Question 1

Your patient has RDS. What clinical manifestations are associated with the more negative intrapleural pressures needed during inspiration?
1) See-saw breathing movement
2) Vesicular breath sounds
3) Pulmonary edema
4) Dependent thoracic areas are cyanotic

A)1, 4
B)2, 4
C)1, 2, 3
D)1, 2, 3, 4

1, 4

Accepted Answer

The see-saw breathing movement is a clinical manifestation of increased work of breathing due to the negative intrapleural pressures needed during inspiration. The dependent thoracic areas may also become cyanotic due to inefficient ventilation, which requires more force to be applied for inspiration. Vesicular breath sounds and pulmonary edema are not directly related to the increased negative intrapleural pressures seen in RDS.

Question 2

All of the following amniotic fluid lab findings would indicate mature fetal lungs, EXCEPT:&#10;A) S:A ratio is >55&#10;B)PG is present&#10;C)L:S ratio is 2:1&#10;D)L:S ratio is 1:2

Accepted Answer

A mature fetal lung is indicated by an L:S ratio of greater than 2:1. The other three choices indicate immature lungs. The S:A ratio should be less than 35, the presence of PG indicates surfactant production but not necessarily mature lungs, and an L:S ratio of 1:2 indicates a high risk for respiratory distress syndrome.

Question 3

What special environmental concerns are there with a neonate with RDS in order to avoid compromising its oxygenation?&#10;A) Keep a normal body temperature&#10;B)Shine bilirubin lights on the neonate&#10;C)Keep the infant cool&#10;D)Humidify the inhaled oxygen

Accepted Answer

Maintaining a normal body temperature is crucial for neonates with RDS to prevent additional stress and oxygen consumption.

Question 4

What is the primary cause of RDS in the newborn?&#10;A) Underdevelopment of alveolar type I cells&#10;B)Deficiency or abnormality of pulmonary surfactant&#10;C)Hypoxia causing pulmonary hypoperfusion&#10;D)Excessive amniotic fluid in the lungs

Accepted Answer

Deficiency or abnormality of pulmonary surfactant is the primary cause of RDS in the newborn. Surfactant helps to reduce surface tension in the alveoli and prevent their collapse. In the absence of surfactant, the alveoli collapse and cause respiratory distress.

Question 5

Which of the following are usually seen in the lungs of a neonate with RDS?&#10;A) Alveolar collapse (atelectasis)&#10;B)Segmental atelectasis&#10;C)Lobar atelectasis&#10;D)Pulmonary fibrosis

Accepted Answer

Alveolar collapse (atelectasis) is a common feature of respiratory distress syndrome (RDS) in neonates. Segmental or lobar atelectasis may also occur, but alveolar collapse is more commonly observed. Pulmonary fibrosis is not typically seen in RDS.

Question 6

Your patient with RDS has alveolar hypoxia and pulmonary vasoconstriction. How will this affect his blood flow?
1) Blood shunts through the foramen ovale
2) Increased systemic blood flow
3) Blood shunts through the ductus arteriosus
4) Decreased blood flow to the gut

A)2, 4
B)1, 3
C)1, 2, 3
D)1, 2, 3, 4

Accepted Answer

In a fetus, blood shunts through the foramen ovale and ductus arteriosus, but in a patient with RDS, these shunts may remain open due to the alveolar hypoxia and pulmonary vasoconstriction. This can lead to decreased blood flow to the gut and increased risk for pulmonary hypertension, but not increased systemic blood flow. Therefore, only option B is correct.

Question 7

What vascular anatomic alteration could occur as a consequence of hypoxia in your RDS patient?&#10;A) Closure of the ductus arteriosus&#10;B)Transient pulmonary hypertension&#10;C)Increased flow through the ductus venosus&#10;D)Airway mucosal edema

Accepted Answer

Hypoxia can cause vasoconstriction in the pulmonary blood vessels, leading to an increase in pulmonary vascular resistance and ultimately pulmonary hypertension. This is a common complication in neonates with respiratory distress syndrome. Closure of the ductus arteriosus increases pulmonary blood flow and is not a consequence of hypoxia. Increased flow through the ductus venosus is not related to hypoxia. Airway mucosal edema is a consequence of inflammation and is not directly related to hypoxia.

Question 8

Which of the following are associated with an increased risk of developing RDS?
1) Low birth weight infant
2) Prenatal asphyxia
3) Maternal bleeding
4) Second-born twin

A)1, 2
B)3, 4
C)2, 3, 4
D)1, 2, 3, 4

Accepted Answer

All of the listed conditions, and others, increase the risk of the neonate developing RDS.

Question 9

The respiratory pattern of a neonate with RDS will have these characteristics:
1) Respiratory rate of about 50/min
2) Respiratory rate of >60/min
3) Cyclical breathing pattern
4) Hard and deep breaths

A)1
B)2, 3
C)1, 4
D)2, 4

Accepted Answer

Neonates with Respiratory Distress Syndrome (RDS) typically have a respiratory rate greater than 60/min and exhibit hard and deep breaths due to difficulty in breathing.

Question 10

Respiratory distress syndrome (RDS) primarily affects infants who are:&#10;A) pre-term with insufficient surfactant.&#10;B)full-term.&#10;C)post-term with too much surfactant.&#10;D)pre-term with too much surfactant.

Accepted Answer

Respiratory distress syndrome primarily affects infants who are pre-term with insufficient surfactant. Surfactant is a substance that helps keep the air sacs in the lungs from collapsing. If an infant is born prematurely, their lungs may not have produced enough surfactant, which makes it difficult for them to breathe.

Question 11

Management of a neonate with RDS may include:
1) CPAP
2) Instilling surfactant into the lungs
3) Mechanical ventilation
4) Supplemental oxygen

A)2
B)1, 3
C)2, 3, 4
D)1, 2, 3, 4

Accepted Answer

The answer of Management of a neonate with RDS may...

Question 12

A mother is about to deliver a 25 weeks' gestation infant. As the respiratory therapist in the delivery room, what therapeutic intervention should you be prepared to give to minimize the risk of RDS?&#10;A) Mask CPAP&#10;B)Airway suctioning&#10;C)Exogenous surfactant&#10;D)Mechanical ventilation

Accepted Answer

The answer of A mother is about to deliver a...

Question 13

The neonate with RDS would have a phosphatidylglycerol (PG) level that is&#10;A) present.&#10;B)absent.&#10;C)above normal.&#10;D)below normal.

Accepted Answer

The answer of The neonate with RDS would have a...

Question 14

It is likely that a neonate with RDS will have the following chest radiograph finding:&#10;A) airway dilation and distortion.&#10;B)fluffy infiltrates in the bases of the lungs.&#10;C)ground-glass appearance.&#10;D)cardiomegaly.

Accepted Answer

The answer of It is likely that a neonate with...

Question 15

The hyaline membrane seen in the alveoli of a neonate with RDS is similar to the anatomic alteration found in what other pulmonary disease?&#10;A) Bacterial pneumonia&#10;B)Pulmonary fibrosis&#10;C)Acute respiratory distress syndrome (ARDS)&#10;D)Meconium aspiration syndrome (MAS)

Accepted Answer

The answer of The hyaline membrane seen in the alveoli...

Deck 34: Respiratory Distress Syndrome