CH 24 Flashcards
Acquired Disorders
-occur at or soon after birth
-problems or conditions experienced by the woman during preg or at birth
-possibly no identifiable cause for the disorder
Congenital Disorders
-present at birth
-due to some type of malformation occurring during the antepartal period; a problem w/ inheritance
-majority w/ a complex etiology
Acquired Conditions of the Newborn
neonatal asphyxia
transient tachypnea
RDS
meconium aspiration
perisisten pulmonary hypertension
bronchopulmonary dysplasia
retinopathy
+ more
Neonatal Asphyxia
-failure to establish adequate sustained respirations after birth - baby on vent
-insufficient oxygen delivery to meet metabolic demands
Assess: risk factors, newborn’s color, breathing, HR, temp, Apgar scores (usually bad)
RN Management: immediate resuscitation, cont observation, neutral thermal environment, blood glucose, parental support & education
Transiet Tachypnea
- mild respiratory distress; pulmonary liquid removed slowly or incompletely; resolved by 72 hrs of age
Assess: maternal sedation or csection, tachypnea, expiratory grunting, retractions, labored breathing, nasal flaring, mild cyanosis, resp rate 100-140; barrel shaped chest
-if you give mom pain meds baby can come out not breathing well
-chest x ray - white out, need to cough/cry to get that stuff out.
Transiet Tachypnea - RN Mangement
-oxygenation
-support
-IV fluids/ gavage feedings
-neutral thermal environment
RDS (respiratory distress syndrome)
-lung immaturity and lack of alveolar surfactant
Assess: risk factors. check for: grunting, nasal flaring, chest wall retractions (chest caves in), see saw respirations, cyanosis, inspiratory crackles, tachypnea (>60), hr (>150 to 180)
chest x ray: more white out
Bladder Exstrophy
-protrusion of bladder onto abdominal wall; bladder grows on the outside
-separation of rectus muscles & symphysis pubis
-boys also w/ epispadias (abnormal opening of the urethra)
-initial bladder closure w/in 48 hrs of birth, further reconstruction 2-3 yrs old
Imperforate Anus
-rectum ending in blind pouch or fistulas btwn rectum and perineum
-no opening in the rectum
-check if there is a large intestine
-most of the time a piece of skin has gone over the opening; just need to remove it
Assess: no anal opening, no passage of meconium, s/s of intestinal obstruction
RN Management: prepare for surgery, post op care
Omphalocele
umbilical ring defect w/ evisceration of abdominal contents into external peritoneal sac
-organs on the outside in a covering. stomach, intestines
Gastroschisis
herniation of abdominal contents thru abdominal wall defect (no sac).
-organs on the outside w/ no pouch. Mostly intestines
-put a funnel like thing around opening and put all the organs in. everyday put a little bit more in. keep moist.
-once everything is in they close it up and there will be a scar on the stomach
-no pouch is easier to deal with
Esophageal Atresia & Tracheoesophageal Fistula
-lack of normal separation of esophagus and trachea during embryonic development
-artesia = it just ends. congenitally interrupted esophagus
-fistual = communication between the 2. abnormal communication between trachea and esophagus
Assessment:
1. hydramnios
2. copious frothy bubbles of mucus and drooling; abdominal distention
3. coughing, choking, cyanosis
-
Esophageal Artesia & Tracheoesophageal Fistula RN Management
-prepare for surgery
1. NPO, head elevation, hydration, fluids
2. oxygen and suctioning equipment available
3. comfort measures
4. parent education
-post op
1. TPN and antibiotics; oral feedings w/in 1 wk
2. parent teaching
*keep pt calm -crying = aspiration risk goes up
Cleft Lip & Palate
-cleft lip involves fissures or opening in lip & repaired between 6-12 weeks
-cleft palate involves roof of mouth & repaired between 6-18 months
-most common craniofacial birth defect
-put finger in mouth to check roof of mouth and sucking reflex
-issues w/ feeding - need special nipple
Spina bifida MENINGOCELE
defect that you can see on the outside of the baby.
NO nerves in it
