Oxygen toxicity in pre-term babies causes?

DSSSB - 28 August 2019 (Shift-1)

Pediatric Nursing

Easy

Appeared in: DSSSB - 28 August 2019 (Shift-1)

Explanation

Oxygen toxicity in preterm infants directly causes Retrolental Fibroplasia, also known as Retinopathy of Prematurity (ROP).
High concentrations of oxygen damage the immature retinal blood vessels, leading to initial vasoconstriction and vessel obliteration.
This is followed by a phase of abnormal new vessel growth (neovascularization) which can lead to scarring, retinal detachment, and blindness.
The image provided shows the classic fundoscopic findings of ROP, including tortuous and dilated vessels.

Option A: Respiratory Distress Syndrome (RDS) is caused by a deficiency of surfactant in the immature lungs of a preterm infant, leading to alveolar collapse and difficulty breathing.
Option C: Neonatal sepsis is a systemic blood infection caused by pathogens like bacteria or viruses.
Option D: Neonatal hypoglycemia is a condition of low blood sugar. Common causes include prematurity, maternal diabetes, and infection.

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 in the NICU play a critical role in preventing ROP by meticulously monitoring and titrating oxygen saturation levels to keep them within prescribed target ranges, avoiding both hypoxia and hyperoxia.
This involves using pulse oximetry continuously, ensuring proper probe placement, and responding to alarms promptly.
What if? If the infant required high levels of oxygen for severe Respiratory Distress Syndrome (RDS), the nurse's role becomes even more critical. They must balance the need for adequate oxygenation to prevent brain and organ damage against the risk of causing ROP. This requires constant vigilance, frequent blood gas analysis, and collaboration with the medical team to wean oxygen as quickly as is safe.

How to Approach the Question

First, identify the key concepts in the question: 'Oxygen toxicity' and 'pre-term babies'.
Next, analyze the provided image. Observe the abnormal, twisted blood vessels in the eye, which is a hallmark sign of a specific retinal disease in infants.
Recall the major complications associated with prematurity and the therapies used in the NICU, such as oxygen administration.
Evaluate each option. Differentiate between conditions that are treated with oxygen (like Respiratory Distress Syndrome) and those that are caused by excessive oxygen.
Connect the visual evidence from the image with the known pathophysiology of the options. The image strongly suggests Retinopathy of Prematurity (Retrolental Fibroplasia).
Select the option that is a direct and well-documented complication of hyperoxemia in the preterm population.

Concept Tested & Keywords

Concept Tested: Complications of oxygen therapy in premature infants
Stem keywords: Oxygen toxicity, pre-term babies
Lead-in keywords: causes
Clinical cues: The image shows the fundus of an eye with abnormal, tortuous blood vessels, which is characteristic of Retinopathy of Prematurity.

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E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 465-467

E6 Obstetrics Williams p. 28-48