Neonate with retrolental fibroplasia is associated with?

RUHS, Jaipur, PB B.Sc Nursing Entrance-2018

Child Health Nursing (Pediatrics)

Easy

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2018

Explanation

Retrolental fibroplasia is the older term for Retinopathy of Prematurity (ROP), a disease affecting the eyes of premature infants.
ROP is caused by hyperoxenaemia (also spelled hyperoxemia), which refers to excessively high levels of oxygen in the blood.
The high oxygen concentration causes initial constriction and later abnormal, fragile growth of retinal blood vessels, which can lead to scarring and retinal detachment.
This process is a well-documented complication of oxygen therapy in neonates, especially those born very prematurely.

Option A: Hypoxia, a state of low oxygen in the tissues, is the opposite of the condition that causes ROP. While hypoxia is dangerous and can lead to other forms of organ damage like hypoxic-ischemic encephalopathy (HIE), it does not cause the specific vascular changes of ROP.
Option B: Hypocapnea is a state of low carbon dioxide (CO2) in the blood. It is primarily associated with an increased risk of brain injury in preterm infants, specifically periventricular leukomalacia (PVL), due to cerebral vasoconstriction. It is not a cause of ROP.
Option C: Hypoxenaemia (also spelled hypoxemia) means low oxygen levels in the arterial blood. Like hypoxia, this is the opposite of the condition that causes ROP. ROP is a disease of oxygen toxicity, not oxygen deficiency.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pathophysiology of Retinopathy of Prematurity (Retrolental Fibroplasia) as background academic context rather than a clinical decision trigger.
The nurse's role in preventing ROP is critical. It involves meticulous management of oxygen therapy, including using blenders, titrating FiO2 carefully, and responding promptly to pulse oximetry alarms to avoid hyperoxia.
All extremely premature infants require routine screening for ROP by an ophthalmologist. The nurse is responsible for ensuring these screenings are scheduled and performed according to hospital protocol.
Patient safety depends on understanding that oxygen is a drug with a narrow therapeutic window in premature infants. Too little causes hypoxia and organ damage, while too much causes ROP and lung injury (bronchopulmonary dysplasia).

How to Approach the Question

First, identify the key term in the question: 'retrolental fibroplasia'.
Recall or recognize that this is an older name for Retinopathy of Prematurity (ROP).
Access your knowledge about the causes of ROP. The most well-known cause is oxygen toxicity in premature infants.
Analyze the options provided. 'Hyperoxenaemia' means high oxygen in the blood.
Contrast this with the other options: 'Hypoxia' and 'Hypoxenaemia' mean low oxygen, and 'Hypocapnea' means low carbon dioxide.
Conclude that hyperoxenaemia is the term that describes the oxygen toxicity responsible for ROP.

Concept Tested & Keywords

Concept Tested: Pathophysiology of Retinopathy of Prematurity (Retrolental Fibroplasia)
Stem keywords: Neonate, retrolental fibroplasia
Lead-in keywords: associated with

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E6 Obstetrics Williams p. 28-48

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1071-1073