Chapters 3, 20, 23, 24 Flashcards
autoimmune disorders
Group of diseases that disrupt the function of the immune system, causing the body to produce antibodies against itself, resulting in tissue damage.
cardiac decompensation
condition of heart failure in which the heart is unable to maintain a sufficient cardiac output.
euglycemia
pertaining to normal blood glucose level; also called normoglycemia
gestational diabetes mellitus (GDM)
glucose intolerance first recognized during pregnancy
glycosylated hemoglobin A1C
glycohemoglobin, a minor hemoglobin with glucose attached; the glycosylated hemoglobin concentration represents the average blood glucose level over the previous several weeks and is a measurement of glycemic control in diabetic therapy
hydramnios (polyhydramnios)
amniotic fluid in excess of 2000mL
hyperglycemia
excess glucose in the blood, usually caused by inadequate secretion of insulin by the islet cells of the pancreas or inadequate control of diabetes mellitus.
hyperthyroidism
excessive functional activity of the thyroid gland
hypoglycemia
less than a normal amount of glucose in the blood; usually caused by the administration of too much insulin, excessive secretion of insulin by the islet cells of the pancreas, or dietary deficiency.
hypothyroidism
deficiency of thyroid gland activity with underproduction of thyroxine
ketoacidosis
Accumulation of ketone bodies in the blood as a consequence of hyperglycemia ; leads to metabolic acidosis.
macrosomia
large body size as seen in neonates of mothers with pregestational or gestational diabetes.
peripartum cardiomyopathy
inability of the heart to maintain an adequate cardiac output; congestive heart failure occurring during the peripartum
pregestational diabetes mellitus
diabetes mellitus type 1 or type 2 that exists before pregnancy.
amenorrhea
absence or cessation of menstruation
dysfunctional uterine bleeding (DUB)
excessive uterine bleeding with no demonstrable organic cause
dysmenorrhea
painful menstruation beginning 2 to 6 months after menarche, r/t ovulation or to organic disease such as endometriosis, pelvic inflammatory disease, or uterine neoplasm
endometriosis
tissue closely resmbling endometrial tissue located outside the uterus
fibroademona
firm, freely movable, solitary, solid, benign breast tumor
fibrocyctic changes
benign changes in breast tissue
leiomyoma
benign smooth-muscle tumor
lumpectomy
removal of a wide margin of normal breast tissue surrounding a breast cancer
menorrhagia
abnormally profuse or excessive menstrual flow
metorrhagia
abnormal bleeding from the uterus, particularly when it occurs at any time other than the menstrual period.
modified radical mastectomy
surgery that includes the removal of the breast and fascia over the pectoralis major muscle
oligomenorrhea
abnormally light or infrequent menstruation
pelvic inflammatory disease
infection of internal reproductive structures and adjacent tissues usually secondary to sexually transmitted infections
premenstrual syndrome
syndrome of nervous tension, irritability, weight gain, edema, headache, mastalgia, dysphoria, and lack of coordination occurring during the last few days of the menstrual cycle preceding the onset of menstruation.
radical mastectomy
surgery that includes the total removal of the breast, as well as the underlying pectoralis major and pectoralis minor muscles
simple mastectomy
surgery that includes the removal of the beast without the underlying muscle or fascial tissue
endometritis
postpartum uterine infection, often beginning at the site of placental implantation
hemorrhagic (hypovolemic) shock
clinical condition in which the peripheral blood flow is inadequate to return sufficient blood to the heart for normal function, particularly oxygen transport to the organs or tissue
inversion of the uterus
condition in which the uterus is turned inside out such that the fundus intrudes into the cervix or vagina
mastitis
infection in a breast, usually confined to a milk duct, characterized by influenza-like symptoms and redness and tenderness in the affected breast.
mood disorders
disorders that have a disturbance in the prevailing emotional state as the dominant feature; cause is unknown
pelvic relaxation
lengthening and weakening of the fascial supports of pelvic structures
postpartum depression
depression occurring within 4 weeks of childbirth, lasting longer than postpartum blues and characterized by a variety of symptoms that interfere with activities of daily living and care of the baby
postpartum hemorrhage
excessive bleeding after childbirth; traditionally defined as a loss of 500ml or more after a vaginal birth and 1000 ml after a cesarean birth
postpartum psychosis
syndrome characterized by depression, delusions, and thoughts by the mother of harming herself or her infant
puerperal infection
infection of the pelvic organs during the postbirth period; also called postpartum infection
subinvolution
failure of a part (e.g., the uterus) to reduce to its normal size and condition after enlargement from functional activity (e.g., pregnancy)
thrombophlebitis
inflammation of a vein with secondary clot formation
urinary incontinence
uncontrollable leakage of urine
uterine atony
relaxation of uterus; leads to postpartum hemorrhage.
ABO incompatibility
hemolytic disease that occurs when the mother’s blood type is O and the newborn’s is A, B, or AB
alcohol-related birth defect
Congenital abnormality or anomaly resulting from excessive maternal alcohol intake during pregnancy characterized by typical craniofacial and limb defects. cardopvascular defects, IUGR, and developmental delay; newer terminology for fetal alcohol syndrome.
alcohol-related neurodevelopmental disorder
disorder in infants affected by prenatal exposure to alcohol but who do not meet the criteria for FAS; previously termed fetal alcohol effects
barotrauma
physical injury resulting from changing air pressure, often associated with ventilatory assistance in preterm infants
bereavement
the feeling of loss, pain, desolation, and sadness that occur after the death of a loved one
continuous positive airway pressure
means of infusing oxygen or air under a preset pressure via nasal prongs, a facemask, or an endotracheal tube.
Coombs test
Indirect: determination of Rh-positive antibodies in maternal blood
Direct: determination of maternal Rh- positive antibodies in fetal cord blood;
positive test result indicates the presence of antibodies or titers.
corrected age
taking into account the gestational age and the postnatal age of a preterm infant when determining expectations for development
developmental care
care that takes into consideration the gestational age and condition of the infant and promotes the development of the infant
developmental dysplasia of the hip
abnormal development of the hip joint, resulting in instability of the hip causing one or both of the femoral heads to be displaced from the acetabulum (hip socket)
erythroblastosis fetalis
hemolytic disease of the newborn usually caused by isoimmunization resulting from Rh incompatibility or ABO incompatibility
exchange transfusion
replacement of 75% to 85% of circulating blood by withdrawal of the recipient’s blood and injection of a donor’s blood in equal amounts the purposes of which are to prevent an accumulation of bilirubin in the blood above a dangerous level, to prevent the accumulation of other by-products of hemolysis in hemolytic disease and to correct anemia and acidosis
extracorporeal membrane oxygenation
oxygenation of blood external to body using cardiopulmonary bypass and a membrane oxygenator, used primarily for newborns with refractory respiratory failure of meconium aspiration syndrome
grief
physical, emotional, social, and cognitive response to a loss such as the death of a loved one
hydrops fetalis
most severe expression of a fetal hemolytic disorder with high mortality, a possible sequela to maternal Rh isoimmunization; infants exhibit fross edema (anasarca), cardiac decompensation, and profound pallor from anemia
inborn error of metabolism
Group of recessive disorders cause by a metabolic defect that results from the absence of or change in a protein, usually an enzyme, and mediated by the action of a certain gene
kangaroo care
skin-to-skin infant care, especially for preterm infants, that provides warmth to infant; infant is placed naked or diapered against the mother’s or the father’s bare chest and is covered with the parent’s shirt or a warm blanket
late preterm (near term) infant
An infant born between 34 0/7 & 36 6/7 weeks of gestation, regardless of birth weight.
mechanical ventilation
respiratory support technique used to provide predetermined amount of oxygen; requires intubation
meconium aspiration syndrome
function of fetal hypoxia; with hypoxia the anal sphincter relaxes and meconium is released; reflex gasping movements draw meconium and other particulate matter in the amniotic fluid into the infant’s bronchial tree, obstructing the airflow after birth
neonatal abstinence syndrome
signs and symptoms associated with drug withdrawl in the neonate
neutral thermal environment
environment that enables the neonate to maintain a normal body temperature with minimum use of oxygen and energy
nonnutritive sucking
use of pacifier by infants; may include thumb or fingers
respiratory distress synfrome
condition resulting from decreased pulmonary gas exchange, leading to retention of carbon dioxide (increase in arterial partial pressure of carbon dioxide); most common neonatal causes are prematurity and perinatal asphyxia, and maternal diabetes mellitus. Also called hyaline membrane disease.
thrush
fungal infection of the mouth or throat characterized by the formation of white patches on a red, moist, inflamed mucous membrane, cause by Candida albicans
TORCH
infections caused by organisms that damage the embryo or fetus; acronym for toxoplasmosis, other (e.g. syphilis), rubella, cytomegalovirus, and herpes simplex
trophic feedings
very small feedings given to stimulation maturation of the gut.
Infants born to mother’s with diabetes mellitus are 4x’s more likely to develop this….
respiratory distress syndrome
low birth weight infant
an infant whose birth weight is less that 2500g, regardless of gestational age
very-low birth weight infant
an infant whose birth weight is less than 1500g
extremely-low birth weight infant
an infant whose birth weight is less than 1000g
appropriate for gestational age infant
an infant whose birth weight falls between the 10th and 90th percentile on intrauterine growth curves
small-for-date infant or small for gestational age
an infant whose rate of intrauterine growth was restricted and whose birth weight falls below the 10th percentile on intrauterine growth curves
large for gestational age infant
an infant whose birth weight falls above the 90th percentile
IUGR
found in infants whose intrauterine growth is restricted.
Symmetric: small all over
Asymmetric: Head is normal sized body is small
periodic breathing
respiratory pattern commonly seen in preterm infants. Exhibiting 5 - 10 second pauses in breathing followed by 10 - 15 seconds of compensatory rapid respiration.
Difference between apnea and periodic breathing
Apnea is pauses in breathing greater than 20 seconds. Periodic is less than 10 seconds.
Neonatal resuscitation steps
- initial steps in stabilization: provide warmth by placing the baby under warmer, open airway, clear airway, dry baby, stimulate breathing, reposition baby
- ventilation
- chest compressions
- administration of epinephrine or volume expansion or both.
Surfactant
surface-active phospholipid secreted by the alveolar epithelium. Reduces the surface tension of fluids that line the alveoli and respiratory passages, resulting in uniform expansion and maintenance of lung expansion at low intraalveolar pressure.
Infants born before 32 weeks do not have adequate amounts of surfactant to survive extrauterine life
Patent ductus arteriosis
Symptoms/Treatment
Signs: Systolic murmur, active precordium, bounding peripheral pulses, tachycardia, tachypnea, crackles, and hepatomegaly.
Treatment: ventilatory support, fluid restriction, diuretics, and indomethacin.
Surgical ligation
Respiratory distress syndrome
Signs/ treatment
Signs: tachypnea; grunting; nasal flaring; intercostal, or subcostal retractions; hypercapnia; acidosis; pallor; crackles; poor air exchange
treatment: establish and maintain adequate ventilation and oxygenation. Administer surfactant, maintain neutral thermal environment, maintain fluid balance
Periventricular-intraventricular hemorrhage
Signs/treatment
signs: usually asymptomatic; some experience decrease hematocrit, glucose instability, resp. acidosis, apnea, hypotonia, stupor, ashen color, respiratory distress
treatment: recognize early factors and intervene to prevent bleeding episodes. Initiate early Breastfeeding bc it significantly reduced the incidence of this implication
Necrotizing enterocoloitis
Signs/treatment
Signs: GI symptoms: abdominal distention, increasing of bile-stained residual gastric aspirates, vomiting (bile or blood), grossly bloody stools, abdominal tenderness, and erthema of abd wall
treatment: Rest GI, NG tube inserted to low suction, TPN, antibiotic therapy, possible surgery.
Retinopathy of prematurity
Signs/treatments
No external signs; diagnosed by using retinal examination and scleral depression
Treatment:prevention and early detection at preterm birth. circumferential cryopexy, laser photocoagulation, vitamin E therapy, and decreasing intensity of ambient light
Bronchopulmonary dysplasia
signs/treatments
signs: tachypnea, retractions,nasal flaring, increased work of breathing, exercise intolerance, tachycardia
treatment: O2 therapy, nutrition, fluid restriction and medications (diuretics, corticosteriods, and bronchodilators)
Gavage feeding
method of providing breastmilk or formula through a nasogastric or orogastric tube.
Goal of kangaroo care
promote thermoregulation, bonding and early breastfeeding.
Normal Arterial Blood Gas Values
pH: 7.35 - 7.45 PaO2: 60 - 80 PaCO2: 35 - 45 HCO3: 18 - 26 O2 Sat: 92 - 94% Base excess + or - 5
The single most important factor influencing fetal well-being is…..
the euglycemic status of the mother
Problems seen in infants of diabetic mothers
- congenital anomalies
- macrosomia
- birth injury (resulting from macrosomia or method of birth)
- Respiratory distress syndrome
- Hypoglycemia
- Cardiomyopathy
- hyperbilirubinemia and polycythemia
Injuries of Scalp
Caput succedaneum
Cephalohematoma
subgaleal hemorrhage
Injuries of Skull
linear fracture
depressed fracture
Most common fracture during birth
Clavicle
Alcohol
neonatal effects
FAS; craniofacial features vary, many include short eyelid opening, flat midface, flat upper lip groove, thin upper lip; microcephaly; hyperactivity; developmental delays; attention deficits
Cocaine
neonatal effects
CNS stimulant and peripheral sympathomimetic. Preterm birth, small for gestational age, microcephaly, poor feeding, irregular sleep patterns, diarrhea, visual attention problems, hyperactivity, difficult to console, hypersensitivity to noise and external stimuli, irritability, developmental delays, congenital anomalies such as PRUNE BELLY SYNDROME
Heroin
neonatal effects
increased rate of still birth, low birth weight, SGA, meconium aspiration, microcephaly, neurobehavioral problems, irritability, tachynpnea, feeding difficulty, vomiting, high-pitched cry, seizures, 74x risk for SIDS
Marijuana
neonatal effects
tremors, low birth weight, growth restriction, meconium staining.
Methamphetamine
neonatal effects
effects dose related; SGA, preterm birth, abruptio placenta, perinatal mortality, poor weight gain, lethargy, cleft lip and palate, cardiac defects, delays in fine and gross motor, behavioral problems later in childhood.
Methadone
therapy for heroin addiction. methadone withdrawal more severe and prolonged than withdrawal from heroin. Signs of withdrawal include tremors, irritability, state lability, hypertonicity, hypersensitivity, comiting, mottling, and nasal stuffiness; disturbed sleep pattern. Increased SIDS risk
Tobacco
neonatal effects
preterm birth; low birth weight; increased risk for SIDS, increased risk for bronchitis, pneumonia, developmental delays
Caffeine
neontal effects
more than 150mg/day associated with IUGR and low birth weight.
Encephalocele
herniation of brain and meniges through a skull defect usually at the base of neck.
surgical repair and shunting to relieve hydrocephalus
Anencephaly
absence of both cerebral heispheres and the overlying skull. incompatible with life
comfort measures until infant dies of temperature instability and respiratory failure
spina bifida
failure of the neural tube to close
usually no treatment
meningocele
external sac that contains meninges and CSF and that protrudes through a defect in the vertebral column.
protect sac. cover with sterile, moist nonadherent dressing. surgical repair needed ASAP
myelomeningocele
similar to meningocele, also contains nerves
