Neonatal Nurse Practitioner Practice Exam

What is a primary risk factor for cholestasis in premature infants?

1. Hypercalcemia

2. Long term parenteral nutrition

3. Structural renal disease

4. Hypoglycemia

The correct answer is: Long term parenteral nutrition

Long-term parenteral nutrition is a primary risk factor for cholestasis in premature infants due to the nature and composition of the nutrition provided. When infants receive parenteral nutrition, particularly for extended periods, they may experience a disruption in normal liver function. The presence of high concentrations of certain lipids and other nutrients in the intravascular system can lead to bile stasis, inflammation, and damage to the biliary system, resulting in cholestasis. In premature infants, the liver is often immature, making them particularly susceptible to the effects of parenteral nutrition. They may not metabolize certain components as efficiently as term infants, leading to an accumulation of bile acids in the liver. This can ultimately inhibit bile flow and contribute to cholestatic liver disease. Other options, while they can pose risks in different contexts, do not have the same direct link to cholestasis in premature infants as long-term parenteral nutrition does. Hypercalcemia primarily affects calcium metabolism and is more associated with specific disorders, structural renal disease involves anatomical anomalies affecting kidney function, and hypoglycemia is related more to glucose management rather than biliary function. Therefore, among the given choices, long-term parenteral nutrition is the most significant risk factor