Maternity- Ch 29- High Risk Nb

Front 1

Low Birth weight

Back 1

< 5 lbs 8 oz

Front 2

Very low birth weigt

Back 2

< 3 lb 5 oz

Front 3

extremely low birth weight

Back 3

< 2 lbs 3 oz

Front 4

Pre term infant
appearance

Back 4

-frail, weak
-underdeveloped muscles
-extended
-red, tranparent looking skin
-abundant vernix and lanugo
-no plantar creases if < 32 weeks GA
-undecendd testes
-flat pinna
-

Front 5

Pre term infant
behavior

Back 5

-little excess energy
-easily exausted
-may have lowered O2 levels
-feeble cy

Front 6

Surfactant
action

Back 6

- reduces surface tension in the alveoli and prevents their collapse during expiration

Front 7

Periodic breathing
def

Back 7

cessation of breathing for 5-10 seconds with no other changes

Front 8

Apneic breathing

Back 8

-cessation of breathing for more than 20seconds with cyanosis or bradycardia

Front 9

Preterm infant with resp problems
nursing interventions

Back 9

-O2 admin
-Continuos positive airway pressure
-side lying or prone
-reposition q 2 hours
-suction secretions

Front 10

Preterm infant
complications of heat loss

Back 10

-hypoglycemia
-metabolic acidosis
-pulm vasoconstriction
-impaired surfactant prod

Front 11

Signs of inadequate thermoregulation

Back 11

- change in feedinh behavior
-irritability
-decreased mscle tone
-cool skin temp
-mottled skin
-signs of hypoglycemia
-signs of resp diffculty

Front 12

Criteria for open crib weaning

Back 12

- weight of 3lbs 7 oz
-no medical complications
-tolerating eneral feedings
-consistant weight gain for 5 days

Front 13

signs of dehydrated

Back 13

-urine output <2 mL/kg/hr
-urine specific gravity?1.010
-weight loss greater than expected
-sunken anterior fontenel
-poor tissue turgor
-blood:> Na,protein and hct

Front 14

signs of overhydration

Back 14

-urine ouput > 5ml/kg/hr
- urine specific gravity < 1.002
-edema
-weight gain greater than expected
-bulgding fontenels
-moist breath sounds
-difficulty breathing
-blood <Na, protein, hct

Front 15

Overstimulation
O2 changes

Back 15

-> or < in pulse of RR
-cyanosis, pallor or mottling
-flaring nares
- < O2 sat

Front 16

Over stimulation
behavior changes

Back 16

-stiff extended, arms and legs
-fisting of the hands or -splaying of the fingers
-alert,worried expression
-hicupping
-regurg
-coughing
-yawning
-faitigue

Front 17

Excessive reidual amounts of stomach contents

Back 17

- > 2-4 mL or the amount f the last feeding

Front 18

Excessive residual may indicate

Back 18

-the amount type or formula flow rate may need to bee changed

Front 19

Signs of readiness for nipple feedings

Back 19

- rooting
-sucking on gavage tube, finger or pacifier
-resp rate <60
-presence of gag relfex

Front 20

Oral feedings are started

Back 20

when the infant can coordinate the suck swallow breath reflex- what would be the 32-34 week gestational age

Front 21

Resp distress syndrome
risk factors

Back 21

- less than 30 weeks GA
- < 1200g
-birth asphyxia
-DM mothers

Front 22

RDS
manifestations

Back 22

- begin during the first hour after birht
- tachypnea
- nasal flaring
- retractions
- cyanosis
-exp grunting
-rales
-acidosis may develop
-CXR ground glass

Front 23

RDS
theraputic managemetn

Back 23

- surfactant replacement therepy(instilled into trachea)
-mechanical ventilation
- correction of acisosis
- IV feedings

Front 24

RDS
RN considerations

Back 24

- constant assessment of condition
signs of comp- PDA, bronhopulmonary dysplasia
-bloods gases
-watch for sepsis

Front 25

Bronchpulmonary Dysplasia

Back 25

-chronic lund ds
-occurs when infants are tx with mechanical ventilation or O2
-damage is a result of prolonged dependance

Front 26

Periventricular-Intraventricular Hemorrhage
when

Back 26

-more common in infants less than 32 weeks GA
-occurs during the first few days of life

Front 27

Periventricular-Intraventricular Hemorrhage
def

Back 27

-rupture of fragile blood vessels in the brain

Front 28

Periventricular-Intraventricular Hemorrhage
s/s

Back 28

-lethargy
-poor muscle tone
-< resp status
-< HCT
-decreased refelxes
- full or dulging fontanel
-seizures
-abberations of the eye poition or movement

Front 29

Periventricular-Intraventricular Hemorrhage
Therapeutic management

Back 29

- early and repeated screening throuh US or CT
(prevention)
-supportive
-lumbar taps

Front 30

Periventricular-Intraventricular Hemorrhage
nursing considerations

Back 30

- mechanical ventilation
-suctioning
-excessive handling
-head circumferance
-neuro status change
-

Front 31

Retinopathy of Prematurity
def

Back 31

-damage to the immature blood vessels in the retina
- ? high levels of O2 as a cause
-new vessesl may cause fluid leakage and hemorrhage

Front 32

Retinopathy of Prematurity
Therapeutic managment

Back 32

-cryotherapy to destry porlificating blood vessels
-reaatachemtn of the retina
- some have spontaneuous regression

Front 33

Retinopathy of Prematurity
nursing considerations

Back 33

-frequent pulse ox
-support durin geye exams
- eye drops may cause apnea, brady and increase in BP

Front 34

Necrotizing Enterocolitis
def

Back 34

- serious inflammaotory condition of the GI tract that leads to cellular death of mucousa and intestines

Front 35

Post term infants
Assessment

Back 35

-if LGA check for injury and hypoglycemia
-little or no lanugo and vernix
-check for mecomium stained cord, skin, nails

Front 36

Post term infants
nursing considerations

Back 36

- s/s o f post maturity syndrome
- hypoglycemia
-early and more frequent feedings
-poor temp regulation
-polycythemia
-hyperbilirubinemia

Front 37

SGA infants
def/rf

Back 37

-below 10% on growth chart
- congenital malformation
-fetal inf
- poor placental functioning
-PIH
-maternal DM
- Smoking/drugs/alcohol

Front 38

SGA infants
asymetric restiction
def

Back 38

- caused by comp in 3rd trimester
-head seems large for body
-abd circumfetance is decreased
-are able to "catch up"

Front 39

SGA infants
nursing considerations

Back 39

-temp regulation
-jaundice

Front 40

LGA def

Back 40

above 90% percitile on growth chart weigh more than 400g or 8 lbs 13 oz