Deck 43: Medical and Nutrition Therapy for Low-Birth-Weight Infants

Question 1

Which of the following must be supplemented to preterm infants fed parenterally or fed human milk to prevent the development of osteopenia?

A)Protein
B)Calcium and phosphorus
C)Vitamins A and D
D)All fat-soluble vitamins

Answer 1

B
Osteopenia of prematurity results from early birth because two-thirds of the calcium and phosphorus body content is accumulated in term infants during the last trimester of pregnancy.Prematurity results in lower calcium and phosphorus stores.Although both parenteral nutrition and human milk provide calcium and phosphorus, the amount of these nutrients is not enough to build up the stores in the infant.Parenteral nutrition cannot provide increased calcium and phosphorus because at high levels, these can precipitate out into crystals that make the minerals unavailable to infant and could block the access site.Human milk needs to be fortified to provide for the additional calcium and phosphorus needs of premature infants.

Question 2

Gastric residuals should be checked when feeding an LBW infant by bolus gavage feeding

A)1 hour after each feeding.
B)before each feeding.
C)once each day at the same time.
D)when abdominal distension is suspected.

Answer 2

B
Because premature infants have stomachs with very limited capacity, residual checks are necessary when feeding these infant through a tube to ensure that an obstruction has not occurred.When providing bolus gavage feeding, aspiration of stomach contents for gastric residuals should be performed before the feeding starts.If residuals are found, depending on the volume in relation to the last time of feeding, continued feeding may need to be held off.When providing feedings via continuous drip, intermittent checks for gastric residuals should be performed to ensure that gastric emptying is occurring.

Question 3

Compared with term infants, preterm infants have an increased need for vitamin

A)A.
B)C.
C)D.
D)E.

Answer 3

A
Preterm infants need more vitamin A compared with term infants.The reasons for this increased need for facilitating tissue repair and because preterm infants have low vitamin A stores.Vitamin A is suggested for the prevention of BPD.

Question 4

After discharge, most preterm infants need approximately _______mL/kg/day of breast milk or standard infant formula

A)124
B)120
C)180
D)250

Question 5

How much fluid should be provided to an LBW infant during the first day of life?

A)40 to 85 mL/kg
B)50 to 100 mL/kg
C)80 to 105 mL/kg
D)1000 mL total

Question 6

An infant born at 32 weeks' gestation is now 6 months old.Her adjusted age is _____ months.

A)6
B)4
C)3
D)2

Question 7

It is appropriate to use caloric supplements such as glucose polymers or MCT for

A)all infants requiring catch-up growth.
B)infants whose nutrient needs are being met with the exception of energy.
C)small-for-gestational-age infants until they has reached acceptable weight for age.
D)infants receiving inadequate protein.

Question 8

Low birth weight is defined as birth weight

A)less than 1000
B)less than 1500
C)less than 2500 g.
D)for age less than the 10th percentile.

Question 9

Which of the following helps promote better feeding of a premature infant after being discharged from the hospital?

A)Attracting the infant's attention with toys
B)Playing with the infant at feeding time
C)Supporting the infant's body during feeding
D)Feeding while playing age-appropriate DVDs

Question 10

An infant has a birth weight below the 10th percentile, but her linear and head growths are between the 10th and 00th percentiles.This infant would be classified as

A)AGA.
B)SGA with asymmetric IUGR.
C)SGA with symmetric IUGR.
D)only SGA.

Question 11

Which of the following is NOT adequately provided to preterm infants through the use of human milk fortifiers?

A)Zinc
B)Calcium
C)Phosphorus
D)Iron

Question 12

Which of the following is a fluid loss is preventable in the care of low-birth-weight (LBW) infants?

A)Insensible water loss caused by increased permeability of the skin
B)Insensible water loss caused by radiant warmers
C)Sensible water loss caused by an inability to concentrate urine
D)Insensible water loss caused by a larger surface area relative to body weight

Question 13

Which of the following is the recommendation for administration of IV fat emulsion to an LBW infant?

A)Provide at least 40% of nonprotein calories.
B)Do not exceed 60% of nonprotein calories.
C)Provide 10% to 15% of nonprotein calories.
D)Provide only the 10% emulsion.

Question 14

Which of the following is NOT one of the characteristics that makes premature infant formula different from standard infant formula?

A)Premature infant formula may provide 24 kcal per ounce.
B)Premature infant formula provides more casein than whey protein.
C)Premature infant formula provides MCT oil.
D)Premature infant formula provides more sodium.

Question 15

Infants begin to gain weight above their birth weight

A)by the end of the first day postpartum.
B)within 48 to 72 hours postpartum.
C)by the end of the first week postpartum.
D)by 2 to 3 weeks post partum.

Question 16

The metabolic rate of the premature newborn is _____ kcal/kg/day.

A)30
B)50
C)90
D)105

Question 17

Which of the following may contribute to dehydration in a premature infant?

A)Hypoglycemia
B)Hypercholesterolemia
C)Hyperglycemia
D)Hypovolemia

Question 18

Which of the following procedures should be used in the transition from parenteral to enteral feedings with an LBW infant?

A)Advance to enteral feeding as quickly as possible.
B)Begin full-volume enteral feeding.
C)Stop parenteral feeding until enteral feeding is well established.
D)Maintain parenteral feeding until enteral feeding is well established.

Question 19

The energy needs of a premature infant fed parenterally differ from those of a premature infant fed enterally because parenterally fed infants

A)require less energy per kilogram of body weight.
B)require an equal amount of energy per kilogram of body weight.
C)require more energy per kilogram of body weight.
D)have very erratic energy requirements.

Question 20

Because of a preterm infant's decreased ability to concentrate urine, in which of the following should sodium concentration be monitored regularly?

A)Serum
B)Urine
C)Stool and urine
D)Urine and serum