Ch 28 The Newborn At Risk: Acquired And Congenital Problems

Front 1

What are the 2 skull fractures identified in the newborn? Which is most common?

Back 1

Linear and depressed fractures. Linear account for 70%.

Front 2

This is caused by damage to the upper plexus and usually results from a stretching or pulling away of the shoulder from the head such as might occur with shoulder dystocia or with a difficult vertex or breech delivery.

Back 2

Erb palsy (Erb-Duchenne paralysis)

Front 3

What are the clinical manifestations of Erb Palsy?

Back 3

paralysis of the affeted extremity and muscles. The arm hangs limp alongside the body. The shoulder and arm are adducted and internally rotated. The elbow is extended, and the forearm is pronated, with the wrist and fingers flexed; grasp reflex possible. Moro reflex missing on affected side.

Front 4

Nursing care for newborn with bracial palsy

Back 4

The affected arm should be abducted 90 degrees with external shoulder rotation, forearm supination, and extension at the wrist with the palm facing the infant's face.
- Pass ROM after first week
- Dressing: affected arm first, undressing: unaffected arm.
-parents taught to use football position when holding / avoid picking up by axilla.

Front 5

When is facial palsy most noticed? How long does it last? What nursing care is involved?

Back 5

-when the infant cries.
-It resolves within hours or days of birth.
-aid the infant in sucking and helping mother with feeding techniques.
The mother will need additional assistance in helping the infant grasp and compress the areolar area.
If the lid of the eye on the affected side does not close completely, artificial tears can be instilled daily to prevent drying of the conjunctiva, sclera, and cornea. The lid is often taped shut to prevent injury.

Front 6

Phrenic nerve paralysis results in:

What's the nursing care?

Back 6

Diaphragmatic paralysis as demonstrated by ultrasonography,m which shows paradoxic chest movement and an elevated diaphragm. Because injury to the phrenic nerve is usually unilateral, the lung on the affected side does not expand, and respiratory efforts are ineffectual. The infant is positioned on the affected side to facilitate maximum expansion of the uninvolved lung.

Front 7

A life-threatening collection of blood in the subdural space most often produced by the stretching and tearing of the large veins in the tenorium of the cerebellum, the dural membrane that separates the cerebrem from the cerebellum.

Back 7

Subdural hematoma. Usually happens with a primiparous mother, with labor less than 3 hours; forcept birth or a LGA. It is especially serious because it can't be aspirated by subdural tap.

Front 8

These almost always occur from complicated breech births, especially when version and extraction are used. Clinical manifestations include: respiratory failure and flaccid extremities. stillbirth not uncommon.

Back 8

Spinal cord injuries.

Front 9

The presense of microorganisms or their toxins in the blood or other tissues

Back 9

Sepsis

Front 10

What is the most common infecting organism of Sepsis?

Back 10

E. coli, which may be present in the vagina and accounts for approximately half of all cases.

Front 11

When does early-onset sepsis occur and when does late-onset sepsis occur?

Back 11

Early: acquired in the perinatal period
Late: 7 to 30 days of age.

Front 12

Septicemia

Back 12

generalized infection in the bloodstream.

Front 13

Neonatal sepsis is characterized by

Back 13

lethargy, poor feeding, poor weight gain, and irritability.
Be cautious, these are very similar to hypoglycemia and respiratory distress so additional labs are needed.

Front 14

Pseudomonas aeruginosa and Klebsiella cause serious infections and morbidity. They are seen commonly in neonates because of:

Back 14

Artificial and long natural fingernails.

Front 15

Plexus injury that is caused by damage to the upper plexus usually resulting from a stretching or pulling away of the shoulder from the head such as might occur with shoulder dystocia or with a difficult vertex or breech delivery

Back 15

Erb's palsy (Erb- Duchenne paralysis)

Front 16

Life threatening collection of blood in the subdrual space, most often produced by the stretching and tearing of the large veins in the dural membrane that separates the cerebrum from the cerebellum

Back 16

Subdural Hematoma

Front 17

result of phrenic nerve paralysis

Back 17

Diaphragmatic paralysis

Front 18

presence of microorganisms or their toxins in the blood or other tissues

Back 18

Sepsis

Front 19

generalized infection in the bloodstream

Back 19

Septicemia

Front 20

acronym used to designate certain maternal infections during early pregnancy that are known to be associated with various congenital malformations and disorders

Back 20

TORCH

Front 21

multisystem disease caused by a protozoa found in the feces of infected cats

Back 21

Toxoplasmosis

Front 22

________ and ___________ The pathogenic organisms responsible for opthalmia neonatorum

Back 22

Gonorrhoeae; Chlamydia

Front 23

_______________ infection caused by Treponema pallidum. ________________ Copius, clear, serosanguineous mucous discharge from the nose of an infant infected with this microorganism.

Back 23

syphilis; snuffles

Front 24

Viral infectin of the liver that is not associate with an increase in malformations, stillbirths, or IUGR although the risk for preterm birth is increased; a vaccine is available for prevention and immune globulin is available for treatment.

Back 24

Hep B Virus (HBV)

Front 25

infection with this virus during pregnancy can result in miscarriage, stillbirth, or conenital illness including microcephaly, healing loss, and mental retardation; it is the most common cause of congenital viral infections in the US

Back 25

Cytomegalovirus

Front 26

Neonatal infection with this virus can result in disseminated infection, localized CNS disease, or localized infection of the skin, eye or mouth

Back 26

Herpes simplex virus

Front 27

Virus responsible for fifth disease. infection with this virus during pregnancy can result in miscarriage or the development of fetal hydrops and IUGR.

Back 27

Parvovirus B19

Front 28

Disorder that occurs when the blood groups of the mother and newborn are different; the most common of these are Rh incompatibility and ABO incompatibility.

Back 28

Hemolytic disease of the newborn

Front 29

Condition in which the fetus produces large numbers of immature erythrocytes to replace those hemolyzed as a result of severe Rh incompatibility.

The most severe form of this condition; it is characterized by marked anemia with hypoxia, cardiac decompensation, cariomegaly, hepatosplenomegaly, and generalized edema.

Back 29

Erythroblastosis fetalis; hydrops fetalis

Front 30

Blood test used to determine whether maternal blood contains antibodies to the Rh antigen.

Back 30

Indirect Coombs'

Front 31

Blood test performed on cord blood to determine whether fetal blood contains maternal antibodies to the Rh antigen.

Back 31

Direct Coombs'

Front 32

Procedure used to alternately remove a small amount of the infant's blood and replace it with an equal amount of donor blood when severe Rh incompatibility is present.

Back 32

Exchange transfusion

Front 33

A group of disorders caused by a metabolic defect that results from the absence of, or a change in, a protein, usually an enzyme and mediated by the action of a certain gene. Examples include phenylketonuria and galactosemia.

Back 33

Inborn errors of metabolism

Front 34

A head circumference that measures more than three standard deviations below the mean for age and gender; brain growth is usally restricted and mental retardation is common.

Back 34

Microcephaly

Front 35

Urethral meatus opens below te glans penis or anywhere along the ventral surface of the penis, scrotum, or perineum.

Urethral meatus opens on the dorsal surface of the penis.

Abnormal development of the bladder, abdominal wall, and symphysis pubis that causes the bladder, urethra, and ureteral orifices to be exposed.

Back 35

Hypospadias; epispadias; exstrophy of the bladder

Front 36

Enlargement of the ventricles of the brain, usually as a result of an imbalance between production and absorption of cerebrospinal fluid (CSF). It is characterized by a bulging anterior fontanel, an abnormal increase in the circumference of the head and an increasing CSF pressure.

Back 36

Hydropcephalus

Front 37

Anatomic abnormalities of the heart that are present at birth; ventricular septal defects and tetralogy of Fallot are two common forms of this type of these abnormalities.

Back 37

Congential heart defects

Front 38

Complex deformity of the ankle and foot that includes forefoot adduction, midfoot supination, hindfoot varus, and ankle equinus; these deformities are described according to the position of the ankle and foot.
Most common form of this deformity in which the foot points downward and inward in varying degrees of severity.

Back 38

Congenital club foot; talipes equinovarus

Front 39

Most common congenital anomaly of the nose characterized by a bony or membranous septum located between the nose and the pharynx; it may be unilateral or bilateral.

Back 39

Choanal atresia

Front 40

Most common defect of the CNS that result from failure of the neural tube to close at some point; there are two categories of this defect, namely___________and_______________.

Back 40

Spina bifida; spina bifida occulta; spina bifida cystica

Front 41

Form of spina bifida cystica (a neural tube defect) in which an external sac containingthe meninges and spinal fluid protrudes through a dect in the vertebral column.

Back 41

Meningocele

Front 42

Form of spina bifida cystica (a neural tube defect) in which an external sac contianing the meninges and spinal fluid, and nerves protrudes through a defect in the vertebral column.

Back 42

Myelomeningocele

Front 43

Herniation of the brain and meninges through a skull defect, usually at the base of the neck.

Back 43

Encephalocele

Front 44

Type of neural tube defect characterized by the absence of both cerebral hemispheres and the overlying skull. It is incompatible with life.

Back 44

Anencephaly

Front 45

Covered defect of the umbilical ring into which varying amounts of the abdominal organs may herniate. It is covered with a peritoneal sac.

Back 45

Omphalocele

Front 46

Herniation of the bowel through a defect in the abdominal wall to the right of the umbilical cord. No membrane covers the content.

Back 46

Gastroschisis

Front 47

Passageway from teh mouth to the stomach ends in a blind pouch or narrows into a thin cord; thus, a continuous passageway to the stomach is not present.

Back 47

Esophageal atresia

Front 48

Abnormal connection between the passageway described above and the trachea.

Back 48

Tracheoesophageal fistula

Front 49

Disorder characterized by displacement of the abdominal organs into the thoracic cavity.

Back 49

Diaphragmatic hernia

Front 50

Commonly occurring congenital midline fissures or opening in the lip, palate, or both resulting from failure of the primary palate to fuse.

Back 50

Cleft lip and cleft palate

Front 51

Spectrum of disorders related to abnormal development of the hip in which there is a shallow acetabulum, subluxation, or dislocation; it may appear at any time during fetal life, infancy, or childhood.

Back 51

Developmental dysplasia of the hip (DDH)

Front 52

Erroneous or abnormal sexual differentiation.

Back 52

Ambiguous genitalia

Front 53

Embryonal tumor that may be solid, cystic, or mixed; it is composed of at least two and usually three types of embryonal tissued: ectoderm, mesoderm, and endoderm.

Back 53

Teratoma