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NURS 3800 > Alterations In The Newborn > Flashcards

Alterations In The Newborn Flashcards

0
Q

What qualifies a baby for SGA

A

Below 10th percentile or 5lb 8 oz

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1
Q

Factors that can affect fetal growth

A

Maternal nutrition
Genetics
Placental function
Environmental functions

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2
Q

What qualifies a baby for LGA

A

Above 90th percentile or 8lb 13oz

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3
Q

Typical characteriscs for a SGA newborn

A 
Thin umbilical cord
Head disproportionate large to body 
Sunken appearance to abdomen
Loose dry skin
Wide skull sutures
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4
Q

Common problems for SGA newborns

A 
Hypoglycemia 
Difficulty regulating temperature 
Polycythemia
Birth trauma 
Meconium aspiration 
Hyperbilirubinemia
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5
Q

Nursing management for SGA newborns

A 
Weight, length, and head circumference measurements
Serial blood glucose monitoring
Monitor vital signs
Early and frequent oral feedings
Anticipatory guidance
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6
Q

Risk factors associated with LGA newborns

A 
Maternal diabetes mellitus
Prior history of a macroscomic infant 
Post dates gestation
Male fetus 
Genetics
Maternal obesity
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7
Q

Common characteristics of LGA newborns

A

Large body
Plump, full face
Poor motor skills
Difficulty regulating behavioral states

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8
Q

Common problems with LGA newborns

A

Birth trauma
Hypoglycemia
Polycythemia
Hyperbilirubinemia

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9
Q

What is the one nursing management that is different for LGA newborns than for SGA newborns

A

Hydration

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10
Q

If a baby is full term, at what weeks are they born?
Preterm?
Late preterm?
Post term?

A

38-42
Before 37 weeks
34- end of 36
After 42

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11
Q

Why are creases on the foot important

A

Can tell us more about gestational age

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12
Q

Why is a postterm baby at risk

A

Inability of placenta to provide adequate oxygen and nutrients to fetus after 42 weeks

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13
Q

Postterm newborn complications

A

Hypoglycemia
Hypothermia
Polycythemia
Meconium aspiration

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14
Q

Nursing management for postterm babies

A 
Resuscitation 
Blood glucose monitoring
Initiation if feedings
Prevention of heat loss
Evaluation for polycythemia
Parental support
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15
Q

What are some etiologies leading to preterm birth

A

Infections/inflammation
Maternal or fetal distress
Bleeding
Stretching

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16
Q

What are issues with a preterm baby

A

Body system immaturity affecting transition to extra uterine life

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17
Q

Common characteristics for preterm newborn

A 
Weight less than 5.5
Scrawny, poor muscle tone
Undescended testes
Lots of lanugo
Fused eyelids
Soft, spongy skull bones
Thin transparent skin
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18
Q

Common problems for preterm newborns

A

Hypothermia
Hypoglycemia
Hyperbilirubenemia
Problems with immaturity of body systems

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19
Q

Nursing management for preterm newborn

A 
Oxygenation
Thermal regulation
Nutrition and fluid balance
Infection prevention
Stimulation
Parental support
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20
Q

Acquired disorders

A

Occur at or soon after birth

Possibly no identifiable cause

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21
Q

Congenital disorders

A

Present at birth
Typically some problem with inheritance
Happens during antepartal period
Majority with complex etiology

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22
Q

Examples of acquired conditions for newborns

A 
Transient tachypnea
Respiratory distress syndrome
Meconium aspiration
Birth trauma
Hyperbilirubinemia
23
Q

Neonatal asphyxia

A

Failure to establish sustained respirations after birth
Asses: color, work of breathing, heart rate, temp, and apgar
Management: immediate resuscitation, neutral thermal environment, blood glucose, parental support and education

24
Q

Transient tachypnea of newborn

A

Mild respiratory distress
Pulmonary liquid removed slowly or incompletely
Usually resides in 72 hours of age

25
Q

Respiratory distress syndrome

A

Lung immaturity and lack of alveolar surfactant

26
Q

Meconium aspiration syndrome

A

Inhalation of particulate Meconium with amniotic fluid into lungs

Secondary to hypoxic stress

27
Q

Persistent pulmonary hypertension of the newborn (PPHN)

A

Marked pulmonary hypertension causing right to left extrapulmonary shunting and hypoxemia

28
Q

Nursing assessment for PPHN

A

Tachypnea within 12 hours after birth
Marked cyanosis, grunting, and retractions
Systolic ejection murmur
Echocardiogram (to see right to left shunting)

29
Q

Bronchopulmonary dysplasia

A

Chronic lung disease
Associated with newborns who have lung injury
Need continued oxygen after initial 28 days of life

30
Q

Possible causes for bronchopulmonary dysplasia

A 
Surfactant deficiency
Pulmonary edema
Lung immaturity
Barotrauma
Fluid overload
31
Q

Therapeutic management for bronchopulmonary dysplasia

A

Administer steroids to mother during antepartal period and exogenous surfactant to newborn

32
Q

Retinopathy of prematurity

A

Developmental abnormality affecting immature blood vessels of the retina
5 different stages
If newborn is premature vessels may not develop

33
Q

Does retinopathy of prematurity develop in one or both eyes

A

Both due to hyperoxemia acidosis, or shock

34
Q

What is one thing you must be careful doing to a patient with retinopathy of prematurity

A

Administer oxygen carefully

Ensure lowest concentration and shortest duration

35
Q

Preventricular-intraventricular hemorrhage

A

Bleeding in the brain due to fragility or cerebral vessels

Most common in first 72 hours of life

Grades 1-5

May be no symptoms

36
Q

Necrotizing enterocolitis

A

3 pathological mechanisms: bowel ischemia, bacterial flora, and effect of feeding

37
Q

Signs and symptoms of necrotizing enterocolitis

A 
Abdominal distention and tenderness 
Bloody stools
Feeding intolerance
Sepsis
Lethargy
Apnea
Shock
38
Q

Infants with diabetic mothers

A

High levels of maternal glucose pass through placenta, stimulating fetal insulin production leading to somatic fetal growth

39
Q

What must you watch in a newborn of a diabetic mother

A

Prevention of hypoglycemia

40
Q

Newborns of substance abusing mothers

A

Fetal alcohol syndrome
Birth defects
Drug dependency
Mental disorders

41
Q

Most common substances for substance abusing mothers

A

Tobacco
Alcohol
Marijuana

42
Q

Types of birth trauma

A

Fractures
Cranial nerve trauma
Head trauma

43
Q

Hyperbilirubinemia

A

Imbalance in rate of bilirubin production and elimination

Total serum bilirubin level greater than 5mg/dL

44
Q

Physiologic signs of hyperbilirubinemia

A

Jaundice

45
Q

What does bilirubin do in the body

A

It is produced when the liver breaks down red blood cells

46
Q

Neonatal sepsis

A

Bacterial, fungal, or viral microorganism or their toxins in blood or other tissues

Can be congenital, early onset (perinatal period) or late onset

Antibiotic therapy

47
Q

Congenital conditions

A 
Neural tube defect
Micro/hydrocephalus 
Cleft lip and palate
Congenital club foot
Development of dysplasia of the hip
48
Q

Neural tube defects

A

Occur when the neural tube fails to close properly

Normally between 17 and 30 days of gestation

49
Q

Difference between cleft lip and cleft palate

A

Cleft lip- involves fissure or opening in lip

Cleft palate- involves roof of mouth

50
Q

Esophageal atresia

A

Congenitally interrupted esophagus

51
Q

Tracheoesophageal fistula

A

Abnormal communication between trachea and esophagus

52
Q

Omphalocele

A

Umbilical ring defect with evisceration of abdominal contents into external peritoneal sac

53
Q

Gastroschisis

A

Herniation of abdominal contents through abdominal wall defect

54
Q

Imperforate anus

A

No opening in anus

Prepare newborn for surgery

55
Q

Club foot

A

Tendons of foot are shorter
May be associated with Edwards syndrome
Surgical intervention with complete recovery

56
Q

Skin rashes

A 
Stork bites
Mongolian spots
Hemangiomas
Port-wine stains
Jaundice

NURS 3800 (19 decks)

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