Deck 42: Medical Nutrition Therapy for Low-Birth-Weight Infants

Question 1

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 1

B
Because premature infants have stomachs with very limited capacity, residual checks are necessary when feeding these infants 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 feedings 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 2

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.

Answer 2

A
Because parenteral nutrition bypasses the gastrointestinal tract, no loss of energy occurs because of energy cost of digestion and absorption and the inefficiency of absorption.As a result, infants receiving parenteral nutrition require less energy intake than those being fed enterally.Enterally fed premature infants need 105 to 130 kcal/kg, and parenterally fed premature infants need 90 to 100 kcal/kg.

Question 3

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.

Answer 3

D
Transitioning of feedings must be performed slowly to accommodate the LBW infant's ability to tolerate either feeding modality.If parenteral nutrition is the primary source of nutrition for the infant, parenteral nutrition must be maintained until the infant tolerates an adequate volume of enteral formula to maintain nutritional status.For VLBW infants, this process may take 7 to 10 days for the transition to occur.Stable infants may be able to tolerate enteral feeding advances of 20 to 30 ml/kg/day.Enteral feeding is never started at full volume because prior disuse of the gastrointestinal tract leaves it unprepared for mature digestion and absorption.Stopping parenteral nutrition completely may result in fluid and electrolyte imbalances and hypoglycemia.

Question 4

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

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

Question 5

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

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

Question 6

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

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

Question 7

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 postpartum.

Question 8

The total of IV lipid in an LBW infant is generally

A)25% to 40% of nonprotein calories.
B)10 g/kg/day.
C)10% to 15% of nonprotein calories.
D)60% of nonprotein calories.

Question 9

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

Question 10

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 11

An infant has a birth weight below the 10th percentile, but her linear growth and head growth are between the 10th and 90th percentiles.This infant would be classified as

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

Question 12

Which of the following is a fluid loss that is preventable in the care of low birthweight (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 NOT adequately provided to preterm infants through the use of human milk fortifiers?

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

Question 14

After discharge, most preterm infants need approximately _______ ml/kg/day of breastmilk or standard infant formula.

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

Question 15

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 16

Low birth weight is defined as birth weight

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

Question 17

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

A)Premature infant formula may provide 24 kcal/oz.
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 18

Human milk

A)has a different composition in the mothers of preterm infants.
B)has zinc and iron that is more readily absorbed.
C)has hormones.
D)all of the above.

Question 19

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

Question 20

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