SIDS, ALTE (BRUE) Flashcards
What are group is affected by SIDS?
Answer: < 1 years old
What is the MOST important part of the exam to explain cause of death in a patient with SIDS?
Answer: postmortem autopsy
What are often the determined causes of death in a patient with SIDS? SELECT ALL THAT APPLY! A: suffocation B: ingestion C: cardiac arrest D: trauma
A: suffocation B: ingestion C: cardiac arrest D: trauma Answer: all of the above (infection, ingestion, metabolic diseases, cardiac arrhythmias, trauma, accidental suffocation and strangulation – unsafe sleep surfaces)
What age does SUID peak and at what time of day do most deaths occur?
Answer 2-4mo old, most deaths occur at night
What is NOT a risk factor for SUIDs?
Answer: recent immunizations
Should the FNP suspect SUID, what is the MOST consistent finding he/she should be looking for? A: emaciated appearance B: ligature marks on the body C: intrathoracic petechiae D: cyanosis
C: intrathoracic petechiae
Answer: C (Intrathoracic petechiae and mild inflammation / congestion of the respiratory tract: brainstem gliosis, extramedullary
hematopoiesis, increase in peri-adrenal brown fat à suggests infant had intermittent or chronic hypoxia before death)
While providing teaching to a new mother, you as the FNP should include what in your education/discharge teaching?
A: place all infants on the stomach to sleep
B: co-sleeping is not preferred
C: bundle your child to sleep
D: breast feeding, and bottle feeding have the same risks
B: co-sleeping is not preferred
Answer: B (supine sleep position, no co-sleeping, no extra blankets/pillows/soft objects in crib, use form fitted sheet only; breast feeding is better than formula feeding; maternal smoking or drug use cessation; infant over-heating. The FNP must SCREEN ALL INFANTS for SUID risk factors, and be mindful of the childcare setting, where risk factors may not be recognized or addressed)
T or F: ALTEs are due to an insidious onset of change in an infant’s breathing, appearance, or behavior
Answer: False (acute unexpected change – patient will go apneic, appear cyanotic or pallor, limpness in muscle tone, choke or gag)
T of F: ALTEs infants are slightly younger than SIDs infants
Answer: True
T or F: any history of initiation of CPR for an ALTE increases the risk of SIDS
Answer: True
T or F: ALTE is a specific diagnosis
Answer: False (50% remain unexplained and referred to as apnea of infancy)
The MOST frequently identified problems leading to an ALTE is? A: respiratory B: neurological C: cardiovascular D: GI
D: GI
Answer: D (GI (50%), neurologic (30%), respiratory (20%), cardiovascular (5%), and metabolic / endocrine (<5%); also, can be caused by non-accidental trauma)
What is MOST important for the FNP to obtain from parents of patient with suspected ALTE?
Answer: Careful history (duration of event, measures taken to resuscitate the infant, infant’s recovery from event à help determine severity + Physical Exam)
What is the treatment plan for a patient with ALTE?
Answer: Hospitalization for further observation / testing based on history and physical exam
