The nurse is caring for four clients in the neonatal intensive care unit. Which infant has the greatest risk of developing retinopathy of prematurity (ROP)?

Question

1. 28-weeks'-gestation infant who has been on long-term oxygen and weighed 1,400 grams
2. 32-weeks'-gestation infant of African heritage with a congenital heart defect who needed no oxygen and weighed 1,850 grams
3. 28-weeks'-gestation female infant who was on short-term oxygen, weighed 1,420 grams, and was treated with phototherapy
4. 36-weeks'-gestation, small-for-gestational-age infant who was in an oxyhood for 12 hours and weighed 1,800 grams

Answer 1

1
Rationale 1: The 28-weeks'-gestation infant on oxygen weighing 1,400 grams has the greatest risk of retinopathy of prematurity because of gestational age (28 weeks or less), weight (less than 1,600 g), and oxygen therapy.
Rationale 2: The 32-weeks'-gestation infant was not placed on oxygen, and therefore is not at risk. Risk for developing retinopathy of prematurity is lower for infants of African heritage than Caucasian infants. Congenital heart defects are not associated with ROP.
Rationale 3: The 28-weeks'-gestation infant was only placed on short-term oxygen. Phototherapy is associated with hyperbilirubinemia and is not associated with ROP.
Rationale 4: The 36-weeks'-gestation infant was on oxygen for short period of time. A small-for-gestational-age baby would be more mature than an infant of the same weight but lower gestational age.
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