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41 Cards in this Set
- Front
- Back
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What are the risks for infants with DM mothers?
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Congenital anomalies
Macrosomia Birth trauma and perinatal hypoxia RR distress syndrome Hypoglycemia Hypocalcemia and hypomagnesemia Cardiomyopathy Hyperbiliubinemia and polycythemia (hct >60 - jaundice, slow blood flow, hypoxia and clotting) |
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What is the nursing care for a infant from a DM mother?
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check BG q3hrs for 1st 24hrs
assess for s/s |
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What are the s/s of sepsis?
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non specific
T drops (hypothermia) possibly fever |
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How do you prevent sepsis?
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handwashing
Standard precautions antibiotic instillation into the eye |
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How do you treat sepsis?
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Breast feeding
Med administration if bacteria documented |
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What are the types of alcohol infant problems?
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FAS
Alcohol related neurodevelopental disorders Alcohol related birth defects |
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What is the intervention for substance abuse?
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Assess
Edu to prevent support Rx treatment (try non Rx tx first) Phenonarbitol has least amt of s/e |
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What are the infections for infants?
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Toxoplasmosis
Other (HIV bacteria) Rubella Cytomeglia Infection Herpes (congenital infection) |
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What infants are at risk for infections?
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Preterm infants
Late preterm infants SGA LGA |
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What are the types of preterm infants and LBW infants?
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Moderate: 32-36weeks
Very <32 VLBW <1500g (3lb 5oz) EVLBW <1000g (2.3) |
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What is the growth and development of a preterm infant?
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organ systems immature and lack nutrient reserves
Care needs different Infant not slow, may take 18mo-2yr for them to catch up with normal growth Difficult to predict potential Calculate corrected age (preterm age + postnatal age) until 2.5 yrs old |
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What is a late preterm baby?
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34 0/7 - 36 6/7 weeks
greater cx or death prior to 1yr of age just bec APGAR or weight is low that doesn't mean QOL is going to be bad |
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What are nursing interventions for Preterms?
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maintain body T
O2 therapy (monitor for need) Skin care (inc r/f infection, tears easily) Enviornmental Concerns: dim lighting, keep quiet, cover infant Developmental care Parental adaption (edu) |
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How do you care for an infant who has a NG tube in?
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initially NPO
NG tube check placement and residual - don't want >10% residual (hold feed, check for cause) |
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What are the Cx in preterm infants?
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Respiratory Distress Syndrome
Cx with oxygen therapy Germinal Matrix Hemorrhage- IV Hemorrhage Necrotizing Enterocolitis |
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WHat is RDS and what is the treatment?
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no surfactant making the lungs stiff and unable to expand
Give surfactant Ventilation and O ABG Nutrition |
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What are the cx associated with O therapy in preterm infants?
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Reinopathy of prematurity (cause vessles to tear)
Bronchopulmonary dysplasia Patent ductus arteriosis (pressure doesn't allow it to close) |
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What is GMH-IVH and what are the s/s?
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hemorrhage that occurs in infants <34weeks
hx of hypoxia and birth asphyxia Dec Hct Dec BP |
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What are the causes of Necrotizing Colitis?
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Intestinal Ischemia
Bacterial colonization enteral feeding too soon |
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What is the RR assessment and interventions
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Periodic breathing vs apnea
Position infant prone or side lying to inc oxygen Suctioning Hydration O2 21-22% |
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What should you assess in thermoregulation of an infant and what treatment?
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Assess:
placement of the probe on the tummy lateral to the umbilicus Hypoglycemia and Respiratory distress may be the first sign Interventions: Neutral thermal environment Weaning to open crib |
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When is a infant ready for discharge from the NICQ
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infants able to hold T
breathe without O2 supplementation |
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What are the problems found in f/e imbalances in preterm infants?
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Excess calcium
Too much or too little Na or K |
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What assessment should be made and what treatment should be made for f/e imbalances?
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Assessment:
fluid needs UOP (1-3mL/hr) Interventions: monitor for conditions weigh diapers |
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What are the integumentary assessments made on a preterm baby?
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Thin and Friable skin
Infection higher in preterm |
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What pain scale is used and how do you treat pain?
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NIPS
Sucrose Swaddling Gentle walking or talking no extra stimuli Opioids |
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What is the assessment of environmentally caused stress?
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response to noise
s/s of overstimulation |
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What should be assessed about feeding?
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feeding tolerance
readiness for nipple feedings weight gain or loss |
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What are the interventions for parenting in preterm babies?
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advanced preparations
assist at birth support information kangaroo care interaction inc decision making alleviate concerns ongoing problems discharge |
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What problems are associated with postterm babies?
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meconium aspiration
inc glottis aspiration r/f pneumonia birth trauma hypoglycemia |
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What are the causes and characteristics of SGA
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smoking
hyperirratible reduces SQ fat loose dry skin sunken in abdomen sparse hair |
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What is a SGA infant at risk for?
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poor T control
hypoglycemia developmental problems learning problems TTN risk |
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What are other neonatal complications?
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Transient Tachypnea of Newborn TTN
Meconium Aspiration Syndrome Persistent Pumonary HTN of the Newborn PPH Pathologic Hyperbilirubinemia Polycythemia |
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WHat is TTN?
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when the RR >60
happens in c/s babies usually resolves in 12-72hrs |
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What are the Persistent Pulmonary HTN?
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vessles didn't close causing inc pressure in lungs and they aren't ventilated
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What is important to understand about meconium aspiration?
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occurs in asphyxiated infants and in SGA post term infants
becomes severe if meconium below the cords no signs of depression at birth |
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What are the s/s of TTN and what is the treatment?
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S/S:
hypoxia vasoconstriction tachycardia cyanosis TxL Surfactant ECMO, NO Environmental strategies Ventilation |
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What are the causes of hyperbilirubinemia?
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Cephlahematoma
AB&O incompatable Hemolytic disease Infection Metabolic disorders |
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WHat is the prevention of hyperbilirubinemia?
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can't prevent, but can prevent cx
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What are the levels of a normogram for hyperbilirubinemia?
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8 at day 8 is ok
8 at day 3 is bad 19 at any day is bad esp first 10 days out |
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What is polycythemia?
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Hct >65% Hgb >22
caused by fetal hypoxia and stress during labor making the body produce more RBC to allow for more O2 asymptomatic risk for hyperbilirubinemia |
