The High-Risk Infant

Question 1

The highest risk of neonatal mortality occurs in infants whose weight ___ at birth and whose AOG ___

Answer 1

Less than 1000g, less than 28 weeks

Question 2

Lowest risk of neonatal mortality occurs in infants whose birthweight ___ and AOG ___

Answer 2

3000-4000g, 38-42 weeks

Question 3

Criteria for fetal transfusion syndrome

Answer 3

1) Difference of 5 g/dl hgb 2) Difference of 20% body weight

Question 4

Criteria for monovular twins

Answer 4

1) Same sex 2) Features obviously alike 3) Same hair color, texture, curliness 4) Same color and shade of eyes 5) Same skin texture and color 6) Same conformation and size of hands and feet 7) Close anthropometric agreement

Question 5

Symmetric vs asymmetric IUGR: Earlier onset

Answer 5

Symmetric

Question 6

Symmetric vs asymmetric IUGR: Associated with diseases that seriously affect fetal cell number

Answer 6

Symmetric

Question 7

Symmetric vs asymmetric IUGR: Associated with poor maternal nutrition

Answer 7

Asymmetric

Question 8

Symmetric vs asymmetric IUGR: Associated with exacerbation of maternal vascular disease such as preeclampsia and chronic htn

Answer 8

Asymmetric

Question 9

T/F: Survival rate of LBW and sick infants is higher when they are cared for at or near their neutral thermal environment

Answer 9

T

Question 10

Optimal environmental temp for minimal heat loss and O2 consumption for an unclothed infant is one that maintains the infant’s core temp at ___

Answer 10

36.5-37C

Question 11

Very premature infants (less than 1000g) may lose as much as ___ml/kg/hr

Answer 11

2-3

Question 12

A larger premature infant (2000-2500g) may have an insensible water loss of approximately ___ml/kg/hr

Answer 12

0.6-0.7

Question 13

Fluid intake in term infants is usually begun at ___ on day 1

Answer 13

60-70ml/kg

Question 14

Smaller more premature infants may need to start with ___ fluid intake on day 1

Answer 14

70-80

Question 15

For TPN, infusate should contain ___ synthetic amino acids and usually ___ glucose

Answer 15

2.5-3.5g/dL, 10-15g/dL

Question 16

The process of oral alimentation requires a synchronized process that is usually absent before ___

Answer 16

34 weeks of gestation

Question 17

___ is the practice of feeding very small amounts of enteral nourishment to VLBW preterm infants to stimulate development of the immature GIT

Answer 17

Trophic feeding

Question 18

Benefits of trophic feeding

Answer 18

1) Enhanced gut motility 2) Improved growth 3) Decreased need for parenteral nutrition 4) Fewer episodes of sepsis 5) Shortened hospital stay

Question 19

For infant less than 1000g, initial trophic feeding can be given at ___ then increased to ___

Answer 19

10-20ml/kg/24h for 5-10 days, 20-30 ml/kg/24hr

Question 20

While ongoing trophic feeding in infants , IV fluids are needed until feedings provide ___

Answer 20

120ml/kg/24h

Question 21

For infants >1500g, feeding is initiated at a volume of ___ with increments of ___

Answer 21

20-30ml/kg/24h, 20-30ml/kg/24h

Question 22

Vitamin ___ supplementation reduces BPD in ELBW infants

Answer 22

A

Question 23

Iron stores, even in a VLBW neonate, are usually adequate until ___

Answer 23

An infant’s BW has doubled

Question 24

Iron supplementation in VLBW neonates should be started when BW has doubled at a dose of

Answer 24

2ml/kg/24h

Question 25

Factors that increase the chance of survival among premature infants

Answer 25

1) Antenatal steroids 2) Female sex 3) Singleton pregnancy

Question 26

Prior to discharge of a premature infant, growth should be occurring at steady increments of ___

Answer 26

30g/day