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Women's Health > Ch24 > Flashcards

Ch24 Flashcards

1
Q

Acquired Disorders

A

Typically occur at, or soon after, birth
May result from problems or conditions experienced by the woman during her pregnancy or at birth
There may be no identifiable cause for the disorder

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2
Q

Congenital Disorders

A

Present at birth; usually due to some type of malformation occurring during the antepartal period
Typically involve some problem with inheritance
Majority have a complex etiology

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3
Q

Acquired conditions of newborn

A 
Neonatal asphyxia
Transient tachypnea of the newborn
Respiratory distress syndrome
Meconium aspiration
Persistent pulmonary hypertension
Bronchopulmonary dysplasia
Retinopathy of prematurity
Periventricular or intraventricuar hemorrhage (PVH/IVH)
Necrotizing enterocolitis (NEC)
Infants of diabetic mothers
Birth trauma
Newborns of perinatal substance-abusing mothers
Hyperbilirubinemia
Newborn infections
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4
Q

Transient Tachypnea of Newborn (TTN)

A

Retention of lung fluid or transient pulmonary edema
Occurs in 1st hours of life & resolves by 72 hours of age
May have grunting, nasal flaring, cyanosis, barrel chest

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5
Q

Respiratory Distress Syndrome (RDS)

A

Breathing disorder resulting from lung immaturity & lack of alveolar surfactant
Stiff lungs - atelactasis

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6
Q

Respiratory Distress Syndrome (RDS) S/S

A

Expiratory grunting, nasal flaring, chest wall retractions, see-saw respirations, generalized cyanosis; heart rate > 150 to 180; fine inspiratory crackles, tachypnea (rates > 60), Silverman-Anderson Index score > 7
Chest x-ray: Hypoaeration, underexpansion, and ground glass pattern

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7
Q

Meconium Aspiration Syndrome (MAS)

A

Inhalation of particulate meconium with amniotic fluid into lungs; secondary to hypoxic stress

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8
Q

Meconium Aspiration Syndrome (MAS) S/S

A

Staining of amniotic fluid, nails, skin, or umbilical cord
Barrel-shaped chest; prolonged tachypnea, increasing respiratory distress; intercostal retractions, end expiratory grunting, cyanosis
Chest x-ray: patchy fluffy infiltrates, hyperaeration with atelectasis; ABGs: metabolic acidosis

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9
Q

Persistent Pulmonary Hypertension of the Newborn (PPHTN)

A

A cardiopulmonary disorder characterized by marked pulmonary hypertension that causes R-to-L extrapulmonary shunting of blood & hypoxemia
Blood bypasses lungs causing hypoxemia and acidosis

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10
Q

Persistent Pulmonary Hypertension of the Newborn (PPHTN) S/S

A

Tachypnea within 12 hours after birth
Marked cyanosis, grunting, and retractions
Systolic Ejection Murmur
Echocardiogram: right to left shunting of blood

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11
Q

Bronchopulmonary Dysplasia (BD)

A

Referred to as chronic lung disease, associated with newborns who have lung injury; need continued oxygen after initial 28 days of life

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12
Q

Bronchopulmonary Dysplasia (BD) S/S

A

tachypnea, poor weight gain, tachycardia, sternal retractions, nasal flaring, bronchospasm (abnormal breath sounds–crackles, wheezing); abnormal blood gas results (hypoxia)
want to give them high caloric foods

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13
Q

BD risk factors

A

male, preterm birth 1 week, sepsis

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14
Q

Retinopathy of Prematurity (ROP)

A

Developmental abnormality affecting immature blood vessels of the retina
ROP can lead to vision impairment & blindness
No S/S
Minimize use of Oxygen

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15
Q

Periventricular-Intraventricular Hemorrhage (PVH/IVH)

A

Bleeding in the brain due to fragility of cerebral vessels, most common in infants born under 30 weeks gestation, oftentimes occurs in the first 72 hours after birth, Grades I to V

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16
Q

Periventricular-Intraventricular Hemorrhage (PVH/IVH) S/S

A

possibly no symptoms
Unexplained drop in hematocrit, pallor, poor perfusion, oxygen desaturation, seizures, lethargy, weak suck, high-pitched cry, hypotonia
Monitor for bradycardia,

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17
Q

Necrotizing Enterocolitis

A

Serious GI disease occurring in newborns
Oxygen is shunted away from the gut to heart & lungs
Typically occurs in babies who are formula fed, in first few weeks

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18
Q

Necrotizing Enterocolitis S/S

A

abdominal distention and tenderness, bloody stools, feeding intolerance (bilious vomiting), signs of sepsis, lethargy, apnea, shock

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19
Q

Infants of diabetic mothers S/S

A

Full, rosy cheeks with a ruddy skin color
Short-appearing neck (some describe “no-neck” appearance)
Buffalo hump over the nape of the neck
Massive shoulders with a full intrascapular area
Distended upper abdomen due to organomegaly
Excessive subcutaneous fat tissue, producing fat extremities
Hypoglycemia
Birth trauma
Hypocalcemia, hypomagnesemia, polycythemia, hyperbilirubinemia

20
Q

Infant of diabetic mother monitoring

A

want Blood glucose > 40mg/dL

Monitor blood glucose by heel stick q1h x 4h, then q3-4h until stable

21
Q

Alcohol effect on fetus

A

FAS, common cause of mental retardation, alcohol related birth defects, alcohol related neurodevelopmental disorders

22
Q

Tobacco effect on fetus

A

Nicotine crosses placenta, causes impaired oxygenation. Increased risk for low birthweight, SGA, & preterm birth. Increased risk for SIDS, chronic respiratory illnesses, & ear infections

23
Q

Marijuana effect on fetus

A

IUGR is common due to CO to fetus. Increased risk of SGA baby. Altered response to visual stimuli, photophobia, sleep-pattern abnormalities, hyperirritability, increased tremulousness, deficits in memory, attention, cognitive function & motor skills

24
Q

Fetal Alcohol Syndrome (FAS)

A 
Growth restriction                          (prenatal & postnatal)
Craniofacial structural anomalies (short fissures, flat midface, short nose, thin upper lip, micrognathia, epicanthal folds, low nasal bridge, epicanthal folds)
CNS dysfunction
25
Q

Neonatal Abstinence Syndrome (NAS)

A

NAS is the constellation of neurologic & physical behaviors that occur as a result of drug dependence acquired in utero.

26
Q

Neonatal Abstinence Syndrome (NAS) S/S

A 
W = Wakefulness
I = Irritability
T = Temperature variation, tachycardia, tremors
H = Hyperactivity, high-pitched cry, hyperreflexia, hypertonus
D = Diarrhea, diaphoresis, disorganized suck
R = Respiratory distress, rub marks, rhinorrhea
A = Apneic attacks, autonomic dysfunction
W = Weight loss or failure to gain weight
A = Alkalosis (respiratory)
L = Lacrimation
27
Q

Hyperbilirubinemia

A

Results from an imbalance in the rate of bilirubin production and bilirubin elimination
Elevated serum bilirubin levels are manifested as jaundice in the newborn
Breastfed newborns jaundice peaks on day 4 of life; Formula-fed newborns jaundice peaks on day 3 of life.
Bilirubin levels rise >5mg/dL/day & total bili is >17mg/dL

28
Q

Three classes of infection:

A

Congenital (acquired in utero)
Early-Onset (vertical transmission before/during birth- vaginal or breast milk)
Late-Onset (horizontal transmission in the hospital- contact with other people)

29
Q

Microcephaly

A

Head circumference that is more than 2 standard deviations below the mean for age & sex.

30
Q

Hydrocephalus

A

Increase in cerebrospinal fluid in the ventricles of the brain

31
Q

Choanal Atresia

A

Malformation of the upper airway which involves a narrowing of the nasal airway due to membranous or bony tissue. May be unilateral or bilateral.

32
Q

Choanal Atresia S/S

A

respiratory distress, cyanosis unless crying, inability to suck & breathe simultaneously
gagging and spitting when eating

33
Q

Congenital Diaphragmatic Hernia (CDH)

A

Abnormal insertion of the diaphragm, allowing some or all of the abdominal organs/contents to enter the thoracic cavity impeding lung development.

34
Q

Congenital Diaphragmatic Hernia (CDH) S/S

A

Acute respiratory distress, cyanosis, sternal retractions, grunting, nasal flaring, tachycardia, tachypnea, barrel chest & concave abdomen

35
Q

Cleft Lip and Palate treatment

A

Cleft lip, surgical repair between 6 and 12 weeks. Cleft palate, surgical repair between 6 and 18 months

36
Q

Esophageal Atresia (EA)

A

congenitally interrupted esophagus

37
Q

Tracheoesophageal Fistula

A

abnormal communication between trachea and esophagus

38
Q

Esophageal Atresia (EA) & Tracheoesophageal Fistula (TEF) S/S

A

3 C’s: Coughing, choking, and cyanosis, if feeding is attempted
They can’t eat or drink by mouth
High aspiration risk

39
Q

Omphalocele

A

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

40
Q

Gastroschisis

A

Herniation of abdominal contents through abdominal wall defect (no peritoneal sac)

41
Q

Imperforate Anus

A

GI system malformation of the anorectal area.
NPO status & gastric decompression. Monitor hydration status. Explain to parents & treatment modalities. Prepare them for the possibility of a colostomy.

42
Q

Hypospadias

A

Abnormal positioning of the urinary meatus on the underside of the penis
Common birth defect, often occurs in conjunction with chordee

43
Q

Epispadias

A

A rare congenital genitourinary defect occurring in males twice as much as females. Often occurs with exstrophy of the bladder
Males: Urethra generally opens on the top or side rather than the tip of the penis. Circumcision is contraindicated.
Females: Urinary meatus is located between the clitoris and the labia.

44
Q

Bladder Exstrophy

A

Protrusion of bladder onto abdominal wall
Separation of rectus muscles and symphysis pubis
Common in boys also with epispadias

45
Q

Meconium Aspiration Syndrome (MAS) pulmonary effects

A

airway obstruction, surfactant dysfunction, and chemical pneumonitis

Women's Health (10 decks)

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