Chapter 34 Flashcards
High Risk Infants are Classified According to…
Birth weight
Gestational age
Predominant pathophysiologic problems
Extremely Low Birth Weight Infants
Birth weight is 1000 g or less
PRACTICAL AND ETHICAL DIMENSIONS OF RESUSCITATION
Respiratory Issues
Immature lung function caused by lack of surfactant
Cardiovascular Issues
Left-to-right shunting caused by hypoxia
Thermoregulation Issues
Lack of brown fat, larger ratio of body surface area to body weight
Should be transferred from delivery in a prewarmed incubator
Rapid changes in body temperature may cause apnea
Respiratory Care
Neonatal resuscitation
Oxygen therapy
Hood therapy
Nasal cannula
CPAP
Mechanical ventilation
High-frequency ventilation
Surfactant administration
Nitric oxide therapy
Must wean from respiratory assistance
Skin Care
Increased sensitivity and fragility
Avoid the use of soap
Braden Q or Neonatal Skin Condition Scoring should be used daily
Environmental Concerns
NICU infants are exposed to high levels of auditory input and require “time-outs”
Developmental Care
Positioning
Reducing inappropriate stimuli
Infant communication
Infant stimulation
Kangaroo care
Complications in High Risk Infants
Respiratory Distress Syndrome
Retinopathy of Prematurity
Bronchopulmonary Dysplasia
Patent Ductus Arteriosus
Germinal Matrix Hemorrhage-Intraventricular Hemorrhage
Necrotizing Enterocolitis (grossly bloody stools)
GMH-IVH
Usually occurs in infants less than 34 weeks
History of hypoxia, birth asphyxia
PREMATURITY IS MOST COMMON FACTOR IN IVH
Necrotizing Enterocolitis
Intestinal ischemia
Bacterial colonization
Enteral feeding
Grossly bloody stools
Takes 1-3 days to show up
Late Preterm Infant Complications
Respiratory distress
Thermoregulation issues
Nutritional issues
Hypoglycemia
Hyperbilirubinemia
Infection
Postmature Infant Complications
Meconium Aspiration Syndrome
Persistent Pulmonary Hypertension of the Newborn
Small for Gestational Age and Intrauterine Growth Restriction Complications
Perinatal asphyxia
Hypoglycemia
Hyperglycemia
Polycythemia
Heat loss
