High risk Infant Flashcards
what may have compromised the fetus in utero?
- maternal medical and prenatal history
- prenatal care: socioeconomic status and maternal medical disorders
- gestational age
- maternal age: congenital anomalies
what occurred during labor that could compromise the infant
- duration and course of labor
- materal well being: use of nacre, analgesics, anesthia
- fetal well being:
neonatal mortality vs neonatal morbidity
- mortalitiy: possibility of death with first 28 days
- mordity: poor health outcome as a result of adverse fleuve or treatments acting either on the fetus during pregnancy and/or the infant during first 4 weeks of life
causes of intrauterine growth restriction
- chromosoms, early infections, malnutrition, alcohol
- decreased oxygen carrying capacity
- dysfucntional oxygen delivery system
- placental damage
patterns of symmetric IUGR
- growth failure is early
- small overall
patterns of asymmetric IUGR
- growth failure late
- small abdominal circumference compared to head circumference
complications of SGA/IUGR babies
- chronic hypoxia
- hypothermia
- hypoglycemia
- polycythemia
outcomes of a SGA/IUGR baby
- congenital malformations (birth defects): chromosomes, alcoholism, malnutrition, early infection (TORCH)
- cognitive, motor, neuro difficulties (decreased oxygen carrying capacity/ dysfunctional oxygen delivery system
Clinical therapy/care for SGA/IUGR
- early recognition: US, BPP
- medical management of potential problems: early delivery
- nursing care: gestational age assessment at birth, identify signs of potential complications
what to anticipate in a LGA baby
- diabetic mother
- maternal weight
- multiparity
Complications of LGA
- brith trauma related to cephalopelvic disproportion: increased c/s
- hypoglycemia
complications of an infant for a diabetic mother
- birth trauma
- hypoglycemia
- hypocalcemia
- hyperbilirubinemia
- polycythemia
- respiratory distress syndrome
- congenital malformations`
clinical therapy and nursing assessment of LGA abby
- control maternal glucose
- neonatal glucose hourly during first 4 hours and q4 for 24hrs: not below 45: early feeding, IV glucose infusion
- respiratory and cardiac status
- screen for jaundice
premature infant assessment
- gestational age
- new milestones each week in utero. need to know what is functioning and what is not functioning to guide care
infant of substance abusng mother
tobacco: SIS, premature, low birth weight
- weed: lbw, preterm,
- alcohol: FAS
- drugs: infections, developmental problems, birth defects