CH 24 Congenital and Acquired Newborn Conditions Flashcards
congenital vs acuired disorders
congenital: PRESENT at birth due to some kind of malformation occuring during the antepartal period; problem with injeritance
acquired: occur AT or SOON AFTER birth; problems experienced by woman during her pregnancy or at birth; usually no cause
Neonatal asphyxia
- acquired
-lack of oxygen and blood flow to baby’s BRAIN - causes: excess fluid in lungs, umbilical chord arnd throat, baby is postterm and placents is starting to degrade
when is a newborn said to have asphyxia
when within 1 minute of age the newborn fails to establish adequate, sustained respiration on their own
Hypoxic- Ischemic Encephalopathy
1. what is it
2. nursing management
- acute or subacute brain injury due to systemic hypoxemia or reduced cerebral blood flow
- immediate resuscitation, monitor blood glucose levels
Transient Tachypnea
1. what is it
2. what babies do we commonly see it in
3. signs/symptoms
- Fast breathing (mild respiratory distress)
- C-section babies and late preterm
- RR 11-140, barrel shaped chest, mild cyanosis, nasal flaring, labored breathing
If not treated, what can transient tachypnea turn into
Respiratory Distress Syndrome
- What is Respiratory Distress Syndrome
- signs/symptoms
- result from lung immaturity and LACK OF ALVEOLAR SURFACTANT, which keeps the air sacs in the lungs from collapsing and allows them to inflate easily.
- expiratory grunting, HR >150, crackles, tachypnea >60, chest wall retractions, central cyanosis, nasal flaring
Nurse Management for child with Respiratory Distress Syndrome
- ventialtion, oxygen therapy
- antibiotics for positive cultures
- Fluids and vasopressors
- IV feedings
- Monitor blood glucose, O2, RR
most common risk for development of Respiratory Distress Syndrom (RSD)
premature birth
- also can be cesarean birth becuase they did not have vaginal and didn’t experience that thoracic squeezing
CPAP vs PEEP and what is their main purpose
PEEP
Positive end-expiratory pressure maintains positive airway pressure at the END of exhalation.
CPAP
Continuous positive airway pressure maintains positive airway pressure throughout the entire respiratory cycle, including during inspiration.
Treatment For RDS: This helps prevent volume loss during expiration
Meconium Aspiration Syndrome
- what is it
- s/s
- Inhalation of meconium with amniotic fluid into lungs; secondary to hypoxic stress
- prolonged tachypnea, barrel shaped chest, resp. distress, intercostal retractions
What procedure/test can conform meconium aspiration syndrome
If respiratory distress is present, a chest X-ray is usually performed: will show patchy fluffy infiltrates
What is Persisent Pulmonary Hypertension of the Newborn
pulmonary hypertension causing right-to-left extrapulmonary shunting and hypoxemia
Nursing assesment and s/s for Pulmonary Hypertension in newborn
- tachypnea within 12 hours after birth
- marked cyanosis, grunting retractions
- systolic ejection murmur
- echocardiogram: shows right-to-left shunting of blood
Periventricular- Intraventricular Hemorrhage (PVH/IVH)
- what is it
- who is at risk
- s/s
- what do we give moms to prevent this
- Bleeding in the brain due to fragility of cerebral vessels (intracranial bleed)
- at risk: SGA, preterm
- unexplained drop in hematocrit, pallor, poor perfusion, lethargic, weak suck, high pitched cry
- at delivery we give mag sulfate
Necrotizing Enterocolitis
- happens in the gut, part of gut is not working due to lack of blood supply and starts to die
