Complications in the Newborn Period: 12

Question 1

Hypoglycemia

BG levels lower than?

Symptoms?
JPLAR THAS

Treatment?

Answer 1

Blood glucose level lower than 40 in the first 72 hours

Jitteriness
Poor feeding
Lethargy
Abnormal cry
Respiratory distress

Temperature Instability
Hypotonia
Apnea
Seizures

Treatment
* Early and frequent feeds.
* Monitor blood sugar levels in at risk infants

Question 2

Transient Tachypnea of the
Newborn (TTN)

TERM!!!!!

what is it?
More likely to happen?
Resp rate?
Signs/symptoms? 4
Nursing care? 4

what does it look like preterm, term, late

Answer 2

Delayed clearance of fetal lung fluid from lungs.

More likely to happen in C section w/o labor

Respiratory rate > 60 breaths/min.

Signs/Symptoms:
* Grunting, retracting, nasal flaring, cyanosis

Nursing Care & Priorities
* Monitor respiratory rate
* No oral feeding (or very limited)
* Minimal exertion
* Supplemental oxygen

Question 3

Respiratory Distress Syndrome
(RDS)

PRETERM!!!!

What is it? lack of?

Symptoms present?

What are the symptoms?
RRGN TD FGS

Treatment?

Answer 3

Breathing disorder caused by premature lungs
Lack of surfactant

S&S present 4-24 hours of life

Signs/Symptoms:
* Rapid shallow breathing
* Retractions
* Grunting
* Nasal flaring
* Tachypnea then apnea
* Decreased breath sounds
* Fine rales
* Generalized cyanosis
* Shortness of breath

Treatment:
* Warm moist oxygen
* Exogenous surfactant
* Mechanical support prn (CPAP, ventilator)

Question 4

Compare TTN and RDS

TTN is unique to? Generally?

RDS affects? Requires? Can lead to?

Answer 4

TTN
* Unique to the term infant
* Generally time-limited with little respiratory support needed

RDS
* Affects preterm infants
* Requires aggressive support
* Can lead to complications such as BPD

Question 5

Thermoregulation

hypothermia

Symptoms?
HARMPS

Nursing Care?

Answer 5

Due to limited ability to increase metabolic rate

Immaturity of skin leads to Increased trans- epidermal water loss

Symptoms
* Hypothermia
* Acrocyanosis
* Respiratory distress
* Mottled
* Pale
* Skin is cool to touch

Nursing Care:
* Maintain a neutral thermal environment
* Pre-warmed isolette or radiant warmer
* Plastic bag for very low birth weight infants (VLBW)
* Skin to skin
* Warm infusions
* Monitor temperature, blood sugars

Question 6

pathologic jaundice

When does it happen?
Associated with?
Causes?

Answer 6

Before 24 hours of age
Associated with bilirubin encephalopathy or kernicterus

Causes:
* ABO incompatibilities
* Maternal infections
* Maternal ingestion of sulfonamides, diazepam or salicylates near term

Question 7

Physiologic Jaundice

When does it happen?
More common in who?
What happens?

Answer 7

Most common
After 24 hours of age

More common in LPI (late preterm) and preterm infants

• Rapid breakdown of RBC
• Immature liver
• Dehydration

Question 8

How to treat Hyperbilirubinemia?

Increase?
What kind of therapy?
Use a?
Protect?
Observe for?
No what on skin?
Strict?

Answer 8

Increase oral intake

Phototherapy: position light at least 10cm from infant

• Use a bili-blanket
• Protect eyes and genitals
• Observe for lethargy, hyperthermia
• No ointments or lotions on skin
• Strict diaper count

Question 9

Neonatal Abstinence Syndrome
(NAS)

What is it?
What will also cause NAS?
Symptoms?
Treatment?

Answer 9

when a baby withdraws from certain drugs (most often opioids) he’s exposed to in the womb before birth.

Methadone

• Sneezing
• Yawning
• Sweating
• High-pitched cry
• Irritable and hard to soothe
• Vomiting
• Hypertonia & tremors
• If severe: seizures

IV hydration, taper down

Question 10

Necrotizing Enterocolitis
(NEC)

What is it?
Gold standard to treat?
Symptoms? 4
Treatment? 3

Answer 10

Inflames intestinal tissue, causing it to die

Breast milk

• Abdominal distention
• Grossly bloody stools
• Abdominal tenderness
• Erythema of abdominal wall

Treatment
* NPO-no oral intake
* Antibiotics
* May require surgery