CH. 42 NEONATAL CARE Flashcards
a decrease in the amount of oxygen delivered to the extremities. The hands and feet turn blue because of narrowing of the arteries toward the arms and legs
acrocyanosis
a clear slightly yellowish liquid that surrounds the fetus during pregnancy and contained in the amniotic sac
amniotic fluid
scale used to assess the status of a newborn 1 and 5 minutes after birth
Apgar score
respiratory pause greater than or equal to 20 seconds
apnea
condition of severely deficient supply of oxygen to the body leading to end organ damage
asphyxia
a hole in the atrial septal wall that allows oxygenated and deoxygenated blood to mix; patients with this hole have a higher incidence of stroke
atrial septal defect (ASD)
a pulse rate of less than 100 beats/min in the newborn
bradycardia
bluish coloration of the skin due to the presence of deoxygenated hemoglobin in blood vessels near the skin
central cyanosis
a narrowing or blockage of the nasal airway by membranous or bony tissue; a congenital condition meaning it is present at birth
choanal atresia
an abnormal defect or fissure in the upper lip that failed to close during development and is often associated with cleft palate
cleft lip
a fissure or hole in the palate (roof of the mouth) that forms a communicating pathway between the mouth and nasal cavities
cleft palate
pinching or narrowing of the aorta that obstructs blood flow from the heart to the systemic circulation
coarctation of the aorta (CoA)
the most common birth defect and associated with hypoxia in the newborn period requiring intervention during the first months of life
congenital heart disease (CHD)
passage of loops of bowel with or without other abdominal organs through a developmental defect in the diaphragm muscle; occurs as the bowel from the abdomen herniates upward through the diaphragm into the chest cavity
diaphragmatic hernia
lack of movement at the shoulder due to nerve injury resulting from the stretching of the cervical nerve roots (C5 and C6) during the delivery of the newborns head during birth. The effect is usually transient but can be permanent
Erb Palsy
the process through which the fluid in the fetal lungs is replaced with air, the ductus arteriosus constricts and the newborn begins adequate oxygenation of its own blood
fetal transition
an opening in the septum of the heart that closes after birth
foramen ovale
oxygen administered via an oxygen tube and a cupped hand on patient’s face
free flow oxygen
seizure activity that is bilateral synchronous and nonmigratory
generalized seizure
period of time from conception to birth
gestation
noises heard when an infant is having difficulty breathing; short inarticulate guttural sounds as effort is expended
grunting
a deficiency of glucose in the blood caused by too much insulin or too little glucose; in the newborn it is a level of less than 40 mg/dL, and in older neonates it is a level of less than 60 mg/dL
hypoglycemia
underdevelopment of the aorta, aortic valve, left ventricle, and mitral valve; this defect involves the entire left side of the heart
hypoplastic left heart syndrome (HLHS)
a condition in which the core body temperature is significantly below normal (less than 35 degrees celsius)
hypothermia
low or poor muscle tone (floppy)
hypotonia
damage to cells in the central nervous system like the brain and spinal cord from inadequate oxygen
hypoxia ischemic encephalopathy
marked hypertrophy and hyperplasia of the two (circular and longitudinal) muscular layers of the pylorus resulting in the pylorus becoming thick and obstructing the end of the stomach
intercostal retractions
a congenital condition in which part of the bowel does not develop
intestinal atresia
a congenital condition in which part of the bowel is narrow
intestinal stenosis
an event where one part of the intestine folds into another part of the intestines leading to a blockage
intussusception
an injury of childbirth affecting the spinal nerves C7, C8, and T1 of the brachial plexus. It can be contrasted to Erb palsy which affects C5 and C6
Klumpke paralysis
large tongue size
macroglossia
a congenital anomaly of rotation of the midgut, the small bowel is found predominantly on the right side of the abdomen. Results in increased incidence of intestinal volvulus
malrotation
a dark green fecal material that accumulates in the fetal intestines and is discharged around the time of birth
meconium
seizure activity that involves more than one site is asynchronous and is usually migratory
multifocal seizure
intermittent outward movements of the nostrils with each inspiration and indicates an increase in the work needed to breathe
nasal flaring
infant during the first month after birth
neonate
infant within the first few hours after birth
newborn
decreased volume of amniotic fluid during a pregnancy; a risk factor associated with abnormalities of the urinary tract, postmaturity (birth after a prolonged pregnancy), and intrauterine growth retardation
oligohydramnios
a situation in which the ductus arteriosus, which assists in fetal circulation, does not transition as it should after birth to become the ligamentum arteriosum; the result is the the connection between the pulmonary artery and the aorta remains, allowing some oxygenated blood to move back into the heart rather than all of it moving out of the aorta and into systemic circulation
patent ductus arteriosus (PDA)
a condition in which stomach acid rises into the esophagus on a regular or frequent basis potentially causing irritation and damage; a common cause of vomiting
pathogenic gastroesophageal reflux (GER)
delayed transition from fetal to neonatal circulation
persistent pulmonary hypertension
a condition present at birth marked by a small lower jaw (micrognathia). The tongue tends to fall back and downward (glossoptosis) and there is a cleft soft palate
Pierre Robin sequence
abnormal location of the placenta in the lower part of the uterus near or over the cervix
placenta previa
abnormally high red blood cell count
polycythemia
an excessive amount of amniotic fluid. May cause preterm labor
polyhydramnios
method for assisting ventilation (bag mask or intubated) with high flow air or supplemental oxygen
positive pressure ventilation (PPV)
any pregnancy that lasts more than 42 weeks
post-term
underdeveloped
premature
used to describe an infant delivered at less than 37 completed weeks
preterm
apnea caused by oxygen deprivation; usually corrected with stimulation, such as drying or slapping the newborn’s feet. Primary apnea is typically preceded by an initial period of rapid breathing
primary apnea
first pregnancy
primigravida
when the umbilical cord presents itself outside of the uterus while the fetus is still inside; an obstetric emergency during pregnancy or labor that acutely endangers the life of the fetus; can happen when the amniotic sac breaks and with the gush of amniotic fluid the cord comes along
prolapsed cord
elevated blood pressure in the pulmonary arteries from construction; causes problems with the blood flow in the lungs, and makes the heart work harder
pulmonary hypertension
narrowing of the pulmonary valve
pulmonary stenosis
a disease of the eye that affects prematurely born infants and thought to be caused by disorganized growth of retinal blood vessels resulting in scarring and retinal detachment; can lead to blindness in serious cases
retinopathy of prematurity
when asphyxia continues after primary apnea, infant responds with a period of gasping respirations, falling pulse rate, and falling blood pressure. Positive pressure ventilations is indicated to reverse secondary apnea
secondary apnea
a paroxysmal alteration in neurologic function - behavioral and/or autonomic function
seizure
an infant whose size and weight are considerably less than the average for infants of the same age
small for gestational age
a substance formed in the lungs that helps keep the small air sacs or alveoli from collapsing and sticking together; a low level in a premature infant contributes to respiratory distress syndrome
surfactant
used to describe a newborn delivered at 38 to 42 weeks of gestation
term
a cardiac anomaly that consists of four defects; a ventricular septal defect, pulmonary stenosis, right ventricular hypertrophy, and an overriding aorta
tetralogy of Fallot (ToF)
the process by which the body maintains temperature through a combination of heat gain by metabolic processes and muscular movement and heat loss through respiration, evaporation, conduction, convection, and perspiration
thermoregulation
a rare congenital defect in which the four pulmonary veins do not connect to the left atrium; instead, the pulmonary veins connect to the right atrium resulting in diminished oxygen and an increased load on the right ventricle
total anomalous pulmonary venous return (TAPVR)
a defect in which the great vessels are reversed; the aorta is connected to the right ventricle, and the pulmonary artery is connected to the left ventricle
transposition of the great arteries (TGA)
the absence of a tricuspid valve, which normally separates the right atrium and the right ventricle
tricuspid atresia
a condition in which the pulmonary artery and the aorta are combined into one
truncus arteriosus
the blood vessel in the umbilical cord used to administer emergency medication
umbilical vein
a hole in the septum separating the ventricles and allowing blood from the left ventricle to flow into the right ventricle
ventricular septal defect (VSD)
