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OB > Chapter 15 - Phys + Behavioral Responses of Neonates (metab, GI, assessment) > Flashcards

Chapter 15 - Phys + Behavioral Responses of Neonates (metab, GI, assessment) Flashcards

1
Q

T/F large quantities of glycogen is stored in BB during pregnancy

A

T: in prep for meeting energy requirements when transitioning

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2
Q

rise + fall of gluc after delivery

A

1 hr: fall

2-3 hr: rise + stabilize

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3
Q

optimal range for glucose

A

70-100 mg/dL

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4
Q

why do neonates of diabetic moms have a higher risk of hypoglycemia?

A

in uterine, mom produces a lot of insulin in response to high levels of circulating maternal glucose
-neonates’ insulin level remains higher than normal leading to hypoglycemia

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5
Q

risk for hypoglycemia

A
  • neonates of diabetic mom
  • neonates weighing more than 4,000g or lga
  • post-term bb
  • preterm bb
  • sga
  • hypothermia
  • infection
  • resp distress
  • neonatal resuscitation
  • birth trauma
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6
Q

hypoglycemia s/s

A
  • jittery
  • hypotonia
  • irritability
  • apnea
  • lethargy
  • temp instability
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7
Q

hypoglycemia nursing actions

A
  • monitor for s/s
  • assess blood gluc level
  • assist w breast feed or formula feed
  • IV infusion of dextrose soln or buccal 40%
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8
Q

functions of liver

A
  • carb metab
  • amino acid metab
  • lipid metab
  • synth of plasma proteins
  • blood coag
  • conjugation of bilirubin
  • phagocytosis by kupffer/macrophage
  • storage of fat sol vit (ADEK) + Fe
  • detox
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9
Q

carb metab of liver

A
  • reg blood gluc by converting into GLYCOGEN (facilitated by insulin + cortisol)
  • converts glycogen to glucose when low
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10
Q

blood coag factors that are synth by liver

A

factors 2, 7, 9, 10

-vitamin K influences activation of these factors

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11
Q

where is vit K synthesized in BB

A

intestinal flora

  • absent in newborn
  • develops thru introduction of microbes (feeding)
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12
Q

phytonadione [vit K, aquamephyton]

A

prophylaxis to prevent hemorrhagic disease

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13
Q

phytonadione [vit K, aquamephyton]

s/s

A

erythema
pain
swelling at injection site

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14
Q

phytonadione [vit K, aquamephyton]

route + dose

A

IM

0.5-1 mg w/ 1 hr of birth

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15
Q

cause of hyperbilirubinemia

A

incr in RBC turnover (shorter lifespan) + incr RBC count at birth
>leads to incr bilirubin production

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16
Q

2 forms of bilirubin

A

DIRECT (conjugated)

INDIRECT (unconjugated)

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17
Q

indirect/unconjugated bilirubin

A

fat soluble

  • produced fr breakdown of RBC
  • converts into direct bilirubin
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18
Q

direct/conjugated bilirubin

A

water sol

  • bound to albumin
  • can be excreted in urine/stool
19
Q

physiological jaundice

A

fr hyperbilirubinemia that commonly happns AFTER 24 hr + during first week
-usually peaks at day 3

20
Q

pathological jaundice

A

fr various disorders that exacerbate hyperbilirubinemia

  • occurs WITHIN first 24 hr
  • jaundice last more than a week
21
Q

gastric capacity for first few days then day 7

A

5-10mL

>60 mL by day 7

22
Q

stomach emptying time

A

2-4 hr

23
Q

which has more stools per day? breastfed or formula fed

A

breasfed has more stools

4-8 stools per day

24
Q

meconium stool

A
  • passed in 1-2 days
  • sticky, thick, black, odorless
  • forms during 4th gestl month
25
Q

transitional stool

A
  • passed in day 3-5

- greenish black, greenish brown, greenish yellow

26
Q

breastfed stool

A
  • after day 5
  • yellow + semiformed
  • later becomes golden yellow w pasty consistency
  • sour odor
27
Q

formula fed stool

A
  • drier + more formed than breastfed
  • pale yellow to brownish yellow
  • unpleasant odor
28
Q

diarrheal stool

A

loose + green

29
Q

active immunity

A

B cells detect antigens + produce antibodies

  • ACQUIRED: vaccine
  • NATURAL: exposed to antigen
30
Q

passive immunity

A

not permanent

  • ARTIFICIAL: gamma globulin
  • NATURAL: placental transmission of antibodies
31
Q 
IgG
IgA
IgM
IgD
IgE
A

G - blood, ECF, long term
A - external secretin (milk, tears, saliva)
M - blood; produced first
D - B lymphocytes
E - mast cells or basophils for allergies

32
Q

sunken head

A

sign of dehydration

33
Q

Dubowitz

A

neurological exam

  • assess 33 responses in 4 cases:
  • –habituation (response to repetitive light + sound stimuli)
  • –mvmt + muscle tone
  • –reflexes
  • –neurobehavioral items
34
Q

Ballard Maturation Score

A

calculated by assessing the physical + neuromuscular maturity of neonate

  • classifies bb as preterm (<37wk), term (37-42wk), post-term (>42wk)
  • helps to determine if bb is SGA or LGA
35
Q

SGA/LGA

A

sga: below 10th percentile
lga: above 90th percentile

36
Q

Caput Succedaneum

A

localized soft tissue edema of scalp

  • spongy
  • can cross suture lines
  • caused by prolonged head against cervix
  • resolves w/in first week
37
Q

Cephalhematoma

A

hematoma formatn bw periosteum + skull w UNILATERAL swelling

  • well defined outline
  • does NOT cross suture lines
  • appears w/in fe hours of birth + increases over next few days
  • r/t trauma to head fr prolonged labor, forces, or vacuum
  • can lead to jaundice
  • resolves w/in 3 months
38
Q

Epsteins pearls

A

white pearl like epithelial cysts on gum margins + palate

  • benign
  • usually disappears in few weeks
39
Q

Newborn screening consists of..

A

hearing test + blood test

  • include whether or not bb is breastfed
  • DOES NOT test for downs
40
Q

blood test

A

screens for infections, genetic disease, inherited, metabolic disorders, PKU

  • best done at 2-5 days bc bb has time to ingest milk or formula
  • but norm done 1-2 days
41
Q

heelstick

A

warm foot for 10 min

  • don gloves, clean heel w stick
  • puncture in lateral or medial aspect
  • wipe off first drop
  • then use following drops
42
Q

hearing screens

A

1 otoacoustic emission (OAE)

2 automated auditory brain stem response (AABR)

43
Q

otoacoustic emission (OAE)

A

-painless test
-done when bb is sleeping or lying still
-tiny flexible ear probe is inserted
-record the response of hair cells of cochlea to clicking sounds
BAD: no response

44
Q

automated auditory brain stem response (AABR)

A
  • painless test
  • done when bb is asleep or still
  • electrodes are placed on forehead, mastoid + nape of neck
  • screens for electrical activity of cochlea, auditory nerve, + brain stem in response to sound

BAD: no response

OB (18 decks)

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