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NUR 113 > Exam 2 FC's > Flashcards

Exam 2 FC's Flashcards

1
Q

APGAR

A

newborn assessment tool-done at 1 and 5min after birth. 5 categories 0,1,2 for each best score is 10, 8-10=healthy baby, 6-7needs 02, 4 or less may need CPR. Activity (flexion/musc tone) Pulse (100-160 can get from umb stump), Grimace (reflex response-does baby cry when we pull away), Apperance (color), Respiratory effort

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2
Q

rooting

A

stroking a baby’s cheek-should make baby turn head towards

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3
Q

PMI in infant

A

4th intercostal space to the right of the midclavicular line. Heart is size of pecan

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4
Q

moro reflex

A

occurs when an infant is startled by a loud noise or other environmental stimulus or feels that he or she is falling. The reflex causes the baby to extend the arms, legs, and fingers and arch the back

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5
Q

neonatal vital signs

A

HR 110-160, RR 30-60, T 97.8-99.4 (axillary), BP 60/80 / 45/50

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6
Q

neonatal labs

A

RBC 9-30 (18), hbg 14-24(17), hct 44-64 (55),platelet 150-400, BGM 40-60,

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7
Q

periods of reactivity

A

1st period is birth to 30min, then baby rests for couple hrs, then 2-6hrs of life baby awakens and feeds again

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8
Q

Babinski

A

rub sole of baby’s foot-toes should spread and big toe should pull upward. Occurs for first 1-2years, it is a bad sign in adults points to neuromusc problems

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9
Q

what tests newborn for gestational age

A

Ballard scale- SGA less than 10%, AGA 10-90%, LGA 90%+

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10
Q

macrosomic

A

newborn that weighs more 8lb 13oz or 4000gm

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11
Q

4 ways newborn may loose heat to envt

A

convection, radiation, evaporation, conduction

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12
Q

NIPS

A

newborn infant pain scale-subjective pain scale 0-7

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13
Q

baby metabolic screening

A

blood test for 30+ diseases, done at 24hr mark, done with heel stick. Tests thyroid, maple syrup disease, sickle cell, PKU, etc

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14
Q

postpartum assessment

A

4th trimester, BUBBLEEE-breasts, uterus, bladder,bowels, lochia, episiotomy/incision/lacerations, extremities/homan’s sign, emotions

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15
Q

involution

A

shrinking and moving downward of uterus-returning to prepregnancy state

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16
Q

location of uterus

A

is measured in relation to belly button +1/U = 1 above umbulicus, U/0 = at belly button, U/-1 = 1” below belly button

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17
Q

lochia

A

vaginal drainage after birth, day 0-3=rubra(red/brown), day 3-10 serosa(yellow/red), day 11-21 Alba(clearish/gray). Inc in activity will inc lochia

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18
Q

episiotomy

A

cutting b/t vag and rectum. Median incision-straight down, Mediolateral-cutting down and around rectum

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19
Q

homan’s sign

A

dorsiflexion of ankle-if pain in calf it signals mom has DVT

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20
Q

what can tachycardia in postpartum mom signal?

A

hemorrhage or anemia

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21
Q

lactogenesis

A

the onset of milk secretion, begins in 2nd tri, full milk production begins 2-3days after birth. Birth of placenta-decreases progesterone wich initialtes breast milk

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22
Q

how much weight does newborn loose?

A

5-10%

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23
Q

and how long till they gain it back?

A

2 weeks

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24
Q

nestitis

A

infection in nipple d/t baby

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25
Q

how long does alcohol stay in breast milk?

A

2hrs

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26
Q

what causes letdown in milk?

A

oxytocin-which is stimulated by baby sucking on nipple

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27
Q

what is in colostrum

A

digestive enzymes, antioxidants, quinones, immunoglobulins, and growth factors

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28
Q

cues baby is hungry

A

nuzzling and opening mouth, tense appearance, grunting, kicking/waving arms, had to mouth, crying

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29
Q

pee and poop schedule for newborn

A

day 1- 1pee, 1 black poo, day 2- 2pee, 1 black poo, day 6- 6 pee, 3-4 yellow poo

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30
Q

how often should baby nurse

A

8-10 per day or every 3hrs, wake them up

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31
Q

benefits of breast milk for baby

A

reduces neonatal mortality rates, passes on antibodies to protect from inf, digests easier than formula, may protect against diseases later in life, facilitates attachment of mom and baby

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32
Q

benefits of breast milk for mom

A

dec risk of breast, uterine, ovarian cancer, dec postpartum bleeding, facilates weight loss, dec risk of osteoprosis and hip fx.

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33
Q

nutrient requirements for breastfeeding mom

A

additional 500 calories daily, extra Ca, prenatal vitamins, extra fluids

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34
Q

CP

A

chronic nonprogressive neurologic disorder resulting from insult to the brain, usually Dx occurs before 18mo b/c they are not meeting development milestones, infant reflexes persist past infancy (moro, babinski, startle)

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35
Q

causes of CP

A

Prenatal-preeclampsia, exposure to toxins, genetics, Rh type incompabilities, intrauterine ischemia, toxoplasmosis, CMV, rubella. Perinatal-breech birth, cord around neck, low birth weight, birth trauma, hematoma, abruption, previa. Postnatal-shaken baby, meningitis, head trauma/MVA, CVA

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36
Q

Types of CP

A

hypertonic (spastic), Athetoid(dyskinetic), Ataxic

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37
Q

hypertonic SP

A

spastic type, most common, stiff musc, contractures, scissoring of leggs, flexion of arms, hip dysplasia. Classified by number of limbs affected (ex. diplegia, tri, quad, L or R hemiparesis). Lots of surgeries

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38
Q

athetoid CP

A

dyskinetic- 10-20% of CP, slow writhing movements of head arms, legs, face, tongue, can cause drooling and grimacing. Movements inc with stress or when child is upset. They dec when child is sleeping

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39
Q

ataxic CP

A

rare form of CP, affects balance and depth perception, walk with wide gait, diff with fine motor skills, have tremors

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40
Q

complications with CP

A

contractures, frequent resp inf, cognitive impairment, self care deficit

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41
Q

purple crying

A

crying for no reason that cant be consoled

42
Q

medical mgmt of CP pts

A

PT, OT, Speech, meds to control seizures, relax spasms, dec pain, surgeries to release tight muscles or contractures, nutrition through mickey

43
Q

hiatal hernia

A

protrusion of the upper part of stomach into the thorax through a tear or weakness in the diaphragm

44
Q

Nissen fundoplication

A

surgical fixing of a hialal hernia that surrounds the esophagus pushing down on it and causing GERD or inability to eat

45
Q

most important ND for CP pt?

A

risk for injury, aspiration, falls, etc.

46
Q

nursing actions to keep CP pt safe

A

keep suction and 02 nearby, low beds, side rails up, prevent ulcers, no sharp objects, no metal silverware

47
Q

ways to prevent SIDS

A

back sleeping, firm bedding with tight fitting sheet, no loose objects or toys in crib, uncover baby’s head during sleep, use pacifiers while sleeping, don’t smoke, don’t overheat baby

48
Q

what are high risk individuals for SIDS

A

mom smoked, sleeping on side or stomach, sharing a bed/crib, premature, multiples, teen mom, late or no prenatal care, short interval between pregnancy, African Ameriacans, Native Americans

49
Q

side effect of back sleeping

A

plagiocephaly- flattened back of head, have tummy time while awake and try and rotate baby’s head a little while sleeping

50
Q

preterm time periods

A

Late preterm 34-37wks, moderately preterm 32-34, very preterm <32 wks

51
Q

causes of preterm birth

A
  1. infection(body’s inflam response) 2.maternal or fetal stress(stress releases CRH horm that triggers uterine cont) 3. bleeding (causes release of proteines which trigger cont) 4. stretching(d/t twins, excess amniotic fluid or placental abnormalities). BISS-baby is so small
52
Q

women at greatest risk for preterm labor (PTL)

A

previous preterm (bigest risk factor), preg with multiples, cerv or uterine abnormalities, inf, DM, HTN, preeclampsia, clotting disorders, vag bleeding, preg d/t IVF, obesity, underweight, short term b/t pregnancies, teens, over 35, low income, substance abuse, smokers

53
Q

diagnostic tests to predict PTL

A

cervical length (short cervix=inc risk), fetal fibronectin (fFN)-biological glue that helps fetal sac attach to uterine lining, is normally seen in secretions up to 22 weeks, and then reappears 1-3wks before delivery. Only high risk women get this test

54
Q

healthy people 2020 goal for PTL

A

want to dec the amount of PTL to less than 7.6% of births

55
Q

roles of placenta

A
  1. protective barrier 2.provides nutrients 3. eliminates fetal waste 4.synthesis of horms that promote growth
56
Q

serious complications of prematurity

A

RDS, pneumothroax, apnea, IVH, PDA, NEC, ROP, CLD

57
Q

respiratory distress syndrome (RDS)

A

d/t lack of surfactant or immature alveolia, common in newborns before 34 wks, lungs don’t expand enough

58
Q

Tx for RDS

A

give 02, CPAP, or vent

59
Q

what complications of prematurity can be caused my medical interventions?

A

pneumothorax-excessive ambu bagging, retinopathy of prematurity-from excess 02, chronic lung disease-from prolonged vent use

60
Q

apnea

A

20sec or more, or less than 20sec if with dec 02sat or bradycardia

61
Q

intraventricular hemmorhage (IVH)

A

is a stroke, usually in babies younger than 32 wks, if 24wks or less this will most likey occur within 72hrs of birth since brain and vessels are not mature or in babies less than 1500gm

62
Q

patent ductus arteriosus (PDA)

A

heart issue where duct doesn’t close, may be treated with indomethacin or surgery

63
Q

necrotizing enterocolitis (NEC)

A

acute inflam disease of GI mucosa complicated by perforation, occurs d/t vascular compromise. Body conserves blood for brain and heart and therefore GI suffers

64
Q

retinopathy of prematurity (ROP)

A

eye problme d/t eye vessels being exposed to too much 02

65
Q

chronic lung disease (CLD)

A

aka bronchopulmonary displasia (BPD)-results from prolonged vent use, not common now d/t steroid injections and surfactant being given

66
Q

ballard scale

A

newborn assessment scale- adapted from Dubowitz assessment

67
Q

ECMO

A

extracorporeal membrane oxygenation therapy-taking blood out and adding oxygen then putting it back in providing oxygen directly to heart and lungs through a catheter

68
Q

buretrol

A

safety device that limits amoutn of IV fluid available to prevent accidental overdose in infants

69
Q

nonnutritive sucking

A

may give pacifier to encourage sucking in premie to help sucking and swallow reflex develop

70
Q

plagiocephaly

A

flattening of head d/t back sleeping, give them tummy time while awake

71
Q

T/F pacifiers increase the risk of SIDS

A

False, they dec the risk

72
Q

when is the highest risk of SIDS

A

2-4months

73
Q

SGA

A

birthweight <10th percentile

74
Q

gonorrhea

A

ROM can cause baby to be exposed, Tx with erythromycin ointment . Can cause BLINDNESS

75
Q

syphilis

A

if mom + then she will get penicilin early in preg. Want tests to be NON REACTIVE, can cause STILLBORN or abortion

76
Q

toxoplasmosis

A

found in cat feces, don’t eat raw sheep or beef, can cause death of baby, MR, and severe pshcyomotor issues. Tx is pyrimethamine & sulfonamides

77
Q

HIV

A

transmitted through placenta, maternal blood, and breast milk. If mom treated <3% chance baby will get it, if not treated much higher, test baby for up to 15mo, do NOT breastfeed

78
Q

rubella

A

mom should get titer > 1:8, can cause HEARING loss

79
Q

Cytomegalovirus (CMV)

A

can cause HEARING & LEARNING DISAB, can get during birth or through breastmilk

80
Q

GBS

A

treat mom with penicilin-2 doses before labor, causes SEPSIS and MENINGITIS

81
Q

Herpes

A

transmitted through placenta or birth canal, if active outbreak mom may have C/S, treat mom with antiviral meds, affects SKIN/EYE, or ENCEPHALITIS

82
Q

Chlamydia

A

mom may be asymptomatic, give baby erythromycin ointment, CONJUNCTIVITIS & PNEUMONIA, NOTIFY CDC

83
Q

what do we ask parents before circumcision

A

any hx of hemophilia or bleeding disorders? Vit K given

84
Q

Circumcisions

A

Gomco clamp-most common, clamps around head, cut off foreskin with scapal. Will be inflamed after, put petrolium jelly gause wrap till healed, watch for urine within 24hrs. Plastibell-plastic piece is put around head and sutured, skin and plastic piece will fall off in few days-no petrolium jelly needed, clean with drops of water

85
Q

Autism

A

All are Dx before age 3, developmental disorder, causes severe problems with communication, behavior, and social skills, 4:1 males, repetitive movements, strict routines, avoid eye contact, no fear of danger, may not want to be touched

86
Q

types of autism

A

five diff types Autistic disorder, asperger’s, Rett’s, childhood disintegrative disorder, pervasive development disorder NOS.

87
Q

autistic disorder

A

impaired social interaction, comm, and behavior, usually noted in first year of life

88
Q

Asperger’s

A

high functioning autism

89
Q

Rett’s disorder

A

rare, mostly in females

90
Q

Childhood disintegrative disorder

A

diagnosed late, boys appear to regress in toileting and other skills

91
Q

Tx for autism

A

CAM-yoga, massage, music, applied behavior analysis, snoozalin, dietary

92
Q

autism meds

A

antidepressants, antisychotics (risperdal), stimulants (ritalin)

93
Q

Failure to thrive (FTT)

A

when infant does not achieve age appropriate wt gain, either from not taking in enough or not absorbing nutrients, usually caused by psych problems or neglect

94
Q

greatest risk factor for FTT

A

poverty

95
Q

what determines FTT

A

growth chart in 5-3rd percent

96
Q

ADHD

A

chronic condition, affects self esteem, relationships and school, symptoms must be present in more than one setting

97
Q

classic sypmtoms of ADHD

A

hyperactive, inattentive, impulsive

98
Q

ADHD boys vs girls

A

boys-more common in boys, more likely to be hyperactive, less compliant, act out more. Girls-more inattentive, daydream

99
Q

what can cause ADHD

A

LEAD, and polychlorinated biphenyls (PCB), smoking and drugs are also associated with it

100
Q

nursing care for ADHD

A

safety-they are impulsive and don’t like to listen, also may have other psych problems

NUR 113 (4 decks)

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