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fetal devel/assess
Fetal lung devel, Neonatal assessment/exam, High risk delivery
| Question | Answer |
|---|---|
| Which of the following phases of human lung development occurs from 17 to 26 weeks of gestation, and is characterized by the formation of a capillary network around airway passages? Walsh p4 | Canalicular stage |
| Regarding postnatal lung growth, by approximately what age do most of the alveoli that will be present in the lungs for life develop? Walsh p6 | 1.5 years |
| Which of the following mechanisms appear to explain why oligohydramnios is associated with lung hypoplasia? Walsh p7 | Unclear…possibly by mechanical constriction of the chest wall, interference with fetal breathing or failure to produce fetal lung liquid |
| What is the purpose of the material secreted by the type II pneumocyte? Walsh p 7-8 | To lower the surface tension within the alveolus, specifically at the air-liquid interface |
| Which of the following vascular networks is the major source of fetal lung liquid? Walsh p8 | Pulmonary circulation |
| Which of the following events or conditions is the most important risk factor for preterm birth? Walsh p 22 | Prior preterm delivery |
| What is the generally accepted as a safe limit for alcohol consumption during pregnancy to avoid the development of fetal alcohol syndrome? Walsh p22 | No safe range for drinking alcohol during pregnancy has been established. |
| Which of the following conditions are associated with preeclampsia? Walsh p22 | Hypertension, proteinuria, generalized edema |
| Which of the following maternal and/or fetal conditions are associated with pregestational diabetes? Walsh p 23 | Maternal—risk of devel. Diabetic ketoacidosis, proliferative retinopathy, and preeclampsia/eclampsia Fetal—risk of unexplained fetal death in 3rd trimester, major fetal structural malformations |
| Which of the following drugs is recommended to treat a group B Streptococcus infection for a patient who is allergic to penicillin? Walsh p 24 | Clindamycin, erythromycin, vancomycin |
| What is the main potential problem associated with the premature rupture of membranes? Walsh p 24 | the fetal environment is no longer sterile, which may increase the risk of infection and may cause compression of the umbilical cord which causes compromised blood flow between the placenta and fetus. |
| Which of the following maternal or fetal conditions can be determined or assessed via amniocentesis? Walsh p 27 | rh factor, discrete genetic mutations and fetal enzyme deficiencies. |
| Which of the following maternal complications are associated with cesarean section? Walsh p 26 | Increased risk of significant blood loss, anesthesia complications, intraoperative bladder or bowel injuries, postoperative wound infection, endomyometritis, thomboembolic events |
| How should the therapist interpret amniotic fluid of 5 cm? Walsh p 25 | Less than 5cm is associated with congenital anomolies |
| During a contraction stress test, The fetal PO2 drops below 12mmHg and causes the fetal heart to slow. Which of the following conditions is likely indicated by this occurrence? Walsh p 27 | Uteroplacental insufficiency |
| How should the therapist interpret a fetal biophysical profile score of 7? Walsh p 28 | normal |
| In lieu of obtaining a scalp blood gas sample, what can the therapist do to conduct intrapartum assessment of the fetus? Walsh 28 | Transvaginal fetal scalp stimulation |
| Which of the following medications are used as tocolytics? Walsh 31 | Magnesium sulfate B-Mimetic agents (terbutaline and ritodrine) Indomethacin Nifedipine |
| 19. A team has been summoned to the delivery room to perform neonatal resuscitation. Because no perinatal history is available, which of the following information would be useful for the resuscitation team to know in preparation for this event? Walsh p36 | you should at least know: If the mother is in premature labor, the approximate gestational age of the infant, the number of babies expected, and if meconium is present in the amniotic fluid. |
| 20. What measures can the therapist take to prevent heat loss and cold stress before performing resuscitation on a preterm neonate? Walsh p37 | dry/warm baby by rapidly drying the infants skin, remove wet linens, and wrap baby in prewarmed blankets/preheated radiant warmer if the baby is less than 1500 grams/3.3lbs, wrap in a topical polyethylene to reduce heat evaporation |
| As the head of a neonate contaminated w/meconium at birth, heart rate monitor reads 120bpm, and the infant has good muscle tone and a strong respiratory effort. What should the physician do at this time to provide the airway care? Walsh p37 | Do not provide tracheal suction |
| 22. A preterm neonate with a heart rate of 55bpm is receiving positive-pressure ventilation immediately after delivery. What should the therapist do at this time? Walsh p43 | Begin chest compression using the thumb or 2 finger technique at a 3:1 ratio of compression/ventilation, increase FiO2 to 100% |
| A term infant is displaying acrocyanosis. What should the therapist do at this time? Walsh p50-51 | Stimulate and warm the baby but O2 is not required. |
| Know how to evaluate a 1 min Apgar score? Walsh 39 T4-1 | HR: None= 0 <100= 1 >100= 2 RR: None= 0 weak/irregular= 1 strong cry= 2 Skin: pale blue= 0 pink body/ blue hands= 1 completely pink= 2 Reflex: none= 0 slight grimace= 1 cry, cough, sneeze=2 Muscle tone: limp= 0 some flexion= 1 well flexe |
| Which of the following actions constitutes appropriate stimulation of a neonate? Walsh 38 | Stimulate by flicking the bottoms of feet, gentle rubbing of the back, drying with a towel. |
| Baby Cutie is born weighing 4,000 g. How many pounds does Baby Cutie weigh? | 4,000 x 0.002 = 8lbs |
| Which method of estimating gestational uses physical and neurological findings? Walsh p48 | Ballard |
| Baby Cissy is evaluated with an APGAR of 6. What intervention would you perform? Lab scenario | an infant scoring 4-6 Apgar should get FiO2 via mask ventilation, stimulation, and suctioned thru their mouth & nose. |
| The gestational age of a newborn has been evaluated to be 34 weeks. The newborn’s birth weight is greater than the 90th percentile. How should the therapist classify this infant? Walsh p49 | Large for gestational age |
| A physical examination is being performed on a newborn, and the therapist notices that the infant’s arms do not move symmetrically. Which of the following situations could account for this problem? Walsh p56 | It could be a broken clavicle or an injury to the brachial plexus. |
| Which of the following neonatal skin presentation at birth is associate with a high hematocrit value or polycythemia and neonatal hyperviscosity syndrome? Walsh p50 | Ruddy/reddish blue appearance |
| Why are chest retractions more prominent among neonates than among children and adults? Walsh 52 | because neonates musculature is relatively thin and weak and thoracic cage is not as rigid. The flexible chest wall and thoracic cage of a newborn exhibits noticeable retractions as lung compliance |
| Which of the following statements refers to the diagnostic procedure called transillumination? Walsh 52 | Transillumination to detect suspected pneumothorax. Uses high energy flashlight or fiberoptic device in a dark room. You put the light on the suspected side of the chest. If there is a large pneumo, it'll be real pink, illuminated, usually glowing area th |
| A neonate is found to have a bounding pulse. Which of the following conditions may contribute to his finding? Walsh 54 | A patent ductus arteriosus and L to R shunt |
| For the purpose of assessing right –to –left shunting, as in the case of persistent pulmonary hypertension, which of the following sites would render postductal blood? Walsh 54, 474 | the postductal is on the belly (umbilical cord or abdomen). Right to left shunting is indicated in a presample that is greater than 20mmHg than the postductal. |
| Which of the following conditions can cause abdominal distention? Walsh p54 | Sepsis, obstruction, tumors, ascities, pneumoperitoneum, necrotizing entercolitis |
| Which of the following conditions are associated with scaphoid abdomen? Walsh p54 | Congenital diaphragmatic hernia |
| Normal capillary refill time for a newborn should be less than_____ | 3 seconds_____ Walsh 50 |
| Signs of respiratory distress in a newborn include all of the following except (walsh p51) | ARE: nasal flaring, expiratory grunting, tachypnea, retractions |
| The umbilical cord normally consist of | 3 blood vessels (2 small/thick wall arteries and 1 large/thin vein) ad Wharton’s jelly (surrounds the vessels) |
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bowen.jessica1
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