In caring for the preterm infant, which complication is thought to be a result of high arterial blood oxygen level?

Correct Answer: B

Rationale: In caring for preterm infants, it is crucial to understand the impact of high arterial blood oxygen levels. The correct answer to this question is B) Retinopathy of prematurity (ROP). ROP is a known complication associated with high arterial blood oxygen levels in preterm infants. Excessive oxygen can lead to abnormal blood vessel growth in the retina, potentially causing vision impairment or even blindness. Option A) Necrotizing enterocolitis (NEC) is incorrect because it is more commonly associated with factors such as prematurity, formula feeding, and intestinal immaturity rather than high arterial blood oxygen levels. Option C) Intraventricular hemorrhage (IVH) is not directly related to high oxygen levels but is more associated with fluctuations in blood pressure and cerebral blood flow in preterm infants. Option D) Bronchopulmonary dysplasia (BPD) is primarily linked to factors such as mechanical ventilation, prematurity, and oxygen toxicity rather than high arterial blood oxygen levels specifically. Educational context: Understanding the specific complications related to caring for preterm infants is crucial for nurses working in neonatal care. Knowledge of how oxygen levels can impact different organ systems helps nurses provide optimal care and prevent potential complications. Regular monitoring and appropriate oxygen therapy management are essential in preventing conditions like ROP in preterm infants.

Correct Answer: D

Rationale: In pediatrics, polycythemia refers to an elevated red blood cell count, which can lead to hyperviscosity and potential complications. The correct answer is D) Hct 70%, as this level indicates a significantly increased red blood cell count, characteristic of polycythemia in infants. Option A) Hct 50% is within the normal range for infants, while option B) Hct 55% is slightly elevated but not indicative of polycythemia. Option C) Hct 62% is also elevated but may not be high enough to suggest polycythemia as definitively as Hct 70%. Educationally, understanding lab values in pediatric patients is crucial for nurses caring for infants with respiratory disorders. Polycythemia can be a complication of conditions like chronic hypoxia, leading to increased blood viscosity and potential thrombotic events. Recognizing elevated hematocrit levels is essential for prompt intervention and prevention of complications in these vulnerable patients.

Correct Answer: A

Rationale: In pediatric respiratory disorders, a chest CT is essential for evaluating mediastinal lesions. The mediastinum houses vital structures like the heart, great vessels, thymus, and lymph nodes, making it crucial to assess any abnormalities impacting these structures. Mediastinal lesions can include tumors, cysts, or lymphadenopathy, which can compress adjacent structures leading to significant clinical implications. Option B, parenchymal lesions, refers to abnormalities within the lung tissue itself. While chest CT is valuable for assessing lung parenchyma in other contexts, mediastinal lesions require specific evaluation due to their potential impact on critical structures. Option C, cystic bronchiectasis, typically involves dilated bronchi within the lung parenchyma and is best evaluated through other imaging modalities like high-resolution CT scans or MRI, rather than chest CT focusing on mediastinal structures. Option D, pulmonary embolisms, are blood clots within the pulmonary arteries and are diagnosed using imaging studies like CT pulmonary angiography, which specifically targets the pulmonary vasculature rather than mediastinal structures. Understanding the importance of differentiating between various types of lesions and selecting the appropriate imaging modality based on the suspected pathology is crucial in pediatric nursing care. It ensures accurate diagnosis, appropriate treatment planning, and optimal patient outcomes.

Correct Answer: A

Rationale: In the developed world, the most common cause of clinically significant bronchiectasis is primary ciliary dyskinesia (PCD). PCD is a genetic disorder that affects the structure and function of cilia in the respiratory tract, leading to recurrent respiratory infections and bronchiectasis over time. Option A is correct because PCD is a well-known cause of bronchiectasis, particularly in pediatric populations. Children with PCD often present with chronic cough, recurrent pneumonia, and bronchiectasis on imaging studies. Options B, C, and D are incorrect because while foreign body aspiration, gastric aspiration, and immune deficiency can all contribute to respiratory issues in children, they are not the most common causes of bronchiectasis in the developed world. Foreign body aspiration can lead to localized lung issues, gastric aspiration can cause aspiration pneumonia, and immune deficiency can predispose individuals to recurrent infections, but they are not the primary etiology of bronchiectasis as seen with PCD. In an educational context, understanding the common causes of bronchiectasis is crucial for pediatric nurses to provide optimal care for children with respiratory disorders. Recognizing PCD as a significant contributor to bronchiectasis can guide nurses in assessing, managing, and educating patients and families about this chronic condition. It highlights the importance of genetic testing and early intervention in suspected cases of PCD to prevent complications such as bronchiectasis.

Correct Answer: A

Rationale: In cystic fibrosis, the earliest pathologic lesion in the lung is bronchiolitis. This is because cystic fibrosis primarily affects the smaller airways in the lungs, leading to inflammation and obstruction. Bronchiolitis is characterized by inflammation of the bronchioles, which are the smallest air passages in the lungs. Option A is correct because bronchiolitis is the initial lesion seen in cystic fibrosis, reflecting the early changes in the airways due to the disease process. Option B, bronchitis, involves inflammation of the larger airways (bronchi) and is not typically the initial pathology in cystic fibrosis. Option C, bronchiolectasis, is not a recognized medical term. It may have been a distractor meant to confuse students. Option D, bronchiectasis, is a common complication of cystic fibrosis but typically develops later in the disease process after recurrent infections and damage to the airways. Understanding the progression of lung pathology in cystic fibrosis is crucial for nursing care to provide appropriate interventions and support for pediatric patients with this condition. Recognizing the early signs of bronchiolitis allows for timely interventions to manage symptoms and prevent further complications. It is essential for nurses to have a strong foundation in respiratory disorders to deliver optimal care to pediatric patients with cystic fibrosis.