Exam 2 (Newborns)

Question 1

What is Transient Tachypnea of the Newborn (TTN)?

Answer 1

• Delayed clearance of fetal lung fluid from lungs
  
  • More likely to occur in babies delivered via c/s,
    esp. if labor did not occur before birth

Question 2

What are signs and symptoms of TTN?

Answer 2

• Respiratory rate > 60 breaths/min.
• Cyanosis
• Grunting
• Nasal flaring
• Retracting

Question 3

What is Respiratory Distress Syndrome (RDS)?

Answer 3

• Breathing disorder caused by immature (premature) lungs
• Lack of surfactant
• The more premature (earlier the gestation) the higher the chance of RDS

Question 4

What are signs and symptoms of RDS?

Answer 4

• Decreased breath sounds
• Fine rales
• Generalized cyanosis
• Grunting
• Nasal flaring
• Retractions
• Rapid shallow breathing
• Shortness of breath
• Tachypnea then apnea

Question 5

How do you decrease severity of RDS?

Answer 5

betamethasone, 2 doses given 24 hours apart

Question 6

Compare TTN and RDS.

Who does it effect and how should support be given?

Answer 6

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 7

What is Hypoglycemia?

Answer 7

• Abnormally low blood sugar levels (lower than 40 in the first 72 hours)
• Glucose levels stabilize by 2-3 days of life

Question 8

What are the signs and symptoms of hypoglycemia?

Answer 8

• Abnormal cry
• Apnea
• Hypotonia
• Jitteriness
• Lethargy
• Poor feeding
• Respiratory distress
• Seizures
• Temperature instability

Question 9

Describe physiologic Hyperbilirubinemia.

Who does it effect? What are the causes?

Answer 9

• Most common
• After 24 hours of age
• More common in LPI (late preterm) and preterm infants
• Rapid breakdown of RBC
• Immature liver
• Dehydration

Question 10

Describe pathologic Hyperbilirubinemia.

Who does it effect? What are the causes?

Answer 10

• Before 24 hours of age
• Associated with bilirubin encephalopathy or kernicterus
• ABO incompatibilities
• Maternal infections
• Maternal ingestion of sulfonamides, diazepam or salicylates near term

Question 11

Nursing care for thermoregulation?

Answer 11

• Drying the newborn immediately after birth is essential to prevent heat loss from evaporation.
• Skin-to-skin contact (kangaroo care) is an effective way to maintain the newborn’s body temperature.
• Radiant warmers and incubators are commonly used to help maintain body temperature
• Swaddle the newborn or use caps and socks

Question 12

Normal newborn vital signs?

Answer 12

Temp – 97.5-98.6
Resp rate – 30-60
Heart rate – 110-160
B/P not routine

Question 13

Indicators of effective breastfeeding?

Answer 13

• Most breastfed infants should have 3-4 stool diapers by 4th day of life
• Stool should no longer be meconium-like, but yellow in color
• Urine is pale yellow and not concentrated
• Infant seems content between feeds
• Infant gains weight

Question 14

Common causes of infant mortality?

Answer 14

• Birth defects
• Preterm birth and low birth weight
• Sudden infant death syndrome
• Injuries (e.g., suffocation)
• Maternal pregnancy complications