NB at risk 3

Question 1

congenital hydrocephalus-3

Answer 1

measure occipital-frontal circumferance daily, check fontanelles for swelling, gel pillow under head

Question 2

cleft palate-4

Answer 2

side lie pos, feed upright pos, special nipples, burp q 1 oz

Question 3

tracheoesophageal fistula-4

Answer 3

can’t pass NG tube, elevate head, keep calm, resp and fl balance

Question 4

diaphragmatic hernia-2

Answer 4

semi high fowler, turn on affected side

Question 5

omphalocele-2

Answer 5

sterile bag, intestines in membrane

Question 6

gastroschisis-3

Answer 6

sterile bag, side lie, don’t cover w wet gauze

Question 7

prune belly syndrome

Answer 7

missing abdominal muscle layer

Question 8

myelomeningocele-5

Answer 8

cyst containing meninges, spinal cord, and nerve roots, pos on abdo or side, clean butt and genitals after void, cover cyst with plastic, no wet gauze

Question 9

NB w cong heart defect s/s-4

Answer 9

cyanosis in healthy NB 12-24 hrs w no resp distress and not resolved with O2
-cyanosis, heart murmur, CHF

Question 10

patent ductus arteriosus-3

Answer 10

murmur in left sternal border, increase difference b/t sys and dia, bounding peripheral pulse, mom rubella
-high pulmonary flow

Question 11

atrial septal defect-2

Answer 11

higher in females, initially asymptomatic

-high pulmonary flow

Question 12

ventricle septal defect-3

Answer 12

higher in males, initial no s/s, spontaneous close in first 2 years
-high pulmonary flow

Question 13

coarctation of aorta-2

Answer 13

narrow aortic lumen, absent/diminished femoral pulses

-obstruction of sys blood flow

Question 14

hypoplastic left heart syndrome-3

Answer 14

normal at birth, diminshed pulses, thick wall left vent

-obstruction to systemic blood flow

Question 15

tetralogy of fallout-5

Answer 15

boot shape, pulmonary stenosis, right ventricular hypertrophy, ventricular septal defect, overriding aorta
-low pulmonary blood flow

Question 16

transposition of great vessels-4

Answer 16

higher in females, DM mom, LGA

• aorta originates from rt vent and pulmonary art from left vent resulting in parallel circulation sys, “egg on it’s side”
• mixed defect

Question 17

alocohol dependent mom-5

Answer 17

fetal alcohol syndrome, alcohol related birth defects (no facial), alcohol rel neurodevelopment disorder- delay in feed, fetal alcohol spectrum disorder

Question 18

alcohol dependance ass-4

Answer 18

abnormal structural development and CNS d/o, growth def, face abnormal
-w/d s/s 3-12 hrs up to 18mo

Question 19

opiate dependancy complications-8

Answer 19

intrauterine asphysxia, intrauterine infection, IUGR, low APGAR

• naloxone/nalorphine contraindicated
• resp distress, jaundice, cong abnormal and growth restrictions

Question 20

opiate dependancy s/s-5

Answer 20

• w/d 24-48 hrs, meconium analysis, s/s similar to hypogly and hypocal but glu and Ca WNL
• pharmo interventions w 3 consecutive scores above 8
• SIDS increase w heroine and cocaine

Question 21

tobacco complications-5

Answer 21

spontaneous abortion, placenta previa, abruptio placentae, intrauterine hypoxia and ischemia, cotinine factor

Question 22

HIV-2

Answer 22

test after 18 mo, don’t give MMR

Question 23

inborn error of metabolism-4

Answer 23

PKU, congenital hypothyroidism

• musty urine odor
• mental retardation