Maternity- High Risk Nb Slides #2

Front 1

Term infant
def

Back 1

-infant born after week 38 or beofre 42 weeks of preg

Front 2

Low birth weight
def

Back 2

- infant who falls below the 10% of weight for gestational age

Front 3

postterm
def

Back 3

- infant born after 42 weeks

Front 4

small for gestational age
def

Back 4

-infant born between 30 and 37 weeks gestation with birthweight less than 2500g

Front 5

Large for gestational age
def

Back 5

infant who falls above the 90% percentile for gestational age

Front 6

PDA
function

Back 6

-directs blood away from the lungs

Front 7

Foramen Ovale
finction

Back 7

fetal circulation that directs blood away from the lungs by using a right to left shunting through this opening in the fetal heart.

Front 8

PDV

Back 8

-fetal shint that directs blood away from the liver. Closes after cord is clamped

Front 9

Surfactant Develops at

Back 9

24-28 weeks gestation

Front 10

Preterm Infant
Hepatic problems

Back 10

-Neonatal liver is very immature
-cannot utilize drugs as well as a full term infant
-if born vag they have a higher bilirubin level than c sect (need immediate phottherapy)

Front 11

Preterm Infant
Immune problems

Back 11

-incomplete transfer of maternal antibodies therefor
--incomplete immune system
--temp instability
--apnea and bradycardia

Front 12

Preterm Infant
MS problems

Back 12

- flaccid posture
-lack of flexion
-hyper extension

Front 13

Preterm Infant
Metabolic problems

Back 13

-glycogen and iron stores are not adequate
-impaired ability to conjugate bilirubin

Front 14

Preterm Infant
behavioural states

Back 14

- disorganized
-difficult to identify

Front 15

Implementation for O2

Back 15

- maintain patent airway
- suctioning guidlines
- positioning
- surfactant admin
-theophylline or caffeine as ordered
-electronically monitor pulse ans resp
- record apnea and bradycardia events

Front 16

Implementation
F &E and nutrition

Back 16

- monirot O2 sats with feeds
- provide appropriate nutrition
- amount and type of feeding
- check for residuals
- measure abd girth

Front 17

Implementation
thermoregulation

Back 17

- maintain neutral thermal environment
-keep the neonate in isollette until able to regulate temp
- cluster care
- maintain fluid and electrolyte balance
-daily weight
_ - & O

Front 18

Implementation
nurtitional needs

Back 18

- assess electrolytes
- check TPN and intralipid orders
- assess glucose status
-advance to po's via gavage feedings first then bottle
- know how to place a gavage catheter

Front 19

Implementation
to prevent infection

Back 19

- prevent infection
- strict hand washing
- changing IV tubing every 24
-change intralipid tubing every 12 hours
-avoid skin trauma
-couble back tape and use normal saline to remove old tape on skin
-observe for signs of sepsis

Front 20

Implementation
promote parent/child attachment

Back 20

- encourge frequent parental visits
- call infant by name
- give parents opputunities to provide care
- develop appropriate newborn newborn stimulation plan

Front 21

Parental teaching

Back 21

-teach parents about developmental care
- tailor to baby's needs
-provide motor support limit stimuli
-time to care around baby's awake cycles
- provide boundries
-provide kangaroo care

Front 22

Teaching
prepare for d/c

Back 22

-parents gradually assume most of care
- room in on unit to give confidence

Front 23

Resp distress syndrome

Back 23

-occurs in premature infants
-usually occurs within 24 -72 hours after birth
-caused by insufficient
-caused by fetal hypoxia and hypothermia

Front 24

Bronchopulmonary Dysplasia

Back 24

-chronic pulmonary disease requiring mechanical ventilation and high O2 levels in the forst few weeks of life
-lungs develop chronic changes
due to ventilation

Front 25

Periventricular- Intraventricular Hemorrhage

Back 25

-rupture of the the thin, fragile cappilaries whitn the ventricles of the brain
- the bleeding blocksthe drainage of CSF within the ventricles leading to increase ventricular pressure
-this pressure can either be communcating ot non communicating
- leads to hydrocephalus

Front 26

ROP

Back 26

-prolonged use of high concentrations od O@ can cause hemorrhage in the retina
- these tiny vessels that rupture cause bleeding behind the retina
- the retina detaches
- blindness ensues

Front 27

Necrotizing enterocoltiis

Back 27

-intsetinal ischemia r/t shunting of blood to brain and heart in response to fetal or neonatal dsitress
-heart, brain and lungs receive blood first
- ischemic bowel causes abd distenstion which leads to necrotic tissue
- this necrotic tissue is then excised and a colostomy is put in

Front 28

Post maturity
overview

Back 28

- born after 42 weeks gestation
- problems causeed by placental insufficiancy
--> incidance of fetal asyphixia
--mecomium asp
-at risk for birth injury due to macrosomia

Front 29

Post maturity
appearance

Back 29

- no lanugo or vernix
-dry,cracked, pealing skin
-hypoglycemia
-skin and cord may be yello with mecomium staining
-long fingernails

Front 30

Comp of Post term infant

Back 30

-meconium asp
- birht injuries due to macrosomia
- hypoglycemia