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40 Cards in this Set
- Front
- Back
Evidence of fetal distress?
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1.Gestationl age less than 37wks.
2. SGA or LGA |
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Tools used to identify at risk newborn?
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1. Apgar score <6 at 1 min and <7 at 5 min.
2. Gestational age testing-Ballard and Dubewitz scores. |
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Pulse Oximeter
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assess site q4hr and safe clinical range is >90%.
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What is a UAL used to obtain?
(umbilical arterial line) |
ABG
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What is a UVL line used for?
(umbilical venous line) |
IV fluids, meds and blood draws.
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What causes retinopathy?
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High concentrations of oxygen which can lead to blindness.
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Wher is a gavage tube placed?
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Usually orally, can decompress stomach or be used for feeding or medications.
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Common sizes for Gavage tubes?
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5-8 Fr
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Why should you give feedings slowly using the gavage tube?
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To avoid dumping syndrome.
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Premature is an infant being born before ___ week.
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37th
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Number one cause of death in preterm infants?
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Respiratory failure- due to insufficiant surfactant, inadequate alveoli,weak musculature (head to body).
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What affects temperature regulation in a premie?
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1. Lack of subcutaneous fat to insulate body.
2. large body surface that loses heat faster. 3. absent sweat and shiver ability. |
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Why are premies at high risk for infection?
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Because they lack maternal immunoglobulins that cross the maternal membranes in the third trimester.
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What hepatic problems are common in the premie?
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1. hyperbilirubinemia R/T immature liver and inability to break down RBC's.2. Immature production of clotting factors. 3. Decreased hepatic glycogen stores that lead to hypoglycemia.
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Why does the premie bruise easily?
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1. Fragile skin and capillaries. 2. lack of clotting factors.
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What increases the risk for aspiration in the premie?
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Poor gag and cough reflexes.
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Why does the premie require tube feeding if born before 33-34wks?
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Because they have a weak suck and swallow reflex until 33-34wks.
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Renal problems common in the premie?
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1. inability to concentrate urine resulting in dehydration. 2. Prolonged drug excretion due to immature kidneys.
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Postterm newborn
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Born after 42wks (may have been to inaccurate MP dates).
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Post term maturity syndrome include?
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1. Decreased placental function. 2. Decreased oxygenation and nutrition.
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AGA
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Appropiate for gestational age
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SGA
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Small for gestational age. Birthweight <10th percentile.
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LGA
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Large for gestational age. Birthweight >90th percentile.
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S&S of hypoglycemia in the newborn?
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1. Glucose level of <40mg/dl. 2. tremors, jitteriness, lethargy, cyanosis, temp instability, poor feeding, hypotonia and in extreme cases seizures.
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Physiologic jaundice
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Appears after the first 24hrs of life and may require phototherapy.
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Pathologic jaundice AKA hyperbilirubinemia
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SEVERE problem! appears in the first 24hrs of life.
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Causes of pathological jaundice are?
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1. Rh incompatibility.
2. Erythroblastosis fetalis. 3. ABO incompatibility. |
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Most severe form of erythroblastosis?
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Hydrops fetalis
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Kernicticus
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Increase in bilirubin level
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How would you test for jaundice in a darker skin baby?
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Assess sclera, palms, and soles.
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Normal level of bilirubin?
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<12 mg/dl
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Normal stool for a baby with pathologic jaundice?
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Green stool shows excretion of bilirubin.
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Does alcohol cross the placenta?
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YES-resulting in fetal alcohol syndrome (FAS) and interferes with protein synthesis.
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Drugs used to control withdrawal symptoms?
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1.Phenobarbital.
2. Paregoric (elixir)-controversial 3. Diazepam (Valium)-contraindicated with jaundice. |
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If a newborn is exposed to HIV, how often should they be tested?
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at birth, 1-2 months, and 4-6 months.
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How long does it take for a newborn to form their own HIV antibodies?
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15 months
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When would the infant begin antiretroviral drug therapy?
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beginning 8-12 hrs of life and continuing for 6 weeks.
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An inborn metabolic error and can cause mental retardation?
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1. PKU-Phenylketonuria.
2. Galactosemia. |
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Galactosemia?
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Inborn metabolic error of glucose metabolism. Unable to utilize galactose and lactose. Must give "nutramagen", meat and soy based formulas.
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Congenital hypothyroidismmis caused by?
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1. Inborn enzymatic defect.
2. Lack of maternal iodine. 3. Maternal drug use that depresses or destroys thyroid tissue. |