Baby Melody is a neonate who has a very-low-birth-weight. Nurse Josie carefully monitors inspiratory pressure and oxygen (O2) concentration to prevent which of the following?
A. Meconium aspiration syndrome
B. Bronchopulmonary dysplasia (BPD)
C. Respiratory syncytial virus (RSV)
D. Respiratory distress syndrome (RDS)
Correct Answer: B. Bronchopulmonary dysplasia (BPD)
Close monitoring of inspiratory pressure and O2 concentration is necessary to prevent BPD, which is related to the use of high inspiratory pressures and O2 concentrations especially in very-low-birth-weight and extremely low-birth-weight neonates with lung disorders. Injury from mechanical ventilation and reactive oxygen species to premature lungs in the presence of antenatal factors predisposing the lungs to BPD form the basis of pathogenesis of BPD in preterm neonates.
Option A: Meconium aspiration syndrome is a respiratory disorder created by the aspiration of meconium in the perinatal period. Meconium aspiration syndrome (MAS) is the neonatal respiratory distress that occurs in a newborn in the context of MASF when respiratory symptoms cannot be attributed to another etiology.
Option C: RSV is a group of viruses that cause respiratory tract infections, such as bronchiolitis and pneumonia. The most common clinical scenario encountered in RSV infection is an upper respiratory infection, but RSV commonly presents in young children as bronchiolitis, a lower respiratory tract illness with small airway obstruction, and can rarely progress to pneumonia, respiratory failure, apnea, and death.
Option D: RDS, a disorder caused by lack of surfactant, usually is found in premature neonates. RDS primarily affects preterm neonates, and infrequently, term infants. The incidence of RDS is inversely proportional to the gestational age of the infant, with more severe disease in the smaller and more premature neonates.