A premature infant has apnea of prematurity accompanied by ...

[mcmcdaniel]

A premature infant has apnea of prematurity accompanied by bradycardia and desaturation. The infant was started on caffeine citrate (Cafcit), and the results from a blood level have just now returned.
 
  The infant's blood level of Cafcit is 2.3 g/mL. What action by the nurse is most appropriate?
  A.
  Allow infant to grow out of the current Cafcit dose.
  B.
  Document results; maintain cardiorespiratory monitor.
  C.
  Inform parents that this blood level is therapeutic.
  D.
  Prepare for immediate intubation and ventilation.

Question 2

A nurse sees a baby whose left arm is in a flexed position and is held in place by pinning the cuff of the baby's T-shirt sleeve to the opposite shoulder. What can the nurse conclude about this baby?
 
  A.
  Broken clavicle
  B.
  Broken wrist
  C.
  Duchenne-Erb paralysis
  D.
  Klumpke paralysis

[hanadaa]

Answer to Question 1

ANS: B
The therapeutic blood level for caffeine citrate (Cafcit) is 5-20 g/mL; therefore, this blood level is subtherapeutic. The nurse should document the results and continue monitoring the infant with the cardiorespiratory monitor. The physician should also be informed so the dose can be adjusted if warranted. The child should not be allowed to outgrow the dose for weaning as the apnea and bradycardia episodes continue. The parents should not be informed that the level is therapeutic because it is not. There is no information leading to a conclusion that the infant needs intubation and mechanical ventilation.

Answer to Question 2

ANS: A
A broken clavicle is often treated by pinning the infant's arm as described. Duchenne-Erb paralysis is a type of brachial plexus injury caused by nerve injury to C5-T1. Klumpke paralysis is another type of brachial plexus injury caused by nerve injury to C5-C7. Wrist fractures in infants are uncommon.

[mcmcdaniel]

Thank you

[hanadaa]

No problemo