complications of prematurity Flashcards
RDS
Respiratory distress syndrome. <34 weeks. surfactant deficit. alveoli at great risk for collapse. 60% (?) at 29 weeks. treatment: surfactant replacement, O2, mechanical ventilation.
BPD
bronchopulmonary dysplasia. require supplemental O2 and or mechanical ventilation. born 10+ weeks premie. developmental delays. chronic lung disease.
Hylaine membrane disease
seen in babies w/ RDS
Patent Ductus Arteriosus
results in heart murmur
bradycardia
slow heart rate
necrotizing enterocolitis
small intestinal wall necrosis. idiopathic. suspect bacteria, intestinal ischemia, intestinal mucosal immaturity/dysfuntion. increased risk 10 x’s w/ formula feeding
hyperbillirubinemia
jaundice from accumulation of bilirubin in blood since liver can’t process it due to it’s immaturity. excessive jaundice –>kernicterus. treat with phototherapy. Can cause brain damage.
ROP-retinopathy of prematurity
retinal vascularization is incomplete at time of birth leading to retinal detachment. can lead to blindness. <30 weeks at highest risk.. supplemental O2 for RDS.
hearing impairment
due to prematurity.
AGA
appropriate gestational age-birth weight between the 10th and 90th percentile
SGA
small for gestational age. <10th percentile. full term but underweight
LGA
large for gestational age. birth weight >90th%
normal birthweight
5#8oz-8#13oz.
LBW
low birthweight <5#8oz
VLBW
very low birthweight <1500 grams/3#4oz.
ELBW
extremely low birthweight: <2#3oz. born before 27 weeks
MLBW
moderately low birthweight: 3#5oz.-5#8oz.
Micro preemie
750g/1#10oz. about 23 weeks.
major complications of prematurity
RDS, BPD, PDA, NEC, hyperbillirubinemia, ROP, hearing impairment
MAJOR complications of prematurity (born @ 28-32 weeks)
IVH, PVL, RDS, seizures. neurologic, respiratory, cardiac, GI, sensory.
IVH
intraventricular hemorrhage. most common is lateral ventricular bleed in infants<32 weeks and less than 1500g. outcome: spastic hemiparesis, quadriparxsis, cognitive deficits. cranial sonogram will pick this up. suspect CP as a result.
PVL
periventricular leukomalacia. white matter necrosis surrounding lateral ventricles secondary to decreased oxygenation and blood flow to the brain. spastic diplegia or spastic quadriparesis, cognitive deficits. CT.
apnea
in a baby lack of breathing for 20 or more seconds due to system immaturity. may indicate systemic med. probs. occurring in as many as 90% of infants who weigh less than 1000g at birth.
gestational age of development of sense of smell
28 weeks
gestational age of development of sense of taste
13 weeks
gestational age of development of sense of hearing
24 weeks
gestational age of development of pupillary reflex
34 weeks
how many grams is 2#?
1000g
time of the most weight gain for fetus in gestation
36-40weeks
“Florida Power And Light
full term births, pre-mature births, abortion (spontaneous or therapeutic), living
GP/gravida para
g=number of pregnancies. P=outcomes
full term
38-40 wks
post term
born after 40 wks
preterm
before 37 wks
minimum age of viablitiy
23-24 or 21-22
APGAR
appearance, pulse, grimace, activity, respiration. assessment of newborns at 1 and 5 mins after birth. respiration, crying, reflexes, irritability, pulse, HR, skin color, muscled tone
normal APGAR score
8-9. most don’t score a 10 b/c hey lose 1 point for being blue which is normal
0-3 APGAR score
resuscitation
4, 5, 6 APGAR score
requires immediate intervention. O2 and respiratory assistance, suctioning. indicates difficulty adapting to life outside the womb.
Low APGAR can be related to
Rxs given to mother during labor, prematurity, rapid delivery
risks for LBW
born before 37 weeks, low income, lack of education, multiple births, twins, triplets, maternal health problems (DM, HTN)
infant signs of distress indicating it doesn’t want to be held
skin color changes, hiccups, finger splaying, LE stiffness and extension, frowning, turning away from face or sound, change in vital signs
complication from lack of proper NICU positioning
skull deformities, preferential head turning to one side, fine motor delays, W arms, M legs
M legs
frog leg position w/ hips abducted and ER. seen when NICU positioning is not good. LE tightness.
W arms
UE tightness thru shoulder girdle. scapula retracted and humerus ER.
positioning for premature infants
position in flexion in all positions. 34 wks can lift head and turn in prone. <32 weeks eye patches-difficulty dealing with light and sound. sidelying promotes hands together and hand to mouth (self calming, sucking thumb)
