High concentration of oxygen administration in premature infants can cause:

AIIMS Raipur NO- 2019 (shift 3rd)

Child Health Nursing (Pediatrics)

Easy

Appeared in: AIIMS Raipur NO- 2019 (shift 3rd)

Explanation

High concentrations of oxygen (hyperoxemia) administered to premature infants are a primary cause of Retrolental Fibroplasia, also known as Retinopathy of Prematurity (ROP).
The pathophysiology involves a two-stage process in the infant's immature retina.
First, high oxygen levels cause vasoconstriction and obliteration of the developing retinal blood vessels.
Subsequently, when oxygen levels are lowered, the relative hypoxia stimulates an overgrowth of abnormal new blood vessels (neovascularization).
These fragile new vessels can leak, cause scarring, and lead to retinal detachment and blindness.

Option A: Oxygen toxicity is a general term for harm caused by breathing too much oxygen. While technically correct, Retrolental Fibroplasia is the more specific and classic disease process that occurs in the eyes of premature infants due to hyperoxia.
Option C: Apnea of prematurity is primarily caused by the immaturity of the infant's central nervous system and its respiratory control center, not directly by the administration of high-concentration oxygen.
Option D: Respiratory Distress Syndrome (RDS) is the underlying condition that necessitates oxygen therapy in premature infants. It is caused by a deficiency of surfactant in their immature lungs, not by the oxygen treatment itself.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Complications of oxygen therapy in premature infants as background academic context rather than a clinical decision trigger.
Nurses are at the forefront of preventing ROP through meticulous management of oxygen therapy. This includes vigilant monitoring of oxygen saturation levels (SpO₂) and ensuring they remain within the narrow target range set by the neonatal care team.
It is a critical nursing responsibility to advocate for and participate in the gradual weaning of oxygen as the infant's condition stabilizes to minimize the duration of hyperoxic exposure.
Ensuring that at-risk infants (especially those born very prematurely or requiring prolonged oxygen) undergo scheduled ophthalmology screenings is a key patient safety and care coordination task.

How to Approach the Question

First, identify the key elements of the question: the intervention is 'high concentration of oxygen' and the patient population is 'premature infants'.
This is a factual recall question that tests knowledge of specific complications in a vulnerable population.
Consider each option. Differentiate between the underlying disease (RDS) and the complications of its treatment.
Recognize that 'Oxygen toxicity' is a broad category, while 'Retrolental fibroplasia' is a very specific, classic complication directly linked to oxygen use in premature infants.
Recall the pathophysiology: high oxygen damages the immature retinal vessels. This direct link makes Retrolental fibroplasia the most precise and best answer.

Concept Tested & Keywords

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E6 Obstetrics Williams pp. 28-48, 25-43