High Risk Neonatal Flashcards
What two factors largely effect infants health and surviability.
- Length of gestation
- Birth weight
How many weeks is considered very preterm
< 32 weeks
How many weeks is considered preterm
32 to 34 weeks
How many weeks is considered late preterm
34 to 36 weeks
What is the primary reason for low birth weight?
prematurity
What are the categories for low birth weights?
- Extremely low < 1000 g
- Very low < 1500 g
- Low < 2500 g
Common characteristics of premature for the following
- Hair
- Tone & Flexion
- Testes
- Cries
- Lanugo present (20 to 28 wks)
- Decreased tone and flexion
- Undescended
- Weak cries
Common characteristics of prematurity
- Creases on foot
- Blood pressure
- Heart
- Reflexes
- Absent creases
- Hypotension
- Murmurs present
- Diminished or absent
What are the following a sign of?
Grunting, flaring, retracting, cyanosis
Respiratory Distress
Identify the disorder
Small underdeveloped alveoli and insufficient levels of pulmonary surfactant
Respiratory Distress Syndrome
life threatening
Nursing Actions for
Respiratory Distress Syndrome
(3)
- Provide respiratory support
- Monitor vital signs
- Maintain neutral thermal environment (prevents cold stress)
Identify this order
chronic lung disorder that have been treated w/ mechanical ventilation and O2 due to an inflammatory response from prematurity
Bronchopulmonary Dysplasia (BPD)
How long can it take for the ductus arteriosus to close?
up to 96 hours (4 days)
What is occuring with Patent Ductus Arteriosus (PDA)?
Ductus arteriosus remains open after birth
What is intraventricular hemorrhage (IVH)
Bleeding in the ventricles of the developing brain.
Identify this disorder
Inflammation and necrosis of the bowel
Necrotizing enterocolitis (NES)
Identify this disorder
Respiratory failure induced when meconium fluid enters the fetal lungs and causes partial obstruction
Meconium Aspiration Syndrome (MAS)
When can bilirubin be excreted?
When it becomes conjugated.
Identify this disorder
Abnormal accumulation of unconjugated bilirubin in the brain cells
Kernicterus
What type of bilirubin can cross the blood brain barrier causing neurological disorders?
unconjugated bilirubin
What is conjugated bilirubin bound to?
albumin
When serum bilirubin levels are greater than ? mg/dL, neonates will exhibit visible signs of jaundice.
> 5 mg/dL
Which type of jaundice occurs after the first 24 hours and during the first week of life?
Physiological jaundice
Which type of jaundice occurs within the first 24 hours of life.
Pathological jaundice
What are two diagonistic tests for hyperbilirubinemia
- Total serum bilirubin
- Antiglobulin (Coombs) test
Additionally: transcutaneous bilrubinometry
What is the treatment for hyperbilirubinemia
Phototherapy
converts bilirubin to water-soluble molecules that can be excreted
What are the Five Rights of Teaching
- Right Time
- Right Context (environment)
- Right Goal
- Right Content
- Right Method
What is the risk with hyperbilirubinemia?
accumulation of unconjugated bilirubin in the brain causing neurological disorders (*deafness, delayed motor skills, intellectual deficits, and hypotonia)
hypotonia = decreased muscle tone
What vulnerabilities do preterm babies have that put them at risk for infection (e.g., necrotizing enterocolitis)
Two vulnerabilities
- Fetal lung maturity
- Organ sensitivity
Signs and symptoms
Newborn
Respiratory Distress syndrome
(3)
- Tachypnea
- Gray or dusky skin
- Lethargic and hypotonic
What is breastfeeding jaundice?
When does it occur?
Why does it occur?
- Caused by ineffective breastfeeding
- Early onset (first few days of life)
- Not receiving enough milk causes delay in meconium stool leading to reabsorption of bilirubin.
What hormones are associated with lactogenesis?
Prolactin
High levels of estrogen and progesterone suppress lactation.
