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NU314 OB > Acquired/Congenital Newborn Conditions > Flashcards

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
Q

Risk Factors for Meconium Aspiration Syndrome

A 
maternal hypertension
placental insufficiency 
preeclampsia
fetal hypoxia 
transient umbilical compression
oligohydramnios 
drug abuse
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26
Q

What would indicate that meconium has been present for some time?

A

yellowish-green staining of umbilical cord, nails, and skin

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27
Q

S/S of MAS

A 
Barrel-shaped chest
prolonged tachypnea
increasing respiratory distress
intercostal retractions 
expiratory grunting 
cyanosis
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28
Q

MAS Nursing Management

A 
Suctioning at birth 
Adequate tissue perfusion
Decrease in oxygen demand and energy
Neutral thermal environment 
Parental support
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29
Q

Necrotizing Enterocolitis

A

inflammatory disease of the bowel

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30
Q

What can NEC cause?

A

ischemic and necrotic injury in the GI tract

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31
Q

What are the 3 pathologic mechanisms for NEC?

A

Bowel ischemia
Bacterial flora
Effect of feeding

32
Q

S/S of NEC

A 
abdominal distention and tenderness 
bloody stools
feeding intolerance/bilious vomiting 
sepsis 
lethargy 
apnea
shock
33
Q

NEC Nursing Management

A

Maintenance of fluid/nutritional status
Surgery w/ proximal enterostomy
Supportive care
Family education

34
Q

How can you maintain fluid and nutritional status for NEC?

A

Bowel rest and antibiotic therapy

IV fluids

35
Q

What happens to infants of diabetic mothers?

A

high levels of maternal glucose cross placenta stimulating increased fetal insulin production leading to fetal complications

36
Q

Infants of Diabetic Mothers Characteristics

A 
Full rosy cheeks 
ruddy skin color
short neck 
buffalo hump 
massive shoulders 
distended upper abdomen 
excessive fat 
hypoglycemia 
birth trauma
37
Q

When would hypomagnesemia be suspected?

A

when hypocalcemia does NOT respond to calcium

38
Q

What laboratory tests should be performed for babies of mothers w/ diabetes?

A

hypocalcemia
hypomagnesemia
polycythemia
hyperbilirubinemia

39
Q

Nursing Management for Infants w/ Diabetic moms

A

Prevention of hypoglycemia
Maintenance of fluid/electrolyte balance
Parental support

40
Q

How can you help to prevent hypoglycemia?

A

Oral feedings, neutral thermal environment, and rest periods

41
Q

Maintenance of Fluid/Electrolyte balance

A

calcium level monitoring
fluid therapy
bilirubin level monitoring

42
Q

What are the most commonly abused substances during pregnancy?

A

tobacco
alcohol
marijuana

43
Q

Fetal Alcohol Syndrome

A

physical and mental disorders appearing at birth and remaining problematic throughout life

44
Q

What are other disorders related to alcohol?

A

Fetal alcohol spectrum disorders
Alcohol related neurodevelopmental disorder
Alcohol related birth defects

45
Q

Neonatal Abstinence Syndrome

A

drug dependency acquired in utero manifested by neurologic and physical behaviors

46
Q

What maternal history should you look for to identify risk factors of substance abuse?

A 
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
Q

Newborn Behaviors w/ substance abuse

A

CNS dysfunction
Metabolic, vasomotor, and respiratory disturbances
GI dysfunction

48
Q

Nursing Management for Infants of Substance-Abusing Moms

A

comfort promotion; stimuli reduction
nutrition
prevention of complications
parent-newborn interaction

49
Q

Birth Trauma

A

injuries due to forces of labor and birth

50
Q

Types of Birth Trauma

A 
fractures
brachial plexus injuries 
cranial nerve trauma 
head trauma 
cephalhematoma 
caput succedaneum
51
Q

Nursing Management for Birth Trauma

A 
Supportive 
Assessment for resolution or complications 
Support/Education 
Realistic appraisal of situation 
Community referrals
52
Q

Hyperbilirubinemia

A

imbalance in rate of bilirubin production and elimination

level > 5 mg/dL

53
Q

Physiologic Jaundice

A

unconjugated hyperbilirubinemia that occurs after the first postnatal day and can last up to 1 week

54
Q

What are the 2 different types of physiologic jaundice?

A

Early-onset breast feeding

Late-onset breast feeding

55
Q

Early-Onset Breastfeeding Jaundice is associated w/ what?

A

ineffective breastfeeding practices b/c of relative caloric deprivation in the first few days of life

56
Q

Late-Onset Breastfeeding Jaundice may occur b/c of?

A

change in milk composition resulting in enhanced enterohepatic circulation

57
Q

Pathologic Jaundice

A

manifested w/in the first 24 hours of life

58
Q

Kernicterus

A

chronic bilirubin encephalopathy

59
Q

S/S of Kernicterus

A

movement disorder
auditory dysfunction
oculomotor impairment
dental enamel hypoplasia

60
Q

What is the most common condition associated w/ pathologic jaundice?

A

hemolytic disease of the newborn secondary to incompatibility of blood groups

61
Q

What are the 2 most frequent blood incompatibility conditions?

A

Rh isoimmunization

ABO incompatibility

62
Q

Where does neonatal jaundice first become visible?

A

face and forehead

63
Q

Nursing Assessment for Hyperbilirubinemia

A

Risk factors
Jaundice
Signs of Rh incompatibility
Bilirubin levels

64
Q

Nursing Management for Hyperbilirubinemia

A

Reduction of bilirubin levels w/ early feedings, phototherapy, exchange transfusions
Education and Support

65
Q

Neonatal Sepsis

A

bacterial, fungal, or viral microorganisms or their toxins in blood or other tissues

66
Q

Classifications of Neonatal Sepsis

A 
Congenital (intrauterine)
Early onset (perinatal period)
Late Onset
67
Q

Nursing Assessment for NNS

A

risk factors
nonspecific symptoms
elevated C-reactive protein
positive culture

68
Q

Nursing Management for NNS

A
  • Antibiotic therapy
  • Circulatory, respiratory, nutritional, and developmental support
  • Education for prevention/recognition
  • Primary disease prevention
  • Family education
69
Q

Esophageal Atresia

A

congenitally interrupted esophagus

70
Q

Tracheoesophageal Fistula

A

abnormal communication b/t trachea and esophagus

71
Q

Nursing Assessment for EA/TF

A

hydramnios
copious frothy bubbles of mucus and drooling
abdominal distention
coughing, choking, and cyanosis

72
Q

Preparation of Surgery/Preop Care for EA/TF

A
  • NPO, head elevation, hydration and fluids
  • Oxygen and suctioning
  • Comfort measures
  • Parental education
73
Q

Postop Care for EA/TF

A
  • TPN and antibiotics
  • Oral feeding w/in 1 week
  • Parental teaching
74
Q

Omphalocele

A

umbilical ring defect w/ evisceration of abdominal contents into external peritoneal sac

75
Q

Gastroschisis

A

herniation of abdominal contents through abdominal wall defect w/ NO peritoneal sac

NU314 OB (21 decks)

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