Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
84 Cards in this Set
- Front
- Back
|
What is LGA?
|
large, falls greater than the 90% in weight r/t to gestational age
|
|
|
What is AGA?
|
average, b/t 10&90%
|
|
|
What is SGA?
|
small, less than 10%
|
|
|
When does neonatal mortality risk decrease?
|
as gestational age and weight increases
SGA and premature babies are at higher risk for neonatal mortality |
|
|
How of resp. of a newborn established and maintained?
|
suction the nose and mouth
|
|
|
How the lungs of a newborn expanded?
|
w/ first breath
|
|
|
What are some infants at risk for asphyxia?
|
fetal distress
difficult birth (forceps, vacuum, breech) fetal blood loss (placenta separation, mom has anemia) apnea persistent fetal circulation inadequate ventiliate |
|
|
How can you reduce a newborns 02 loss?
|
reducing heat loss
|
|
|
What would albumin be used for in a newborn?
|
volume expander
|
|
|
What would sodium bicarb be used for in a newborn?
|
correct acidosis
|
|
|
What would epi be used for in a newborn?
|
if no spontaneous resp and HR > 100 by 5 minutes, bradycardia
|
|
|
What is atropine used for in a newborn?
|
bradycardia
|
|
|
What is dextrose used for in a newborn?
|
hypoglycemia
|
|
|
What is naloxone used for in a newborn?
|
counteract narcotics given to mom
|
|
|
What HR requires chest compressions?
|
< 60
|
|
|
What would be given to a newborn to maintain f&e?
|
D5W, D10W
|
|
|
What happens with inadequate temp regulation?
|
brown fat stores utilized
increased metabolic rate increased 02 demand hypoxia vasoconstriction decreased pul. perfusion acidosis fetal circulation |
|
|
What will a newborn need if they fed by gavage?
|
oral stimulation
|
|
|
Why are preterm babies at a higher risk for infection?
|
do not have immunoglobulins from mom and do not have the ability to make their own antibodies
thin skin |
|
|
What are SGA babies at a greater risk for?
|
prenatal asphyxia
preinatal mortality |
|
|
What are some causes of SGA?
|
Malnutrition- r/t to maternal malnutrition in the 3rd trimester
Vascular Complications Maternal Disease Maternal Factors Environmental Factors Placental Factors Fetal Factors |
|
|
What are some vascular complications that could cause SGA?
|
PIH
Chronic HTN Diabetes Smoking Narcotic Use |
|
|
What are some maternal factors that could cause SGA?
|
Size
Parity- intervals b/t pregnancy Prenatal Care Age- less than 16, greater than 40 Socio-economic Status |
|
|
What are some environmental factors that could cause SGA?
|
Altitude
X-Rays Teratogens Work Hazards |
|
|
What are some placental factors that could cause SGA?
|
Infarcts- partial separation from wall
Abnormal cord insertions Previa or Abruption |
|
|
What are some fetal factors that could cause SGA?
|
Congenital Infections
Malformations Multiple pregnancy Sex Inborn errors of metabolism |
|
|
What is symmetrical SGA?
|
proportional, usually picked up on US, caused by long term conditions, always small
|
|
|
What is asymmetrical SGA?
|
weight may be decreased but head cirumference and length are normal, usually catch up with their peers
|
|
|
Why are SGA babies at a higher risk for perinatal asphyxia?
|
do not tolerate labor well b/c they may have a chronic hypoxia, may have late decels
|
|
|
Why are SGA at a higher risk for heat loss?
|
thin skin
less subq fat no brown fat stores |
|
|
Why are SGA babies at an increased risk for hypoglycemia?
|
increased metabolic rate
poor glycogen stores d/t chronic hypoxia |
|
|
Why are SGA babies at an increased risk for hypocalcemia?
|
r/t hypoxia
|
|
|
Why could Rh d/s make a baby LGA?
|
edematous and filled with fluid so they weigh more
|
|
|
What are some complications of LGA babies?
|
birth trauma r/t CPD
increased incidence of CS hypoglycemia polycythemia |
|
|
What is preterm?
|
<37 wks
|
|
|
What is extremely preterm?
|
<30 wks
|
|
|
What is moderately preterm?
|
31-36 wks
|
|
|
What is borderline preterm?
|
36-37 6/7
|
|
|
Why do preterm babies have problems with respirations?
|
decreased number of alveoli
surfactant not formed until 36 wks pulmonary vessels are not able to dilate properly DA stays open causing more blood flow to the lungs causing pul. congestion making the baby work harder with every breath using more 02 |
|
|
What are some complications of the preterm infant?
|
apnea
patent DA RDS IVH hypocalcemia hypoglycemia NEC anemia hyperbilirubinemia infection |
|
|
What is apnea?
|
paused in respiration that last > 20 seconds caused by CNS immaturity or a d/s process
|
|
|
How would you stimulate a newborn to breath?
|
rub the sole of the foot
|
|
|
What should you monitor about apnea spells of the newborn?
|
how long they last and how often do they occur
|
|
|
How can you prevent apnea?
|
temp. regulation
avoid fatigue gentle suction medications (theophylline) increases the infants sensitivity to 02 and C02 |
|
|
What will patent DA result in if not treated properly?
|
CHF
|
|
|
How can you treat patent DA?
|
Diuresis
Strict I/O Supplemental O2 Maintenance of normal pH Maintenance of normal hgb Pharmacologic Closure (Indomethacin) inhibits prostaglandin synthesis causing it to constrict Surgical Closure |
|
|
How can you prevent RSD?
|
good oxygenation during labor- can be given to mom during labor to help infant
steroids (betamethazone) |
|
|
What causes RDS?
|
immaturity of the lungs and lack of surfactant
inefficient lung function d/t lack of alveoli obstruction of air passage d/s of fetus birth trauma d/s of mom bleeding in the antepartum period (placenta previa, placenta abruption) |
|
|
What are some S/S of RDS?
|
poor temp regulation
tachypnea tachycardia nasal flaring grunting abnormal breath sounds cyanosis retractions shock |
|
|
How can you diganose RDS?
|
S/S
chest XRAY shows infiltrate in lungs blood gases show resp. acidosis then metabolic acidosis if intervention is appropriate |
|
|
What is CPAP?
|
keep pressure on alveoli to keep them from collapsing
used for RDS |
|
|
What is PEEP?
|
increase functional residual capacity and may keep mechanical ventilation from becoming necessary
|
|
|
What drug therapy may be used for RDS?
|
muscle relaxants
surfactant replacement |
|
|
What is IVH?
|
intraventricular hemorrhage
|
|
|
What is the treatment for IVH?
|
careful handling
temp. regulation vitamin K slow initiation of feedings |
|
|
What are some long term concerns with the preterm infant?
|
increased morbidity and mortality
retinopathy of prematurity BPD speech defects neurologic defects hearing loss |
|
|
What is a post term infant?
|
42 wks or greater
|
|
|
What are some common problems of the post term infant?
|
hypoglycemia
meconium aspiration polycythemia cold stress hypoxia |
|
|
What are the characteristics of the post term infant?
|
Length and circumference may be normal but may have a malnurished appearance
Dehydration Growth “Worrier”- long and thin Skin- dry, cracked and wrinkled Vernix- none Subcutaneous fat- decreased Meconium- passed meconium Amniotic Fluid- decreased (250) |
|
|
What would be looked for with a NST?
|
variability and 2 accels in a 10 min period
|
|
|
What is RH incompatibility?
|
when mom is rh- and the fetal blood is rh+
|
|
|
What is ABO incompatibility?
|
maternal blood type is O and fetal blood is A or B
|
|
|
What would be a sign of ABO incompatibility?
|
hyperbilienmia before 24 hrs
|
|
|
What is an indirect coombs?
|
measure mom's antibodies
|
|
|
What is a direct coombs?
|
measures cord blood
|
|
|
What is the management of hemolytic d/s?
|
early feeding
temporary suspension of breastfeeding phototherapy exchange transfusion |
|
|
What are some nursing implications with phototherapy?
|
eye protection
monitor for dehydration feeding and stimulation monitor temp q4h |
|
|
What are some nursing implications with exchange transfusion?
|
temp. regulation
monitor VS lab values multiple transfusions warm blood to prevent hypothermia |
|
|
What causes hemorrhagic d/s of the newborn?
|
results from vit. k deficiency
|
|
|
What would a donor of a twin to twin transfusion look like?
|
anemic/pale
growth retarded (SGA) hypoglycemic |
|
|
What would the recipient of a twin to twin transfusion look like?
|
ruddy
polycythemic possible hyperbilirubinemia large may need an exchange transfuison |
|
|
What is a TORCH screen?
|
toxoplasmosis
others (gonorrhea, hep. B, syphilis, varicella, paryp virus and HIV) rubella cytomegalovirus herpes |
|
|
What should GBS be treated with?
|
penicillin 5 million units given at least 4 hours before delivery, 2.5 million units q4h
|
|
|
What are some s/s of early onset GBS?
|
s/s pneumonia
tachypnea apnea s/s shock decreased UOP extreme palness hypotonia |
|
|
What are some s/s of late onset GBS?
|
meningitis
lethargy fever loss of appetite bulging fontanelles |
|
|
What could exposure to rubella during pregnancy cause in the newborn?
|
progressive hearing loss
|
|
|
What is ophthalmia neonatroum?
|
gonorrhea or chlamydia
|
|
|
What are the s/s of ophthalmia neonatorum?
|
fiery red conjunctivai
thick pus edema |
|
|
What are some complications of the newborn being exposed to herpes?
|
develop vesicles all over the body
jaudice shock very sick permanent CNS damage |
|
|
What are the s/s of hypoglycemia?
|
jitteriness
paleness apnea poor feeding lethargic tremors temp. instability initiate feedings early |
|
|
What would the nursing implications include for a infant of a drug dependent mother?
|
swaddle
decrease stimulation may be good to give a pacifier no breastfeeding to decrease passing of narcotics to infant social work referral |
|
|
What are the characteristics of an infant with FAS?
|
Pre and post growth restrictions
Microcephaly Characteristic facial features Mental retardation is common Cerebral palsy Tremulous and fidgety Weak sucking reflex Sleep pattern disturbances Hyperactivity with age |
|
|
What are some s/s of transistent tachypnea of newborn?
|
Tachypnea
Retractions Cyanosis May tire from ↑ work of breathing Need to keep warm C/S babies, preterm |
|
|
How can you manage meconium aspiration?
|
suction the mouth and nose prior to the first breath
may require intubation and deep suction in the lungs |
