What is the primary cause of respiratory distress in infants born at 28 weeks gestation?

Correct Answer: A

Rationale: In infants born at 28 weeks gestation, the primary cause of respiratory distress is surfactant deficiency. Surfactant is a substance produced by the lungs that helps keep the air sacs open, allowing for proper oxygen exchange. Premature infants may not have enough surfactant, leading to respiratory distress syndrome (RDS). This condition makes breathing difficult and can be life-threatening if not treated promptly. Option B, Meconium aspiration, is a common cause of respiratory distress in full-term infants who pass meconium (first stool) in the womb and inhale it during delivery. This is less likely to be the primary cause in a premature infant born at 28 weeks gestation. Option C, Congenital heart disease, can lead to respiratory symptoms in infants, but it is not the primary cause of respiratory distress in a preterm infant with surfactant deficiency. Option D, Infection, can cause respiratory distress in infants, but in a premature infant born at 28 weeks gestation, surfactant deficiency is the primary concern due to the underdeveloped lungs. Understanding the specific challenges faced by premature infants and the impact of surfactant deficiency on their respiratory system is crucial for pediatric nurses caring for these vulnerable patients. Recognizing the primary causes of respiratory distress in preterm infants enables healthcare providers to deliver timely and appropriate interventions to support their respiratory function and overall well-being.

Correct Answer: B

Rationale: In pediatric respiratory nursing, understanding the signs of neonatal sepsis is vital for early detection and intervention. The correct answer is B) Tachypnea. Tachypnea, or rapid breathing, is a common early sign of neonatal sepsis. In neonates, their immature immune system makes them vulnerable to infections, which can quickly progress to sepsis. Tachypnea is often one of the first noticeable signs of an underlying infection in neonates. Option A) Hypotension is a common sign of neonatal sepsis, but it typically occurs in the later stages of the condition when sepsis has progressed to a more severe state. Option C) Hyperthermia can be seen in neonatal sepsis, but it is not as specific as tachypnea in early detection. Neonates may also present with hypothermia as a response to infection. Option D) Jaundice is not a common sign of neonatal sepsis. Jaundice is more commonly associated with conditions affecting the liver, such as hemolytic disease or physiological jaundice in newborns. Educationally, nurses must be adept at recognizing subtle signs of neonatal sepsis to initiate prompt treatment. Understanding the hierarchy of symptoms and their relevance to the progression of the condition is crucial in providing quality care to neonates. Regular training and updates on neonatal sepsis signs and symptoms can enhance nurses' clinical judgment and improve patient outcomes.

Correct Answer: C

Rationale: In the context of pediatric respiratory nursing, understanding risk factors for sudden infant death syndrome (SIDS) is crucial. The correct answer is option C) Sleeping on the stomach. This position is a significant risk factor for SIDS because it can lead to airway obstruction, rebreathing of exhaled air, and overheating in infants. Placing infants on their backs to sleep is the safest sleep position recommended to reduce the risk of SIDS. Option A) Breastfeeding is actually associated with a decreased risk of SIDS due to the numerous health benefits it provides to infants, including a stronger immune system. Option B) Using a pacifier during sleep has been shown to reduce the risk of SIDS. The act of sucking on a pacifier can help maintain an open airway and promote self-soothing. Option D) Room-sharing without bed-sharing is recommended to reduce the risk of SIDS. Sharing a room with the infant (but not the same sleeping surface) has been shown to lower the risk of SIDS while promoting safe sleeping practices. Educationally, it's important for healthcare professionals to be well-versed in these risk factors for SIDS to educate parents and caregivers on safe sleep practices for infants. By understanding the rationale behind these recommendations, nurses can effectively communicate and promote evidence-based strategies to reduce the occurrence of SIDS and ensure the safety of infants during sleep.

Correct Answer: A

Rationale: The correct answer is A) Necrotizing enterocolitis (NEC). NEC is the most common complication of enteral feeding in neonates. NEC is a serious condition characterized by inflammation and necrosis of the intestine, particularly affecting premature infants or those with low birth weight. Enteral feeding, especially in premature infants, can disrupt the delicate balance of the gut microbiome, leading to NEC. Option B) Hypoglycemia is incorrect because it is not directly associated with enteral feeding in neonates. Hypoglycemia may occur due to various reasons such as inadequate feeding, sepsis, or metabolic disorders. Option C) Hyperkalemia is also incorrect in this context. Hyperkalemia refers to high levels of potassium in the blood and is not a common complication of enteral feeding in neonates. Option D) Dehydration is unlikely to be the most common complication of enteral feeding in neonates. While dehydration can occur in neonates due to various reasons, it is not typically the primary concern related to enteral feeding. Understanding the complications of enteral feeding in neonates is crucial for pediatric nurses to provide safe and effective care. Recognizing NEC as a potential complication emphasizes the importance of monitoring neonates closely during enteral feeding, especially those at higher risk such as premature infants. Educating healthcare providers about these complications can lead to early detection and intervention, ultimately improving neonatal outcomes.

Correct Answer: B

Rationale: In the context of pediatric respiratory nursing, understanding the importance of early cord clamping in neonates is crucial. The primary benefit of early cord clamping is increased hemoglobin levels in the newborn. When the cord is clamped early, it allows for a more significant transfer of blood from the placenta to the baby, leading to higher hemoglobin levels. This is essential for the newborn's oxygen-carrying capacity, which is particularly relevant in the respiratory system's development. Option A, improved blood pressure, is incorrect in this context because early cord clamping primarily affects hemoglobin levels, not blood pressure. While adequate hemoglobin levels contribute to overall cardiovascular health, it is not the direct result of early cord clamping. Option C, prevention of jaundice, is also incorrect. Jaundice is mainly related to the breakdown of red blood cells and bilirubin levels in the blood, rather than the timing of cord clamping. Option D, reduced risk of infection, is not directly linked to early cord clamping. Infections in neonates are more related to hygiene practices, maternal health, and environmental factors rather than the timing of cord clamping. Educationally, it is essential for pediatric respiratory nurses to understand the rationale behind early cord clamping to provide optimal care for neonates. By knowing that increased hemoglobin levels are the primary benefit, nurses can advocate for evidence-based practices that support neonatal respiratory health and overall well-being. This knowledge can also help nurses educate parents and caregivers about the importance of certain procedures in the neonatal period.