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Acquired/Congenital Newborn Conditions Flashcards

1
Q

Acquired Disorders

A

result from problems or conditions experienced by the woman during her pregnancy or at birth

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2
Q

When do acquired conditions occur?

A

Soon after or at birth

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3
Q

What maternal conditions could cause acquired disorders?

A
  • maternal diabetes
  • maternal infection
  • substance abuse
  • prolonged ROM/fetal distress
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4
Q

Congenital Disorders

A

structural, functional, or metabolic abnormalities at birth

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5
Q

What are the most common serious congenital defects?

A

Heart defects
Neural tube defects
Down syndrome

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6
Q

Congenital Disorders often involve a problem with what?

A

inheritance, structural anomalies, chromosomal disorders, an inborn errors of metabolism

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7
Q

Neonatal Asphyxia

A

failure to establish adequate, sustained respirations after birth

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8
Q

What is the patho for Neonatal Asphyxia?

A

insufficient oxygen delivery to meet metabolic needs

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9
Q

Nursing Assessment for Neonatal Asphyxia

A 
risk factors 
newborn's color
work of breathing 
HR, temp
APGAR scores
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10
Q

Nursing Management of Asphyxia

A 
immediate resuscitation 
continued observation
neutral thermal environment
 BG levels 
parental support/education
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11
Q

Risk factors for Asphyxia

A 
trauma
intrauterine asphyxia 
sepsis 
malformation 
hypovolemic shock
medication
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12
Q

Transient Tachypnea

A

self-limiting condition involving mild respiratory distress, retention of lung fluid, or transient pulmonary edema

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13
Q

When does transient tachypnea typically resolve?

A

w/in 24-72 hours

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14
Q

Nursing Assessment for Transient Tachypnea

A
  • maternal sedation or birth by c/s
  • tachypnea
  • expiratory grunting
  • retractions
  • labored breathing; nasal flaring
  • mild cyanosis
  • RR 100-140
  • barrel-shaped chest
  • low breath sounds
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15
Q

Nursing Management for Transient Tachypnea

A

Oxygenation
Supportive Care
IV fluids or gavage feedings
Neutral thermal environment

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16
Q

Where does an intraventricular hemorrhage usually originate?

A

The subependymal germinal matrix region of the brain w/ extension into the ventricular system

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17
Q

Respiratory Distress Syndrome results from what?

A

lung immaturity and lack of alveolar surfactant

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18
Q

What is the most common risk factor for the development of respiratory distress syndrome?

A

Premature birth

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19
Q

What other risk factors are there for RDS?

A 
C/S
male gender
previous birth w/ RDS
perinatal asphyxia 
cold stress
maternal diabetes
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20
Q

S/S of RDS

A 
expiratory grunting 
nasal flaring 
chest wall retractions 
seesaw respirations 
generalized cyanosis 
HR > 150-180
inspiratory crackles 
tachypnea (RR > 60)
silverman-anderson index score > 7
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21
Q

Silverman-anderson Index

A

assessment scoring system that can be used to evaluate 5 parameters of work of breathing

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22
Q

What will the chest x-ray reveal for RDS?

A

hypoaeration
underexpansion
ground glass pattern

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23
Q

Nursing Management for RDS

A
  • supportive care; close monitoring
  • respiratory modalities
  • antibiotics/correction of metabolic acidosis
  • fluids and vasopressors; gavage/IV feedings
  • cluster care; prone/side-lying position
  • parental support
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24
Q

Meconium Aspiration Syndrome

A

inhalation of particulate meconium w/ amniotic fluid into lungs

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25
Risk Factors for Meconium Aspiration Syndrome
``` maternal hypertension placental insufficiency preeclampsia fetal hypoxia transient umbilical compression oligohydramnios drug abuse ```
26
What would indicate that meconium has been present for some time?
yellowish-green staining of umbilical cord, nails, and skin
27
S/S of MAS
``` Barrel-shaped chest prolonged tachypnea increasing respiratory distress intercostal retractions expiratory grunting cyanosis ```
28
MAS Nursing Management
``` Suctioning at birth Adequate tissue perfusion Decrease in oxygen demand and energy Neutral thermal environment Parental support ```
29
Necrotizing Enterocolitis
inflammatory disease of the bowel
30
What can NEC cause?
ischemic and necrotic injury in the GI tract
31
What are the 3 pathologic mechanisms for NEC?
Bowel ischemia Bacterial flora Effect of feeding
32
S/S of NEC
``` abdominal distention and tenderness bloody stools feeding intolerance/bilious vomiting sepsis lethargy apnea shock ```
33
NEC Nursing Management
Maintenance of fluid/nutritional status Surgery w/ proximal enterostomy Supportive care Family education
34
How can you maintain fluid and nutritional status for NEC?
Bowel rest and antibiotic therapy | IV fluids
35
What happens to infants of diabetic mothers?
high levels of maternal glucose cross placenta stimulating increased fetal insulin production leading to fetal complications
36
Infants of Diabetic Mothers Characteristics
``` Full rosy cheeks ruddy skin color short neck buffalo hump massive shoulders distended upper abdomen excessive fat hypoglycemia birth trauma ```
37
When would hypomagnesemia be suspected?
when hypocalcemia does NOT respond to calcium
38
What laboratory tests should be performed for babies of mothers w/ diabetes?
hypocalcemia hypomagnesemia polycythemia hyperbilirubinemia
39
Nursing Management for Infants w/ Diabetic moms
Prevention of hypoglycemia Maintenance of fluid/electrolyte balance Parental support
40
How can you help to prevent hypoglycemia?
Oral feedings, neutral thermal environment, and rest periods
41
Maintenance of Fluid/Electrolyte balance
calcium level monitoring fluid therapy bilirubin level monitoring
42
What are the most commonly abused substances during pregnancy?
tobacco alcohol marijuana
43
Fetal Alcohol Syndrome
physical and mental disorders appearing at birth and remaining problematic throughout life
44
What are other disorders related to alcohol?
Fetal alcohol spectrum disorders Alcohol related neurodevelopmental disorder Alcohol related birth defects
45
Neonatal Abstinence Syndrome
drug dependency acquired in utero manifested by neurologic and physical behaviors
46
What maternal history should you look for to identify risk factors of substance abuse?
``` previous unexplained fetal demise/preterm birth lack of prenatal care incarceration toxicology screens History of STI's history of intimate partner violence mental health disorders ```
47
Newborn Behaviors w/ substance abuse
CNS dysfunction Metabolic, vasomotor, and respiratory disturbances GI dysfunction
48
Nursing Management for Infants of Substance-Abusing Moms
comfort promotion; stimuli reduction nutrition prevention of complications parent-newborn interaction
49
Birth Trauma
injuries due to forces of labor and birth
50
Types of Birth Trauma
``` fractures brachial plexus injuries cranial nerve trauma head trauma cephalhematoma caput succedaneum ```
51
Nursing Management for Birth Trauma
``` Supportive Assessment for resolution or complications Support/Education Realistic appraisal of situation Community referrals ```
52
Hyperbilirubinemia
imbalance in rate of bilirubin production and elimination | level > 5 mg/dL
53
Physiologic Jaundice
unconjugated hyperbilirubinemia that occurs after the first postnatal day and can last up to 1 week
54
What are the 2 different types of physiologic jaundice?
Early-onset breast feeding | Late-onset breast feeding
55
Early-Onset Breastfeeding Jaundice is associated w/ what?
ineffective breastfeeding practices b/c of relative caloric deprivation in the first few days of life
56
Late-Onset Breastfeeding Jaundice may occur b/c of?
change in milk composition resulting in enhanced enterohepatic circulation
57
Pathologic Jaundice
manifested w/in the first 24 hours of life
58
Kernicterus
chronic bilirubin encephalopathy
59
S/S of Kernicterus
movement disorder auditory dysfunction oculomotor impairment dental enamel hypoplasia
60
What is the most common condition associated w/ pathologic jaundice?
hemolytic disease of the newborn secondary to incompatibility of blood groups
61
What are the 2 most frequent blood incompatibility conditions?
Rh isoimmunization | ABO incompatibility
62
Where does neonatal jaundice first become visible?
face and forehead
63
Nursing Assessment for Hyperbilirubinemia
Risk factors Jaundice Signs of Rh incompatibility Bilirubin levels
64
Nursing Management for Hyperbilirubinemia
Reduction of bilirubin levels w/ early feedings, phototherapy, exchange transfusions Education and Support
65
Neonatal Sepsis
bacterial, fungal, or viral microorganisms or their toxins in blood or other tissues
66
Classifications of Neonatal Sepsis
``` Congenital (intrauterine) Early onset (perinatal period) Late Onset ```
67
Nursing Assessment for NNS
risk factors nonspecific symptoms elevated C-reactive protein positive culture
68
Nursing Management for NNS
- Antibiotic therapy - Circulatory, respiratory, nutritional, and developmental support - Education for prevention/recognition - Primary disease prevention - Family education
69
Esophageal Atresia
congenitally interrupted esophagus
70
Tracheoesophageal Fistula
abnormal communication b/t trachea and esophagus
71
Nursing Assessment for EA/TF
hydramnios copious frothy bubbles of mucus and drooling abdominal distention coughing, choking, and cyanosis
72
Preparation of Surgery/Preop Care for EA/TF
- NPO, head elevation, hydration and fluids - Oxygen and suctioning - Comfort measures - Parental education
73
Postop Care for EA/TF
- TPN and antibiotics - Oral feeding w/in 1 week - Parental teaching
74
Omphalocele
umbilical ring defect w/ evisceration of abdominal contents into external peritoneal sac
75
Gastroschisis
herniation of abdominal contents through abdominal wall defect w/ NO peritoneal sac

NU314 OB (21 decks)

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