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41 Cards in this Set
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ophthalmia neonatorum
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ETIOLOGY
Infection of the birth canal at the time of delivery. Neisseria gonorrhoeae and Chlamydia trachomatis are responsible for the great majority of cases. Symptoms are present 12 to 48 hr after birth when due to gonorrhea and 1 week or more after birth for Chlamydia infections. |
PROPHYLAXIS
Erythromycin ophthalmic ointment or other approved agents are introduced into the conjunctival sac of each eye of the newborn to prevent gonorrheal or chlamydial conjunctivitis. |
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newborn
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Born recently.
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A term applied to human infants less than 28 days old.
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newborn screening
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The testing of infants in the first days of life for serious illnesses
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e.g., congenital deafness, cystic fibrosis, hemoglobinopathies, hypothyroidism, and phenylketonuria
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pseudomenstruation of the newborn
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Withdrawal bleeding after birth, a scant vaginal discharge that reflects the physiological response of some female infants to an exposure to high levels of maternal hormones in utero.
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anemia of the newborn
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Hemoglobin levels less than 14 g/dl in term newborns.
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Common causes include peripartum bleeding, hemolytic disease of the newborn, twin-to-twin transfusion (15% to 30% of all monochorionic twins with abnormalities of placental blood vessels), and impaired red cell manufacture caused by glucose-6-phosphate dehydrogenase deficiency.
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newborn hypoglycemia
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ETIOLOGY
A high metabolic rate, low glycogen and fat reserves, and limited capacity for gluconeogenesis contribute to the normal newborn's postbirth risk of hypoglycemia. Approximately 8% of normal term infants who were born vaginally and nearly 16% of those born by cesarean delivery experience one or more episodes of hypoglycemia, usually within the 24 to 72 hr period following birth. Premature and small for gestational age infants experience an earlier onset (6 hrs or so after birth) because of reduced glycogen production by their smaller, immature livers. Infants of diabetic mothers and those who are small for gestational age exhibit a higher incidence of low blood sugar. Other maternal risk factors for newborn hypoglycemia include erythroblastosis fetalis, glycogen storage diseases, and toxemia. Newborn risk factors include postmaturity, macrosomia, cold stress, perinatal asphyxia, sepsis, and respiratory distress syndrome. |
PATIENT CARE
Newborns are monitored closely for muscle twitching, tremors, seizures, lethargy, poor feeding, vomiting, sweating, limpness, weak or high-pitched cry, apnea, and cyanosis. For high-risk infants, glucose levels are assessed every 2 hr for 6 hr, then at 12, 24, and 48 hr after delivery. Prompt treatment is provided with oral breast milk or a 5% to 10% glucose solution or intravenous glucose as necessary. IV infusions must be closely monitored to avoid hyperglycemia, circulatory overload, and cellular dehydration. Solutions should be terminated gradually to prevent hypoglycemia due to hyperinsulinemia. |
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jaundice of newborn
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Nonpathological jaundice affecting newborns, usually resulting from the destruction of red blood cells by the immature liver at birth. The destruction of red blood cells causes unconjugated bilirubin to accumulate in the blood and skin. Benign neonatal jaundice manifests 48 to 72 hr after birth, lasts only a few days, and typically does not require therapy.
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PATIENT CARE
Levels of bilirubin less than 2 in the first week of life are common, occurring in about 80% of premature babies and half of all full-term babies. They are typically not hazardous to the developing infant. When jaundice develops in the first 24 hr of life, however, or when bilirubin levels exceed published guidelines, kernicterus (neurotoxicity caused by bilirubin) may develop. Infants with potentially damaging levels of bilirubin in the blood are treated with phototherapy (bili lights). |
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hemolytic disease of the newborn
Neonatal disease characterized by anemia, jaundice, liver and spleen enlargement, and generalized edema (hydrops fetalis). |
ETIOLOGY
This disease is caused by transplacental transmission of maternal antibody, usually evoked by maternal and fetal blood group incompatibility. Incompatibilities of the ABO system are common but are not severe because maternal antibodies are too large to cross the placenta readily. Rh incompatibility, however, can result in profound fetal anemia, causing death in utero. Rh incompatibility may develop when an Rh-negative woman carries an Rh-positive fetus. At the time of delivery, fetal red blood cells may enter maternal circulation, stimulating antibody production against the Rh factor. In a subsequent pregnancy, these antibodies cross the placenta to the fetal circulation and destroy fetal red blood cells. |
TREATMENT
In cases of Rh incompatibility, the condition can be controlled during pregnancy by following the anti-Rh titer of the mother's blood and the bilirubin level of the fetus by amniocentesis. These indices show whether the pregnancy should be allowed to go to full term and if intrauterine transfusion is indicated; or if labor should be induced earlier. Delivery should be as free of trauma as possible and the placenta should not be manually removed. The infant with hemolytic disease should be immediately seen by a physician who is capable of and has the facilities and blood supplies available for exchange transfusion. The use of Rh (D) immune globulin after abortion, at 28 weeks' gestation, and within 72 hr of delivery has been beneficial. |
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gray syndrome of the newborn
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The appearance of vomiting, lack of sucking response, irregular and rapid respiration, abdominal distention, and cyanosis in newborn infants treated at birth with chloramphenicol. Flaccidity and an ashen-gray color are present within 24 hr. About 40% of the patients die, most frequently on the fifth day of life. Because of the risk of this rare syndrome, chloramphenicol is rarely if ever used in pediatric care in the U.S.
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hemorrhagic disease of the newborn
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Hemorrhaging due to an inadequate supply of prothrombin received from the mother or a delay in the establishment of the bacterial intestinal flora that produces vitamin K. Parenteral vitamin K given to the infant within 6 hr of birth prevents this condition.
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transient tachypnea of the newborn
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Abbreviation: TTN.
A self-limited condition often affecting newborns who have experienced intrauterine hypoxia resulting from aspiration of amniotic fluid, delayed clearance of fetal lung fluid, or both. Signs of respiratory distress commonly appear within 6 hr after birth, improve within 24 to 48 hr, and resolve within 72 hours of birth, without respiratory assistance. |
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parent-newborn attachment
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Unconscious incorporation of the infant into the family unit. Characteristic parental claiming behaviors include seeking mutual eye contact with the infant, initiating touch with their fingertips, calling the infant by name, and expressing recognition of physical and behavioral similarities with other family members. Attachment is enhanced or impeded by the infant's responses.
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mother-infant bonding
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The emotional and physical attachment between infant and mother that is initiated in the first hour or two after normal delivery of a baby who has not been dulled by anesthetic agents or drugs. It is believed that the stronger this bond, the greater the chances of a mentally healthy infant-mother relationship in both the short- and long-term periods after childbirth. For that reason, the initial contact between mother and infant should be in the delivery room and the contact should continue for as long as possible in the first hours after birth. It is also called mother-infant attachment.
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en face position
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In obstetrics, a position in which the mother and infant are face to face. This position encourages eye contact and is conducive to attachment.
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hemolytic disease of the newborn
Neonatal disease characterized by anemia, jaundice, liver and spleen enlargement, and generalized edema (hydrops fetalis). |
ETIOLOGY
This disease is caused by transplacental transmission of maternal antibody, usually evoked by maternal and fetal blood group incompatibility. Incompatibilities of the ABO system are common but are not severe because maternal antibodies are too large to cross the placenta readily. Rh incompatibility, however, can result in profound fetal anemia, causing death in utero. Rh incompatibility may develop when an Rh-negative woman carries an Rh-positive fetus. At the time of delivery, fetal red blood cells may enter maternal circulation, stimulating antibody production against the Rh factor. In a subsequent pregnancy, these antibodies cross the placenta to the fetal circulation and destroy fetal red blood cells. |
TREATMENT
In cases of Rh incompatibility, the condition can be controlled during pregnancy by following the anti-Rh titer of the mother's blood and the bilirubin level of the fetus by amniocentesis. These indices show whether the pregnancy should be allowed to go to full term and if intrauterine transfusion is indicated; or if labor should be induced earlier. Delivery should be as free of trauma as possible and the placenta should not be manually removed. The infant with hemolytic disease should be immediately seen by a physician who is capable of and has the facilities and blood supplies available for exchange transfusion. The use of Rh (D) immune globulin after abortion, at 28 weeks' gestation, and within 72 hr of delivery has been beneficial. |
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ophthalmia neonatorum
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ETIOLOGY
Infection of the birth canal at the time of delivery. Neisseria gonorrhoeae and Chlamydia trachomatis are responsible for the great majority of cases. Symptoms are present 12 to 48 hr after birth when due to gonorrhea and 1 week or more after birth for Chlamydia infections. |
PROPHYLAXIS
Erythromycin ophthalmic ointment or other approved agents are introduced into the conjunctival sac of each eye of the newborn to prevent gonorrheal or chlamydial conjunctivitis. |
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newborn
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Born recently.
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A term applied to human infants less than 28 days old.
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newborn screening
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The testing of infants in the first days of life for serious illnesses
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e.g., congenital deafness, cystic fibrosis, hemoglobinopathies, hypothyroidism, and phenylketonuria
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pseudomenstruation of the newborn
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Withdrawal bleeding after birth, a scant vaginal discharge that reflects the physiological response of some female infants to an exposure to high levels of maternal hormones in utero.
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anemia of the newborn
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Hemoglobin levels less than 14 g/dl in term newborns.
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Common causes include peripartum bleeding, hemolytic disease of the newborn, twin-to-twin transfusion (15% to 30% of all monochorionic twins with abnormalities of placental blood vessels), and impaired red cell manufacture caused by glucose-6-phosphate dehydrogenase deficiency.
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ophthalmia neonatorum
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ETIOLOGY
Infection of the birth canal at the time of delivery. Neisseria gonorrhoeae and Chlamydia trachomatis are responsible for the great majority of cases. Symptoms are present 12 to 48 hr after birth when due to gonorrhea and 1 week or more after birth for Chlamydia infections. |
PROPHYLAXIS
Erythromycin ophthalmic ointment or other approved agents are introduced into the conjunctival sac of each eye of the newborn to prevent gonorrheal or chlamydial conjunctivitis. |
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newborn
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Born recently.
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A term applied to human infants less than 28 days old.
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newborn screening
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The testing of infants in the first days of life for serious illnesses
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e.g., congenital deafness, cystic fibrosis, hemoglobinopathies, hypothyroidism, and phenylketonuria
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pseudomenstruation of the newborn
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Withdrawal bleeding after birth, a scant vaginal discharge that reflects the physiological response of some female infants to an exposure to high levels of maternal hormones in utero.
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anemia of the newborn
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Hemoglobin levels less than 14 g/dl in term newborns.
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Common causes include peripartum bleeding, hemolytic disease of the newborn, twin-to-twin transfusion (15% to 30% of all monochorionic twins with abnormalities of placental blood vessels), and impaired red cell manufacture caused by glucose-6-phosphate dehydrogenase deficiency.
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neonatal, premature newborn
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impaired Gas Exchange may be related to alveolar-capillary membrane changes (inadequate surfactant levels), altered blood flow (immaturity of pulmonary arteriole musculature), altered oxygen supply (immaturity of central nervous system and neuromuscular system, tracheobronchial obstruction), altered oxygen-carrying capacity of blood (anemia), and cold stress, possibly evidenced by respiratory difficulties, inadequate oxygenation of tissues, and acidemia.
ineffective Breathing Pattern/Infant Feeding Pattern may be related to immaturity of the respiratory center, poor positioning, drug-related depression, metabolic imbalances, or decreased energy/fatigue, possibly evidenced by dyspnea, tachypnea, periods of apnea, nasal flaring/use of accessory muscles, cyanosis, abnormal ABGs, and tachycardia. |
risk for ineffective Thermoregulation: risk factors may include immature CNS development (temperature regulation center), decreased ratio of body mass to surface area, decreased subcutaneous fat, limited brown fat stores, inability to shiver or sweat, poor metabolic reserves, muted response to hypothermia, and frequent medical/nursing manipulations and interventions.
risk for deficient Fluid Volume: risk factors may include extremes of age and weight, excessive fluid losses (thin skin, lack of insulating fat, increased environmental temperature, immature kidney/failure to concentrate urine). risk for disorganized Infant Behavior: risk factors may include prematurity (immature central nervous system, hypoxia), lack of containment/boundaries, pain, or overstimulation, separation from parents. |
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hyaline membrane disease
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Respiratory distress syndrome of the newborn.
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melena neonatorum
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Melena in the newborn.
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Black tarry feces caused by the digestion of blood in the gastrointestinal tract.
It is common in the newborn and in adult patients with gastrointestinal bleeding from the esophagus, stomach, or proximal small intestine. |
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icterus neonatorum
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Physiological jaundice of the newborn
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transient tachypnea of the newborn
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Abbreviation: TTN.
A self-limited condition often affecting newborns who have experienced intrauterine hypoxia resulting from aspiration of amniotic fluid, delayed clearance of fetal lung fluid, or both. Signs of respiratory distress commonly appear within 6 hr after birth, improve within 24 to 48 hr, and resolve within 72 hours of birth, without respiratory assistance. |
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large for gestational age
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Abbreviation: LGA.
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Term used of a newborn whose birth weight is above the 90th percentile on the intrauterine growth curve. Such babies should be monitored for signs of hypoglycemia during the first 24 hr after birth.
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breastfeeding jaundice
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An exaggerated physiological jaundice of the newborn. It may result initially from hemoconcentration due to inadequate fluid intake.
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epidemic hemoglobinuria
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SYN: Winckel's disease
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Hemoglobinuria of the newborn characterized by jaundice, cyanosis, and fatty degeneration of heart and liver.
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hemolytic disease of the newborn
Neonatal disease characterized by anemia, jaundice, liver and spleen enlargement, and generalized edema (hydrops fetalis). SYN: erythroblastosis fetalis See: Rh blood group |
ETIOLOGY
This disease is caused by transplacental transmission of maternal antibody, usually evoked by maternal and fetal blood group incompatibility. Incompatibilities of the ABO system are common but are not severe because maternal antibodies are too large to cross the placenta readily. Rh incompatibility, however, can result in profound fetal anemia, causing death in utero. Rh incompatibility may develop when an Rh-negative woman carries an Rh-positive fetus. At the time of delivery, fetal red blood cells may enter maternal circulation, stimulating antibody production against the Rh factor. In a subsequent pregnancy, these antibodies cross the placenta to the fetal circulation and destroy fetal red blood cells. |
TREATMENT
In cases of Rh incompatibility, the condition can be controlled during pregnancy by following the anti-Rh titer of the mother's blood and the bilirubin level of the fetus by amniocentesis. These indices show whether the pregnancy should be allowed to go to full term and if intrauterine transfusion is indicated; or if labor should be induced earlier. Delivery should be as free of trauma as possible and the placenta should not be manually removed. The infant with hemolytic disease should be immediately seen by a physician who is capable of and has the facilities and blood supplies available for exchange transfusion. The use of Rh (D) immune globulin after abortion, at 28 weeks' gestation, and within 72 hr of delivery has been beneficial. |
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phototherapy
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Exposure to sunlight or to ultraviolet (UV) light for therapeutic purposes.
One example of phototherapy is the treatment of neonatal jaundice, in which the jaundiced infant is exposed to UV light to decrease bilirubin levels in the bloodstream, thereby reducing the risk of bilirubin deposition in the brain. Phototherapy also is used to treat some skin diseases, including cutaneous T-cell lymphoma and psoriasis, and to relieve the symptoms of seasonal affective disorder. |
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large for gestational age
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Abbreviation: LGA.
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Term used of a newborn whose birth weight is above the 90th percentile on the intrauterine growth curve. Such babies should be monitored for signs of hypoglycemia during the first 24 hr after birth.
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breastfeeding jaundice
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An exaggerated physiological jaundice of the newborn. It may result initially from hemoconcentration due to inadequate fluid intake.
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epidemic hemoglobinuria
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SYN: Winckel's disease
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Hemoglobinuria of the newborn characterized by jaundice, cyanosis, and fatty degeneration of heart and liver.
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hemolytic disease of the newborn
Neonatal disease characterized by anemia, jaundice, liver and spleen enlargement, and generalized edema (hydrops fetalis). SYN: erythroblastosis fetalis See: Rh blood group |
ETIOLOGY
This disease is caused by transplacental transmission of maternal antibody, usually evoked by maternal and fetal blood group incompatibility. Incompatibilities of the ABO system are common but are not severe because maternal antibodies are too large to cross the placenta readily. Rh incompatibility, however, can result in profound fetal anemia, causing death in utero. Rh incompatibility may develop when an Rh-negative woman carries an Rh-positive fetus. At the time of delivery, fetal red blood cells may enter maternal circulation, stimulating antibody production against the Rh factor. In a subsequent pregnancy, these antibodies cross the placenta to the fetal circulation and destroy fetal red blood cells. |
TREATMENT
In cases of Rh incompatibility, the condition can be controlled during pregnancy by following the anti-Rh titer of the mother's blood and the bilirubin level of the fetus by amniocentesis. These indices show whether the pregnancy should be allowed to go to full term and if intrauterine transfusion is indicated; or if labor should be induced earlier. Delivery should be as free of trauma as possible and the placenta should not be manually removed. The infant with hemolytic disease should be immediately seen by a physician who is capable of and has the facilities and blood supplies available for exchange transfusion. The use of Rh (D) immune globulin after abortion, at 28 weeks' gestation, and within 72 hr of delivery has been beneficial. |
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phototherapy
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Exposure to sunlight or to ultraviolet (UV) light for therapeutic purposes.
One example of phototherapy is the treatment of neonatal jaundice, in which the jaundiced infant is exposed to UV light to decrease bilirubin levels in the bloodstream, thereby reducing the risk of bilirubin deposition in the brain. Phototherapy also is used to treat some skin diseases, including cutaneous T-cell lymphoma and psoriasis, and to relieve the symptoms of seasonal affective disorder. |
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neonatal hemochromatosis
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Abbreviation: NH.
A rare congenital disorder causing iron overload in the fetus and newborn, resulting in intrauterine growth retardation, premature birth, end-stage liver disease at birth, or intrauterine death. |
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