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NURSING > 3340: PEDS PRETERM > Flashcards

3340: PEDS PRETERM Flashcards

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1
Q

LBW Infant

A

less than 2500g (5lb 8oz) regardless of gestational age

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2
Q

VLBW

A

less than 1500g (3lb 5oz) regardless of gestational age

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3
Q

ELBW

A

less than 1000g (2lb 3oz) regardless of gestational age

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4
Q

Preterm

A

before 37 weeks

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5
Q

Full term

A

39-40 6/7 weeks

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6
Q

Post term

A

later than 42 weeks

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7
Q

SGA

A

below 10th percentile

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8
Q

LGA

A

above 90th percentile

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9
Q

AGA

A

between 10th and 90th percentile

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10
Q

Biggest problems with preterm infants

A

respiratory
thermoregulation
nutrition

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11
Q

Babies born before __ weeks have minimal to absent reflexes (sucking and swallowing included)

A

32

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12
Q

What position should you place an infant in to facilitate drainage of mucous, regurgitated feedings:

A

side-lying or prone position

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13
Q

To promote drainage of lung secretions in the preterm infant, the nurse should:

A

frequently change the infant’s position

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14
Q

The most common mode of O2 deliver in a newborn

A

hood therapy

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15
Q

Least invasive way to deliver O2

A

nasal cannula

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16
Q

Inhaled Nitric Oxide

A

gas used inboxed babies with pulmonary hypertension; relaxes blood vessels in the lungs without having any effect on vessels of the rest of the body

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17
Q

ECMO

A

the use of a bypass machine to oxygenated the infant’s blood while the infant’s lungs heal
requires anticoagulation

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18
Q

T or F: Premature baby’s blood oxygen can drop fast when agitated

A

True

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19
Q

Pulse Oximetry

A

percentage of hemoglobin that is bound by oxygen

simple, non-invasive, continuous monitoring of oxygen saturation by sensors attached to the skin

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20
Q

NTE

A

environment in which the infant can maintain stable body temperature without an increase in O2 consumption or an increase in metabolic rate
goal: infant maintains temperatures and growth using the least amount of energy

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21
Q

4 methods of heat loss

A

Evaporation
Conduction
Convection
Radiation

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22
Q

Conduction

A

loss of heat from direct contact with cold objects

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23
Q

Evaporation

A

loss of heat from drying the skin or insensible water loss

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24
Q

Convection

A

Loss of heat from air movement surrounding the infant

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25
Q

Radiation

A

Loss of heat from being near cold surfaces (not touching)

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26
Q

Placing the newborn on cold, unpadded scale

A

Conduction

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27
Q

Using a cold stethoscope to listen to breath sounds

A

Conduction

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28
Q

Placing the infant’s crib by the window on a snowy day

A

Radiation

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29
Q

Partially drying the infant’s hair after a bath

A

Evaporation

30
Q

Placing the infant’s crib near an AC vent

A

Convection

31
Q

Brown Fat Oxidation

A 
Non-shivering Thermogenesis
Maintains Temperature
Increases Metabolism
Increased O2 and glucose consumption
May cause respiratory distress, hypoglycemia, acidosis, and jaundice
32
Q

Cold Stress

A

Excessive loss of heat that results in increased respirations and non shivering thermogenesis to maintain core body temperature

33
Q

Nursing Intervention : Cold Stress

A

Warm the baby and seek to identify causes

34
Q

Indications of Inadequate Thermoregulation

A

Hypoglycemia and Respiratory Distress may be the 1st signs to show that the infant’s temp is low

35
Q

Metabolic acidoses r/t anaerobic metabolism is a major hazard of ______

A

Cold Stress

36
Q

4 Consequences of Cold Stress

A

Respiratory Distress
Acidosis
Hypoglycemia
Hyperbilirubinemia

37
Q

Becoming cold can lead to respiratory distress primarily because the infant:

A

Needs more oxygen than he or she can supply to generate heat

38
Q

75-80% of the nutrient stores in a newborn term infant are accumulated during the ___ trimester of pregnancy

A

3rd

39
Q

The neonatal nurse should regularly assess the premature infant’s ability to metabolize the TPN solution adequately by monitoring the infant for which of the following clinical manifestations?

A

Hyperglycemia

40
Q

Normal Blood Glucose in an Infant

A

70-100

41
Q

What is the preferred way of giving gavage feeding to an infant?

A

orogastric because they are obligated nose breathers

42
Q

Signs of being ready to Nipple Feed

A

Strong sucking, Swallowing, Gag Reflexes present

@ least 32 weeks

43
Q

Steady weight gain in an infant

A

20-30g/day

44
Q

RDS

A

Neonatal Respiratory Distress Syndrome
Insufficient production of surfactant, atelectasis, hypoxemia, hypercarbia, acidemia

Incidence INCREASES as gestational age DECREASES

45
Q

Manifestations of RDS

A

crackles, poor air exchange, pallor, retractions, apnea, grunting while breathing

46
Q

What is the most common problem in premature infants?

A

RDS

47
Q

LS Ratio 2:1

A

The baby’s lungs are mature and the baby is ready to be born

48
Q

How would the chest X ray of an infant with RDS appear

A

“ground glass” - reticulogranular appearance

49
Q

RDS ABG

A

respiratory acidosis
Decreased pH
Decreased PaO2
Increased PaCO2

50
Q

RDS Tx

A

Surfactant Replacement Therapy

Supportive Tx: Mechanical Ventilation, Correction of acidosis, Parenteral Feedings

51
Q

ROP

A

Retinopathy of Prematruity
Developing blood vessels in a premature infant’s retina constrict and become permanently occluded in response to high oxygen concentrations; damages retina and may cause decreased vision, myopia, or blindness

52
Q

What should be avoided in babies that weigh less than 1500gm

A

SpO2 > 95%

53
Q

BPD

A

Bronchopulmonary Dysplasia

Lower airway: inflamed and scarred lungs

54
Q

How is BPD defined and classified?

A

Gestational Age and O2 requirement: mild, moderate, severe

55
Q

Most Common Chronic Lung Disease of Infancy

A

BPD

56
Q

Clinical Manifestations of BPD

A 
Irritability
Tachypnea, Retractions, Coughing
Failure to thrive
Barrel Chest
Pulmonary HTN
57
Q

BPD Tx

A 
Supplemental O2
Planned Rest Periods
Small frequent meals to prevent overdistension
Diuretics
Bronchodilators
Chest Percussion
58
Q

IVH

A

Intraventricular Hemorrhage
Immature, fragile blood vessels within the brain burst and bleed into the hollow chambers (ventricles) normally reserved for cerebrospinal fluid

59
Q

IVH Dx

A

Ultrasound

60
Q

IVH Grade 1-2

A

Usually no symptoms or long term damage

61
Q

IVH Grade 3-4

A

Symptoms and Long term problems

62
Q

IVH Grade 4

A

Extension into brains issue
50% mortality rate
90% neurologic disabilities

63
Q

IVH Clinical Manifestation

A

Rising ICP: lethargy, poor muscle tone, decreased reflexes, irregular respirations, bradycardia, bulging fontanels
Seizures if bleeding is severe
Hydrocephalus

64
Q

Tx for persistent Hydrocephalus

A

Ventriculoperintoneal Shunt (VP Shunt)

65
Q

How to avoid increasing ICP

A 
Keep infant calm
Minimum stimulation
Head elevated 15 degrees
Avoid trendelenberg
measure head circumference daily
Be alert for subtle neurologic changes
66
Q

NEC

A

Necrotizing Enterocolitis
Life threatening inflammatory disease of intestinal tract
Immature bowel damaged when blood supply decreased, bacteria then invaded damaged area

67
Q

When does NEC usually occur

A

first 7-14 days

68
Q

NEC Clinical Manifestations

A

Nonspecific: lack of energy, unstable body temp, apnea, bradycardia, hypotension, low urinary output
GI symptoms: increased abdominal girth, bile colored vomiting, decreased or absent bowel sounds, loops of bowel seen through the abdominal wall

69
Q

Dx of NEC

A

X-ray and clinical findings

70
Q

NEC tx

A 
STOP oral/tube feedings
Relieve Gas
Antibiotic Therapy
Surgery if there is a hole
Colostomy if full thickness dies
71
Q

SBS

A

Decreased ability to digest and absorb a regular diet because of shortened small intestine
Diarrhea, Dehydration, Malnutrition, FTT

72
Q

Tx of NEC

A

STEP

LILT

NURSING (16 decks)

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