Chp 26 - High Risk Newborn

Question 1

Newborn Assessment of Transition to
Extrauterine Life

list the immediate assessment

Answer 1

o Initiation and maintenance of respiration
o Establishment of extrauterine circulation
o Thermoregulation
o Fluid and electrolyte balance

Question 2

Newborn Assessment of Transition to
Extrauterine Life

list what to be assess after immediate concerns

Answer 2

o Nutrition
o Waste elimination
o Infection
o Progression of infant–parent/caregiver relationship
o Infant development

Question 3

LGA stands for

Answer 3

large for gestational age

Question 4

AGA stands for

Answer 4

appropriate gestational age

Question 5

SGA stands for

Answer 5

small for gestational age

Question 6

this gestational age is above the 90th percentile

Answer 6

LGA

Question 7

this gestational age is between the 10th and 90th percentiles

Answer 7

AGA

Question 8

this gestational age is below the 10th percentile

Answer 8

SGA

Question 9

list the assessment methods of gestational age

Answer 9

o Mother’s menstrual history
o Prenatal ultrasonography
o Evaluation of obstetric parameter
o Postnatal maturation

Question 10

Commonly used to determine gestational age. Assesses neuromuscular and physical maturity

o Scores are given for 6 physical and 6 nerve and muscle development (neuromuscular) signs of maturity.
o The scores for each may range from -1 to 5.
o The scores are added together to determine the baby’s gestational age.

Answer 10

The Ballard Score

Question 11

-Tool to assess gestational age
-Optimal accuracy within 12 hours
-Most accurate 18 weeks and under 43 weeks
-Physical more accurate than neurological
-GA affected by PIH, DM, meds

Answer 11

Ballard Dubowitz

Question 12

Neuromuscular Maturity

list what to assess

Answer 12

-Resting posture
-Square window
-Arm recoil
-Popliteal angel
-Scarf sign
-Heel to ear

Question 13

How baby holds arms and legs at rest

Answer 13

posture

Question 14

How far baby’s hands can be flexed toward wrists

Answer 14

square window

Question 15

How baby’s arms “spring back” to flexed position

Answer 15

arm recoil

Question 16

How far baby’s knees extend

Answer 16

popliteal angle

Question 17

how far baby’s elbows can be moved across their chest

Answer 17

scarf sign

Question 18

How close baby’s feet can be moved to their ears

Answer 18

heel to ear

Question 19

LBW stands for

Answer 19

low birth weight

Question 20

VLBW stands for

Answer 20

very low birth weight

Question 21

ELBW

Answer 21

extremely very low birth weight

Question 22

weight for LBW

Answer 22

< 2500 gm

Question 23

weight for VLBW

Answer 23

1000 - 1500 gm

Question 24

weight for ELBW

Answer 24

500 - 1000 gm

Question 25

AGA is __% of all births

Answer 25

80

Question 26

SGA is __% of all births

Answer 26

10

Question 27

LGA is __% of all births

Answer 27

10

Question 28

completed 37 weeks gestation till 42 weeks

Answer 28

Term

Question 29

less than 37 weeks gestation

Answer 29

Premature

Question 30

after 42 weeks

Answer 30

Post term

Question 31

It is common caused by intrauterine growth restriction (IUGR), failed to grow at the expected rate in the utero.

Answer 31

SGA

Question 32

risk factors for SGA

Answer 32

-malnutrition -adolescent pregnancy -placental anomaly -smoking -narcotic use -intrauterine infection

Question 33

Also known as macrosomia that appears to be deceptively healthy, but immature development.

Answer 33

LGA

Question 34

risks factors for LGA

Answer 34

-mothers with GDM -obese mother -multiparity

Question 35

complications of LGA

Answer 35

-bruising -polycythemia -hypoglycemia

Question 36

live- born infant born prior to 37 weeks’ gestation

Answer 36

preterm infant

Question 37

born between 34 and 37 weeks' gestation

Answer 37

late preterm

Question 38

born prior to 34 week and after 24 weeks

Answer 38

early preterm

Question 39

The complications that contributes to having preterm

Answer 39

-anemia -kernicterus -persistent patent ductus arteriosus -perventricular/intraventricular hemorrhage -intracranial hemorrhage -respiratory distress syndrome -retinopathy of prematurity -necrotizing enterocolitis

Question 40

It is a live born infant after 42 weeks AOG. May be LGA, AGA, SGA or dysmature depending on placental function

Answer 40

post term infant

Question 41

3 stages of fetal dysmaturity syndrome

Answer 41

stage 1 - chronic placental insufficiency stage 2 - acute placental insufficiency stage 3 - subacute placental insufficiency

Question 42

1. Dry, cracked, peeling, loose, and wrinkled skin 2. Malnourished appearance 3. Open-eyed and alert baby what stage of fetal dysmaturity syndrome

Answer 42

stage 1

Question 43

1. All features of stage 1 except point iii 2. Meconium staining 3. Perinatal depression what stage of fetal dysmaturity syndrome

Answer 43

stage 2

Question 44

1. Findings of stage 1 and 2 except point iii 2. Green staining of skin, nails, cord, and placental membrane 3. A higher risk of fetal intrapartum or neonatal death what stage of fetal dysmaturity syndrome

Answer 44

stage 3

Question 45

The respiratory rate that remains 80 to 120 bpm beyond 1 hour after birth due to retained fluid lungs.

Answer 45

TRANSIENT TACHYPNEA OF THE NEWBORN

Question 46

risk factors of TTN

Answer 46

-mother who gave CS birth -extensive administration of mother during labor -preterm infants -maternal diabetes -macrosomia -male sex -maternal asthma

Question 47

An infant whose resting respirations longer than 20s accompanying bradycardia, a period when breathing briefly stops. It triggers bradycardia, which is a slow heartbeat.

Answer 47

Apnea

Question 48

occurs in babies born early (premature) whose lungs are not fully developed, is caused by the baby not having enough surfactant in the lungs.

Answer 48

respiratory distress syndrome

Question 49

potentially dangerous medical event during childbirth that occurs when a baby inhales meconium and amniotic fluid during childbirth

Answer 49

Meconium aspiration syndrome

Question 50

similar to the heart-lung by-pass machine used in open-heart surgery. It pumps and oxygenates a patient's blood outside the body, allowing the heart and lungs to rest.

Answer 50

ECMO machine

Question 51

ECMO stands for

Answer 51

extracorporeal membrane oxygenation

Question 52

deaths in infants younger than 12 months of age that occur suddenly, unexpectedly, and without obvious cause.

Answer 52

Sudden infant death syndrome

Question 53

risk factors of SIDS

Answer 53

-adolescent pregnancy -closely spaced pregnancy -underweight -preterm infants -bronchopulmonary dysplasia

Question 54

ALTEs stands for

Answer 54

apparent life-threatening events

Question 55

management for ABO incompatibility

Answer 55

-early feeding -phototherapy -exchange transfusion

Question 56

It is an acquire ocular disease that leads to partial or total blindness, This is caused by vasoconstriction of immature retinal blood vessels d/t high concentration of oxygen delivery.

Answer 56

RETINOPATHY OF PREMATURITY

Question 57

This is an eye infection occurs during birth and first month. It is caught during birth by contact with the mother’s birth canal that is infected with a sexually-transmitted disease

Answer 57

OPHTHALMIA NEONATORUM

Question 58

management for OPHTHALMIA NEONATORUM

Answer 58

-Culture -Antibiotics -Standard and contact precaution -NSS irrigation using sterile medicine dropper or bulb syringe

Question 59

QSEN stands for

Answer 59

Quality & Safety Education for Nurses

Question 60

aspects of QSEN

Answer 60

-Patient-Centered Care -Teamwork & Collaboration -Evidence-Based Practice -Quality Improvement -Safety -Informatics