Which clinical events would lead to an increased bilirubin level in the newborn select all that apply?
*Delay in passage of meconium or in newborn feedings could lead to increased bilirubin levels because of increased enterohepatic circulation. Twin-to-twin transfusion syndrome could lead to increased bilirubin levels as a result of an increased amount of hemoglobin.
What are common risk factors for developing newborn jaundice select all that apply?
Which factor places the newborn at risk for the development of jaundice? A preterm infant is experiencing cold stress after birth….Select all that apply.
- fetal-maternal blood group incompatibility.
- certain drugs.
- maternal gestational diabetes.
What are the various modes of heat loss in the newborn select all that apply?
Convection, radiation, evaporation, and conduction are the four modes of heat loss in the newborn. The shivering mechanism of heat production is rarely functioning in the newborn.
Which nursing actions limit overstimulation of the preterm infant select all that apply?
Which nursing actions limit overstimulation of the preterm infant? It is noted that excessive noise can overstimulate the preterm infant. It is up to the nurse to protect the neurologic status of the infant. Minimize overstimulation by speaking softly to the infant and keeping the lights in the nursery low.
Which types of play are most appropriate for the 3 month old who is in an orthopedic cast?
Which types of play are most appropriate for the 3-month-old who is in an orthopedic cast? Explanation: Infants who are in an orthopedic cast must have stimulation by contact and play.
What is the most important nursing action in preventing neonatal infection?
Important measures include (1) the reduction of bacterial colonization through appropriate care of the umbilical stump and skin of the patient; (2) handwashing before and after contact with a patient; (3) low nurse-to-patient ratios; (4) cohorting of newborn infants; (5) isolation and cohorting of infected babies; (6) …
What are the methods for preventing infections in newborns?
Chapter 3.4 Prevention of neonatal infections
- avoiding unnecessary separation of the newborn from the mother e.g.. baby unit.
- hand-washing before delivering and handling the infant.
- good basic hygiene and cleanliness during delivery (e.g. chlorhexidine cream for all maternal vaginal examinations)
- appropriate umbilical cord care.
- appropriate eye care.
Which baby is most likely to express Rh incompatibility?
Which infant is most likely to express Rh incompatibility? If the mother is Rh negative and the father is Rh positive and homozygous for the Rh factor, then all the offspring of this union will be Rh positive. Only Rh-positive offspring of an Rh-negative mother are at risk for Rh incompatibility.
Which infant is a likely candidate for receiving exogenous surfactant?
Intubated infants with RDS should receive exogenous surfactant therapy (grade A). Intubated infants with meconium aspiration syndrome requiring more than 50% oxygen should receive exogenous surfactant therapy (grade A).
How late can you give surfactant?
Ideally the dose should be given within 1 hr of birth but definitely before 2 hours of age. A repeat dose should be given within 4 – 12 hours if the patient is still intubated and requiring more than 30 to 40% oxygen.
Why do we give surfactant to newborn with respiratory distress?
Introduction. Pulmonary surfactant is a complex mixture of phospholipids and proteins that creates a cohesive surface layer over the alveoli which reduces surface tension and maintains alveolar stability therefore preventing atelectasis.
How is newborn surfactant given?
The surfactant is administered via a thin catheter into the trachea in small aliquots, while the baby is spontaneously breathing on CPAP support. In infants 29-32 weeks gestation, LISA may reduce the occurrence of pneumothorax and need for mechanical ventilation.
What is surfactant used for in infants?
Surfactant is a liquid made by the lungs that keeps the airways (alveoli) open. This liquid makes it possible for babies to breathe in air after delivery.
What is the role of surfactant?
The main functions of surfactant are as follows: (1) lowering surface tension at the air–liquid interface and thus preventing alveolar collapse at end-expiration, (2) interacting with and subsequent killing of pathogens or preventing their dissemination, and (3) modulating immune responses.
Why is surfactant important for a baby?
Surfactant is a mixture of fat and proteins made in the lungs. Surfactant coats the alveoli (the air sacs in the lungs where oxygen enters the body). This prevents the alveoli from sticking together when your baby exhales (breathes out).
What are the causes of RDS?
What causes acute respiratory distress syndrome?
- inhaling toxic substances, such as salt water, chemicals, smoke, and vomit.
- developing a severe blood infection.
- developing a severe infection of the lungs, such as pneumonia.
- receiving an injury to the chest or head, such as during a car wreck or contact sports.
What is surfactant and why is it important?
The main function of surfactant is to lower the surface tension at the air/liquid interface within the alveoli of the lung. This is needed to lower the work of breathing and to prevent alveolar collapse at end-expiration.
What happens if there is no surfactant?
Without normal surfactant, the tissue surrounding the air sacs in the lungs (the alveoli) sticks together (because of a force called surface tension) after exhalation, causing the alveoli to collapse.
What increases the production of surfactant?
Surfactant secretion can be stimulated by a number of mechanisms. Type II cells have beta-adrenergic receptors and respond to beta-agonists with increased surfactant secretion . Mechanical stretch such as lung distension and hyperventilation, have also been found to be involved in stimulating surfactant secretion.
Which babies are at risk of RDS?
RDS occurs most often in babies born preterm, affecting nearly all newborns who are born before 28 weeks of pregnancy. Less often, RDS can affect full term newborns. RDS is more common in premature newborns because their lungs are not able to make enough surfactant.
Where is surfactant found?
Abstract. Pulmonary surfactant is a complex and highly surface active material composed of lipids and proteins which is found in the fluid lining the alveolar surface of the lungs.
What are examples of surfactants?
Sodium stearate is a good example of a surfactant. It is the most common surfactant in soap. Another common surfactant is 4-(5-dodecyl)benzenesulfonate. Other examples include docusate (dioctyl sodium sulfosuccinate), alkyl ether phosphates, benzalkaonium chloride (BAC), and perfluorooctanesulfonate (PFOS).
Is soap a surfactant?
Soaps and detergents are made from long molecules that contain a head and tail. These molecules are called surfactants; the diagram below represents a surfactant molecule. The head of the molecule is attracted to water (hydrophilic) and the tail is attracted to grease and dirt (hydrophobic).
What is surfactant and where is it produced?
Surfactant is an agent that decreases the surface tension between two media. The pulmonary surfactant is produced by the alveolar type-II (AT-II) cells of the lungs. It is essential for efficient exchange of gases and for maintaining the structural integrity of alveoli.
Is a surfactant?
Surfactants are compounds that lower the surface tension (or interfacial tension) between two liquids, between a gas and a liquid, or between a liquid and a solid. Surfactants may act as detergents, wetting agents, emulsifiers, foaming agents, or dispersants.
What increases lung compliance?
Compliance also increases with increasing age. Both peak inspiratory and plateau pressure increase when elastic resistance increases or when pulmonary compliance decreases (e.g. during abdominal insufflation, ascites, intrinsic lung disease, obesity, pulmonary edema, tension pneumothorax).
Does surfactant decrease with age?
Results: Changes in lung mechanics, such as increased compliance and decreased airway resistance, were associated with aging but were not affected by exercise. Our data also indicates that surfactant is unaffected by aging and exercise.
Do adults have surfactant?
Surfactant deficiency in adults with acute respiratory distress syndrome has long been recognized. Although clinical trials of surfactant therapy in adults have not achieved the level of success seen in neonates, multiple recent trials have suggested that success is possible.
What causes poor lung compliance?
Common causes of decreased lung compliance are pulmonary fibrosis, pneumonia and pulmonary edema. In an obstructive lung disease, airway obstruction causes an increase in resistance. During normal breathing, the pressure volume relationship is no different from in a normal lung.
What conditions can affect lung compliance?
Compliance is increased in obstructive lung disease like pulmonary emphysema, less in asthma and at a minor degree in chronic bronchitis. In emphysema, the elastic recoil is decreased and the P-V curve is shifted up and left. This is due to the loss of elastic tissue as a result of alveolar wall destruction.