screening, providers can efficiently diagnose and manage this critical condition in preterm infants, leading to improved outcomes.

Correct Answer: D

Rationale: In pediatric nursing, understanding the rationale behind interventions like Vitamin A supplementation in preterm infants is crucial for providing safe and effective care. In this context, the correct answer is D) decreases the need for extracorporeal membrane oxygenation (ECMO). Vitamin A supplementation in infants < 1,000 g has been shown to decrease the risk of death, decrease bronchopulmonary dysplasia (BPD) at 36 weeks, and reduce nosocomial sepsis. However, it does not have a direct impact on the need for extracorporeal membrane oxygenation (ECMO). Understanding this distinction is essential for nurses caring for premature infants as it highlights the specific benefits of Vitamin A supplementation and clarifies its limitations. It also emphasizes the importance of evidence-based practice in pediatric nursing, where interventions should be tailored to address specific outcomes based on research findings. By knowing the effects of Vitamin A supplementation, nurses can advocate for appropriate interventions and contribute to improved outcomes for preterm infants in their care.

Correct Answer: B

Rationale: Eventration of the diaphragm is a condition where there is a thinning or complete absence of the muscular portion of the diaphragm, leading to abnormal elevation of the affected part. This condition is typically associated with other congenital anomalies and chromosomal abnormalities, hence option C, chromosomal trisomies, is correct. Option A, pulmonary hypoplasia, is often seen in conjunction with eventration of the diaphragm due to the restricted lung development caused by the elevation of the diaphragm. Recurrent infections (option D) can occur due to compromised respiratory function associated with eventration of the diaphragm and the resulting respiratory distress. Option B, pulmonary sequestration, is not directly related to eventration of the diaphragm. Pulmonary sequestration is a separate condition where a mass of lung tissue does not communicate with the normal airways and has its blood supply. This condition is not typically associated with eventration of the diaphragm. In an educational context, understanding the associations of eventration of the diaphragm with other conditions is crucial for pediatric nurses to provide comprehensive care to pediatric patients with this condition. Recognizing these associations can aid in early detection, appropriate interventions, and improved outcomes for these patients.

Correct Answer: D

Rationale: The statement 'Isoimmune hemolytic disease may be found in first-born infants irrespective of infant blood group' is incorrect. Isoimmune hemolytic disease typically occurs when maternal antibodies cross the placenta and attack fetal red blood cells. This is more common in subsequent pregnancies due to sensitization during the first pregnancy.