High Risk Newborn

Explanation
A newborn presenting with extreme prematurity, critical illness, and needing surgical intervention should be treated at a Level 3 NICU. Level 3 NICUs are equipped to provide comprehensive care for critically ill newborns, including access to advanced medical technology, specialized surgical services, and a multidisciplinary team of healthcare professionals. These NICUs have the capability to manage complex medical conditions and provide advanced respiratory support, surgical interventions, and specialized neonatal care.

Explanation
Preterm infants have the highest mortality rate because they are born before completing the full term of gestation, which means they may not have fully developed organs and are more susceptible to complications. SGA (small for gestational age) infants have a lower birth weight compared to other infants of the same gestational age, but their mortality rate is not as high as preterm infants. LGA (large for gestational age) and AGA (appropriate for gestational age) infants have normal or higher birth weights for their gestational age, so their mortality rates are lower compared to preterm and SGA infants.

Explanation
The main assessments for a high-risk newborn include monitoring vital signs to ensure their overall health and well-being, assessing the risk for infection to prevent any potential complications, providing proper skin care to maintain skin integrity and prevent any skin-related issues, and emphasizing the importance of hand washing to minimize the risk of infection transmission. These assessments are crucial in identifying any potential problems and ensuring appropriate care for the newborn.

Explanation
RDS, also known as respiratory distress syndrome, is characterized by poor nutrition, impaired gas exchange, lack of exercise, and ventilation failure. Poor nutrition can contribute to the development of RDS as it may lead to inadequate lung development. Impaired gas exchange occurs in RDS due to the inability of the lungs to properly oxygenate the blood. Lack of exercise can worsen the condition by limiting lung expansion and impairing respiratory function. Ventilation failure refers to the inability of the lungs to effectively remove carbon dioxide from the body. High blood sugar, although not mentioned in the answer choices, is not directly associated with RDS.

Explanation
The symptoms described in the question, such as tachypnea, retractions, labored breathing, substernal retractions, rales, expiratory grunting, nasal flaring, and cyanosis, are consistent with respiratory distress syndrome (RDS). RDS is a condition that occurs in newborns, especially premature infants, due to the insufficient production of surfactant in the lungs. This leads to difficulty in expanding the lungs and exchanging oxygen and carbon dioxide, resulting in the symptoms mentioned. Therefore, the correct answer is RDS.

Explanation
The L/S (lecithin/sphingomyelin) ratio is a diagnostic measurement used to assess the maturity of the lungs in a fetus. A 1:1 ratio indicates that the lungs are mature and have enough surfactant, a substance that helps to keep the air sacs in the lungs open. RDS (respiratory distress syndrome) is a condition that occurs in premature infants who do not have enough surfactant, leading to difficulty in breathing. Therefore, a low L/S ratio is indicative of a lack of surfactant related to RDS.

Explanation
Atectasis is the correct answer because it refers to the clinical condition where a portion of the lung collapses. This can occur due to various reasons such as blockage of the airways, lung tissue scarring, or pressure on the lung from outside. Atectasis can lead to symptoms like shortness of breath, coughing, and chest pain. Treatment involves addressing the underlying cause and may include techniques to re-expand the collapsed lung tissue.

Explanation
Monitoring blood glucose is not a treatment for RDS. RDS, or respiratory distress syndrome, is a condition primarily affecting premature infants where the lungs are not fully developed. The interventions listed, such as thermoregulation, oxygen administration, mechanical ventilation, CPAP, administration of surfactant, and correcting respiratory and metabolic acidosis, are all aimed at supporting the infant's respiratory function. Monitoring blood glucose, on the other hand, is not directly related to treating RDS but may be necessary to assess the infant's overall health and manage any potential complications.