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Women's Health > Ch23 > Flashcards

Ch23 Flashcards

1
Q

Early insult

A
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2
Q

Early insult

A
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3
Q

Late insult

A

> 28 weeks. Results in intrauterine malnutrition. These kids have normal growth potential with optimal postnatal nutrition, & better prognosis than a fetus with an early insult

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4
Q

Asymmetric

A

Infants whose head & long bones are spared compared to their abdomen & internal organs

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5
Q

Symmetric

A

Fetuses with equally poor growth rates of the head, abdomen, & long bones

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6
Q

SGA newborns typical characteristics

A

Head disproportionately large compared to rest of body
Wasted appearance of extremities; loose dry skin
Reduced subcutaneous fat stores
Decreased amount of breast tissue
Scaphoid abdomen (sunken appearance)
Wide skull sutures
Poor muscle tone over buttocks and cheeks
Thin umbilical cord

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7
Q

SGA newborns: common probs

A 
Perinatal asphyxia
Difficulty with thermoregulation
Hypoglycemia
Polycythemia 
Meconium aspiration 
Hyperbilirubinemia
Birth trauma
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8
Q

Risk Factors Associated with Large-for-Gestational-Age Newborns

A 
Maternal diabetes mellitus or glucose intolerance
Prior history of a macrosomic infant
Multiparity
Post-dates gestation
Maternal obesity
Male fetus 
Genetics
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9
Q

LGA newborns: common characteristics

A

Large body, plump, full-faced
Proportional increase in body size
Poor motor skills
Difficulty regulating behavioral states

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10
Q

LGA Newborns: Common Problems

A

Birth trauma
Hypoglycemia
Polycythemia
Hyperbilirubinemia

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11
Q

Gestational age: Term

A

Born between 38 and 41 weeks

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12
Q

Late insult

A

> 28 weeks. Results in intrauterine malnutrition. These kids have normal growth potential with optimal postnatal nutrition, & better prognosis than a fetus with an early insult

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13
Q

Asymmetric

A

Infants whose head & long bones are spared compared to their abdomen & internal organs

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14
Q

Symmetric

A

Fetuses with equally poor growth rates of the head, abdomen, & long bones

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15
Q

SGA newborns typical characteristics

A

Head disproportionately large compared to rest of body
Wasted appearance of extremities; loose dry skin
Reduced subcutaneous fat stores
Decreased amount of breast tissue
Scaphoid abdomen (sunken appearance)
Wide skull sutures
Poor muscle tone over buttocks and cheeks
Thin umbilical cord

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16
Q

SGA newborns: common probs

A 
Perinatal asphyxia
Difficulty with thermoregulation
Hypoglycemia
Polycythemia 
Meconium aspiration 
Hyperbilirubinemia
Birth trauma
17
Q

Risk Factors Associated with Large-for-Gestational-Age Newborns

A 
Maternal diabetes mellitus or glucose intolerance
Prior history of a macrosomic infant
Multiparity
Post-dates gestation
Maternal obesity
Male fetus 
Genetics
18
Q

LGA newborns: common characteristics

A

Large body, plump, full-faced
Proportional increase in body size
Poor motor skills
Difficulty regulating behavioral states

19
Q

LGA Newborns: Common Problems

A

Birth trauma
Hypoglycemia
Polycythemia
Hyperbilirubinemia

20
Q

Gestational age: Term

A

Born between 38 and 41 weeks

21
Q

Postterm newborn: common characteristics

A

Inability of placenta to provide adequate oxygen and nutrients to fetus after 42 weeks
Nursing assessment: Typical characteristics
Dry, cracked, wrinkled skin; possibly meconium-stained
Long, thin extremities; long nails; creases cover entire soles of feet
Wide-eyed, alert expression
Abundant hair on scalp
Thin umbilical cord
Limited vernix and lanugo

22
Q

Postterm Newborn: Common Problems

A 
Perinatal Asphyxia
Hypoglycemia
Hypothermia
Polycythemia
Meconium Aspiration
23
Q

Post-term Newborn: Nursing Management

A 
Resuscitation
Blood glucose level monitoring
Initiation of feedings; IV dextrose 10%
Prevention of heat loss
Evaluation for polycythemia
Parental support
24
Q

Etiology Leading to Preterm Birth

A

Infections/inflammation
Maternal or fetal distress
Bleeding
Stretching

25
Q

Preterm Newborn: common characteristics

A

Weight

26
Q

Preterm newborn: Respiratory system effects

A

Last body system to mature
Surfactant deficiency, leads to Respiratory Distress Syndrome
Unstable chest wall, leads to atelectasis
Immature respiratory control center, leads to apnea
Smaller respiratory passageways, increased risk for obstruction
Inability to clear fluids, leads to transient tachypnea

27
Q

Preterm newborn: GI System Effects

A

Small stomach capacity
Weak or absent suck & gag reflexes
Challenges with coordinating suck, swallow, & breathe regimen
Limited ability to digest proteins & absorb nutrients
Compromised metabolic function
Minimal enteral feeding utilized to prepare gut for oral feedings
Perinatal hypoxia can cause oxygen shunting to the heart & brain, resulting in GI ischemia & damage

28
Q

Preterm newborn: Renal System Effects

A

Reduced ability to concentrate urine
Reduced glomerular filtration rate
Increased risk for fluid retention, fluid & electrolyte imbalances
Increased risk for drug toxicity

29
Q

Preterm newborn: Immune System Effects

A

Increased susceptibility to infections (Thin skin, Fragile blood vessels, Immaturity of immune system)
Deficiency of IgG, as transplacental transfer occurs after 34 weeks gestation
Impaired ability to manufacture antibodies

30
Q

Preterm Newborn: Common Problems

A

Hypothermia
Hypoglycemia
Hyperbilirubinemia
Problems related to immaturity of body systems

31
Q

Promoting oxygenation

A

If the 1 or 5 minute Apgar score is 100bpm, a good cry, or good breathing efforts, and a pink tongue

32
Q

If depression is due to narcotics…

A

give naloxone (narcan)

33
Q

If metabolic acidosis is present…

A

give sodium bicarbonate

34
Q

To improve heart rate …

A

administer epinephrine (Adrenalin) via ET tube and repeat

35
Q

S/S of cold stress

A

Respiratory distress, central cyanosis, hypoglycemia, lethargy, weak cry, abdominal distention, apnea, bradycardia, and acidosis

36
Q

Asses fluid status by

A

Weight, urinary output, urine specific gravity, skin turgor, fontanels, temperature elevation, lethargy, & tachypnea
Serum electrolyte levels, blood urea nitrogen, creatinine, & hematocrit

37
Q

S/S of infection

A

Temperature instability, tachycardia, tachypnea, apnea, poor feeding, irritability, pallor, jaundice, hypotonia, hypoglycemia

38
Q

Suspect pain if the newborn exhibits:

A

Sudden high-pitch cry
Facial grimace (furrowed brow and quivering chin)
Increased muscle tone
Body posturing (arching/squirming, kicking/thrashing)
Increase in heart rate, bp, & resp rate
O2 desaturation

Women's Health (10 decks)

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