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60 Cards in this Set

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  • Back
Which direction does the blood flow in Ductus Arteriosus?
Right to left
What glucose level is considered hyperglycemia in a neonate?
Greater than 150
What potassium level is considered hyperkalemia in a neonate?
Greater than 6.5 mEq / liter
What is the definition of "preterm?"
Born at less than 37 completed weeks gestation
What is the major problem in preterm infants?
Variable immaturity of all organs
What is significant about the first 24 hours of life?
Transitioning from nitrauterine to extrauterine life
When is the second assessment performed on a newborn?
1-4 hours
When does a gestational age assessment have optimal accuracy?
within 12 hours of birth
What conditions are common when the mother has diabetes?
*LGA newborn
*retarded maturation
What conditions are common when the mother has hypertension?
*IUGR
*speeded maturity
Describe the appearance of a newborn with RDS:
*flaccid
*edematous
*froglike posture
When is lanugo most abundant?
28-30 weeks
Describe ear cartilage of a preemie:
*Shapeless & flat @ 34 weeks
*no recoil
Describe the skull of a preemie:
Soft, sutures displaceable
Describe the nails of a preemie:
Will not extend beyond the fingertips
When does a preemie's wrist make a "square window?"
28-32 weeks
What is the Scarf sign?
*No resistance til 30 weeks
*elbow at midline at 36-40 weeks
What is a characteristic respiratory /cardiovascular problem in preterm infants?
Poor blood flow to the lungs
What is significant of surfactant in preterm infants?
Not enough
What causes a problem of heat production in preterm infants?
*low brown fat
*no glycogen reserve
*low muscle mass
*unable to shiver
What causes a problem of INCREASED HEAT LOSS in preterm infants?
*high ration of body surface to body weight
*little insulation (or subcutaneous fat)
*blood vessels close to skin
*thinner, more permeable skin
*posture: extension increases surface area for heat loss
*poor ability to vasoconstrict superficial blood vessels
Why do preterm infants experience bone demineralization?
calcium & phosphorus are deposited in the 3rd trimester
What is a serious GI complication in preterm infants?
Necrotizing enterocolitis
What causes necrotizing enterocolitis?
Poor perfusion of the GI system
What is a possible complication in preemies that is due to an immature renal system?
Risk of fluid overload
The immature kidneys of a preterm infant take longer to excrete what?
Lactic acid
Preterm infants are predisposed to what after hypoxia?
acidosis
What is given for the management of acidosis?
Sodium bicarbonate
What is a normal pH for a neonate?
above 7.25
What pH level is considered severe acidosis?
7.20
What common preterm problem may lead to hydrocephalus?
intraventricular or intracerebral hemorrhage
What is the calorie requirement for preterm newborns?
95-130 calories/kg/day
What is the fluid requirement for preterm infants?
10-40 ml/kg/day
What is the ideal weight gain for a preterm infant?
20-30 g/day
What glucose level is considered hypoglycemia in a neonate?
Less than 30
List some symptoms of hypoglycemia in the neonate:
*tachycardia
*cyanosis
*seizures
*apnea
Besides having a coordinated suck, swallow, breathing pattern, what must a neonate accomplish before being allowed to breast feed?
Must be able to maintain body temperature
When is gavage feeding used?
*for infants less than 34 wks
*if infant is losing weight
*may be adjunct to bottle feeding
When can TPN be used?
*If GI feeding contraindicated
*Can be used with minimal enteral nutrition (10 ml/kg/day)
What is the treatment for patent ductus arteriosus?
IV indomethacin
What is a possible complication of indomethacin?
Renal dysfunction
What is apnea?
Periods of not breathing for more than 20 seconds OR causing pallor, cyanosis, bradycardia
what is the most common cause of apnea?
immaturity of the CNS
What is the treatment for apnea?
respiratory support or medication (stimulants)
What treatment is now being studied to reduce the incidence of intraventricular hemorrhage in preterm infants?
Giving vitamin K to the mother prior to birth
What vision problem is common in premature infants?
retinopathy of prematurity
What is a post-term infant?
Any newborn born after 42 weeks
Post term infants are associated with which conditions?
*Primiparity
*high multiparity
What is the major cause of death of post-term infants?
decreased placental function
What are some complications of post-term pregnancies?
*Hypoglycemia (depleted glycogen store)
*Meconium aspiration (babies pass meconium when placed under stress)
*Polycythemia: in response to hypoxia; seizures from hypoxia
What is amnionitis?
infection of amniotic fluid
What can cause IUGR?
*congenital infection
*inborn errors of metabolism
*discordant twins
What are common causes of LGA?
*gestational diabetes
*multiparity
What are common complications of LGA?
*Hypoglycemia
*Polycythemia
*Risk of C-section / induction
When are apgars performed
1 minute and 5 minutes
What is the problem that causes asphyxia in the newborn?
Persistant fetal circulation: inability to transition to extrauterine life
In the newborn with asphyxia, what usually reopens?
foramen ovale
Which should be suctioned first - the mouth or the nose?
The nose
In rescuscitation of an infant, when is cardiac massage used?
If heart rate is below 60 after 30 seconds of o2 administration
What is RDS?
Inappropriate respiratory adaptation to extrauterine life