A preterm newborn of 36 weeks of gestation is admitted to the ...

[storky111]

A preterm newborn of 36 weeks of gestation is admitted to the NICU. Approximately 2 hours after birth, the newborn begins having difficulty breathing, with grunting, tachypnea, and nasal flaring. Which is important for the nurse to recognize?
 
  a. This is a normal finding.
  b. This is not significant unless cyanosis is present.
  c. Improvement should occur within 24 hours.
  d. Further evaluation is needed.

Question 2

Which is the central factor responsible for respiratory distress syndrome?
 
  a. Deficient surfactant production
  b. Overproduction of surfactant
  c. Overdeveloped alveoli
  d. Absence of alveoli

[debra928]

Answer to Question 1

ANS: D
Difficulty breathing, with grunting, tachypnea, and nasal flaring are clinical manifestations of respiratory distress syndrome and require further evaluation. This is not a normal finding and requires further evaluation. Cyanosis may be present, but these are significant findings indicative of respiratory distress without cyanosis. The child's condition will most likely worsen for approximately 48 hours without intervention. Improvement may begin at 72 hours.

Answer to Question 2

ANS: A
The successful adaptation to extrauterine breathing requires numerous factors, which most term newborns successfully accomplish. Preterm newborns with respiratory distress are not able to adjust. The most likely central cause is the abnormal development of the surfactant system. The deficient production of surfactant results in unequal inflation of alveoli on inspiration and the collapse of the alveoli on end expiration. The number and state of development of the alveoli is not a central factor in respiratory distress syndrome. The instability of the alveoli related to the lack of surfactant is the causative issue.

[storky111]

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