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Obstetrics > High Risk Neonatal > Flashcards

High Risk Neonatal Flashcards

1
Q

What two factors largely effect infants health and surviability.

A
  1. Length of gestation
  2. Birth weight
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2
Q

How many weeks is considered very preterm

A

< 32 weeks

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3
Q

How many weeks is considered preterm

A

32 to 34 weeks

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4
Q

How many weeks is considered late preterm

A

34 to 36 weeks

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5
Q

What is the primary reason for low birth weight?

A

prematurity

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6
Q

What are the categories for low birth weights?

A
  • Extremely low < 1000 g
  • Very low < 1500 g
  • Low < 2500 g
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7
Q

Common characteristics of premature for the following

  1. Hair
  2. Tone & Flexion
  3. Testes
  4. Cries
A
  1. Lanugo present (20 to 28 wks)
  2. Decreased tone and flexion
  3. Undescended
  4. Weak cries
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8
Q

Common characteristics of prematurity

  1. Creases on foot
  2. Blood pressure
  3. Heart
  4. Reflexes
A
  1. Absent creases
  2. Hypotension
  3. Murmurs present
  4. Diminished or absent
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9
Q

What are the following a sign of?

Grunting, flaring, retracting, cyanosis

A

Respiratory Distress

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10
Q

Identify the disorder

Small underdeveloped alveoli and insufficient levels of pulmonary surfactant

A

Respiratory Distress Syndrome

life threatening

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11
Q

Nursing Actions for

Respiratory Distress Syndrome

(3)

A
  1. Provide respiratory support
  2. Monitor vital signs
  3. Maintain neutral thermal environment (prevents cold stress)
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12
Q

Identify this order

chronic lung disorder that have been treated w/ mechanical ventilation and O2 due to an inflammatory response from prematurity

A

Bronchopulmonary Dysplasia (BPD)

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13
Q

How long can it take for the ductus arteriosus to close?

A

up to 96 hours (4 days)

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14
Q

What is occuring with Patent Ductus Arteriosus (PDA)?

A

Ductus arteriosus remains open after birth

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15
Q

What is intraventricular hemorrhage (IVH)

A

Bleeding in the ventricles of the developing brain.

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16
Q

Identify this disorder

Inflammation and necrosis of the bowel

A

Necrotizing enterocolitis (NES)

17
Q

Identify this disorder

Respiratory failure induced when meconium fluid enters the fetal lungs and causes partial obstruction

A

Meconium Aspiration Syndrome (MAS)

18
Q

When can bilirubin be excreted?

A

When it becomes conjugated.

19
Q

Identify this disorder

Abnormal accumulation of unconjugated bilirubin in the brain cells

A

Kernicterus

20
Q

What type of bilirubin can cross the blood brain barrier causing neurological disorders?

A

unconjugated bilirubin

21
Q

What is conjugated bilirubin bound to?

A

albumin

22
Q

When serum bilirubin levels are greater than ? mg/dL, neonates will exhibit visible signs of jaundice.

A

> 5 mg/dL

23
Q

Which type of jaundice occurs after the first 24 hours and during the first week of life?

A

Physiological jaundice

24
Q

Which type of jaundice occurs within the first 24 hours of life.

A

Pathological jaundice

25
Q

What are two diagonistic tests for hyperbilirubinemia

A
  1. Total serum bilirubin
  2. Antiglobulin (Coombs) test

Additionally: transcutaneous bilrubinometry

26
Q

What is the treatment for hyperbilirubinemia

A

Phototherapy

converts bilirubin to water-soluble molecules that can be excreted

27
Q

What are the Five Rights of Teaching

A
  1. Right Time
  2. Right Context (environment)
  3. Right Goal
  4. Right Content
  5. Right Method
28
Q

What is the risk with hyperbilirubinemia?

A

accumulation of unconjugated bilirubin in the brain causing neurological disorders (*deafness, delayed motor skills, intellectual deficits, and hypotonia)

hypotonia = decreased muscle tone

29
Q

What vulnerabilities do preterm babies have that put them at risk for infection (e.g., necrotizing enterocolitis)

Two vulnerabilities

A
  1. Fetal lung maturity
  2. Organ sensitivity
30
Q

Signs and symptoms

Newborn
Respiratory Distress syndrome

(3)

A
  1. Tachypnea
  2. Gray or dusky skin
  3. Lethargic and hypotonic
31
Q

What is breastfeeding jaundice?
When does it occur?
Why does it occur?

A
  1. Caused by ineffective breastfeeding
  2. Early onset (first few days of life)
  3. Not receiving enough milk causes delay in meconium stool leading to reabsorption of bilirubin.
32
Q

What hormones are associated with lactogenesis?

A

Prolactin

High levels of estrogen and progesterone suppress lactation.

Obstetrics (9 decks)

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