Ch34 study guide (nursing care of the high risk newborn and family)

Question 1

infant whose birth weight is less than 2500g, regardless of gestational age

Answer 1

low birth weight (LBW)

Question 2

infant whose birth weight is less than 1500g

Answer 2

very low birth weight (VLBW)

Question 3

infant whose birth weight is less than 1000g

Answer 3

extremely low birth weight (ELBW)

Question 4

infant born before the completion of 37weeks of gestation, regardless of birth weight
- these infants are at risk because their organ systems are immature and they lack adequate physiologic reserves to function in an extrauterine environment

Answer 4

premature or preterm

Question 5

infant born between 34.7 and 36.9 weeks of gestation, regardless of birth weight
- by nature of their limited gestation, these infants remain at risk for problems related to thermoregulation, hypoglycemia, hyperbilirubinemia, sepsis, and respiratory function

Answer 5

late preterm

Question 6

infant born from 39.7 to 40.9 weeks of gestation

Answer 6

full term

Question 7

an infant born after 42 weeks of gestation, regardless of birth weight

Answer 7

post mature or postterm

Question 8

infant whose birth weight falls above the 90th percentile on intrauterine growth curves and charts

Answer 8

large for gestational age (LGA)

Question 9

infant whose birth weight falls between the 10th and 90th percentile on intrauterine curves and charts

Answer 9

appropriate for gestational age (AGA)

Question 10

infant whose rate of intrauterine growth was restricted and whose birth weight falls below the 10th percentile on intrauterine growth curves and charts

Answer 10

small for gestational age (SGA) or small for date (SFD)

Question 11

rate of fetal growth that does not meet expected growth patterns

Answer 11

intrauterine growth restriction (IUGR)

Question 12

type of inhibited fetal growth in which the weight, length, and head circumference are all affected

Answer 12

symmetric IUGR

Question 13

type of inhibited fetal growth in which the head circumference remains within normal parameters while the birth weight falls below the 10th percentile

Answer 13

asymmetric IUGR

Question 14

infant born from 37.7 to 38.9 weeks of gestation

Answer 14

early term

Question 15

infant born from 41.7 to 41.9 weeks of gestation

Answer 15

late term

Question 16

complex and costly treatment that is sometimes used to support life and allow treatment of intractable hypoxemia

Answer 16

ECMO (extracorporeal membran oxygenation)

Question 17

therapy using inhaled gas to caused sustained pulmonary vasodilation in the pulmonary circulation

Answer 17

nitrous oxide therapy

Question 18

respiratory pattern commonly seen in preterm infants

- such infants exhibit 5- to 10- second respiratory pauses followed by 10-15 seconds of compensatory rapid respirations

Answer 18

periodic breathing

Question 19

cessation of respirations for 20 seconds or more or a shorter pause accompanied by bradycardia, cyanosis, or hypotonia

Answer 19

apnea

Question 20

noninvasive, effective means for detective alterations in systemic BP (hypo or hypertension) and for identifying the need to implement appropriate therapy to maintain CV function

Answer 20

oscillometric BP measurements

Question 21

the environmental temperature at which oxygen consumption is minimal but adequate to maintain the body temperature

Answer 21

neutral thermal environment

Question 22

surface-active phospholipid secreted by the alveolar epithelium
- it reduces surface tension of fluids that line the alveoli and respiratory passages, resulting in uniform expansion and maintenance of lung expansion at low intraalveolar pressure

Answer 22

surfactant

Question 23

evaporative loss that occurs largely through the skin (70%) and respiratory tract (30%)
- it is increased in preterm infants

Answer 23

insensible water loss (IWL)

Question 24

method of providing breast milk or formula through a nasogastric tube or orogastric tube
- feeding can be accomplished either with a tube inserted at each feeding (bolus) or continuously through an indwelling catheter

Answer 24

gavage feeding

Question 25

nutritional method used to stimulate or prime the GI tract to achieve better absorption of nutrients when bolus or regular intermittent gavage feedings can be given

Answer 25

minimal enteral nutrition (MEN)

Question 26

method of feeding that involves the surgical placement of a tube through the skin of the abdomen into the stomach

Answer 26

gastrostomy tube feeding

Question 27

supplemental parenteral fluids administered to infants who are unable to obtain sufficient fluids or calories by enteral feedings

Answer 27

total parenteral nutrition (TPN)

Question 28

sucking on a pacifier during tube or parenteral feeding or between oral feedings to improve oxygenation and facilitate earlier transition to nipple feeding
- this type of sucking may lead to decreased energy expenditure with less restlessness and to positive weight gain and better sucking skills

Answer 28

nonnutritive sucking

Question 29

method that can be used to provide maternal or paternal skin-to-skin contact with their newborn, to reduce stress in the infant and to create a positive healing effect for the mother who had a high-risk pregnancy

Answer 29

kangaroo care

Question 30

form of grieving experienced by parents as they prepare themselves for the possibility of their infant’s death while still clinging to the hope that the infant will survive

Answer 30

anticipatory grief

Question 31

complex, multicausal disorder that effects the developing blood vessels eyes of preterm infants

• it is often associated with oxygen tensions that are too high for the level of retinal maturity, initially resulting in vasoconstriction and continuing problems after the oxygen is discontinued
• scar tissue formation and consequent visual impairment may be mild or severe

Answer 31

retinopathy of prematurity (ROP)

Question 32

Acute inflammatory disease of the gastrointestinal mucosa commonly complicated by bowel necrosis and perforation
- intestinal ischemia colonization by pathogenic bacteria and enteral feeding all play an important role in its development

Answer 32

necrotizing enterocolitis (NEC)

Question 33

Occurs when the fetal shunt connecting the left pulmonary artery and the dorsal aorta fails to close after birth or reopens after constriction has occurred

Answer 33

patent ductus arteriosus (PDA)

Question 34

Chronic lung disease with a multifactorial etiology that includes pulmonary immaturity, surfactant deficiency, lung injury and stretch, barotrauma, inflammation caused by oxygen exposure, fluid overload, ligation of patent ductus arteriosus (PDA), and familial predisposition

• incidents has decreased with prenatal use of maternal steroids when preterm birth is expected coupled with the use of exogenous surfactant
• it occurs most commonly in preterm infants requiring mechanical ventilation

Answer 34

bronchopulmonary dysplasia (BPD)

Question 35

Lung disorder, usually affecting preterm infants, caused by a lack of pulmonary surfactant, which leads to progressive atelectasis, loss of functional residual capacity, and ventilation-perfusion imbalance with an uneven distribution of ventilation

Answer 35

respiratory distress syndrome (RDS)

Question 36

Combined findings of pulmonary hypertension, right to left shunting, and a structurally normal heart
- it is also called persistent fetal circulation because the syndrome includes reversion to fetal pathways for blood flow

Answer 36

persistent pulmonary hypertension of the newborn (PPHN)

Question 37

One of the most common types of brain injuries encountered in the neonatal period and among the most severe in both short- and long-term outcomes
- incidence is decreasing related to prenatal use of corticosteroids and postnatal use of surfactant

Answer 37

germinal matrix hemorrhage-intraventrivular hemorrhage (GMH-IVH)