High Risk neonate

Question 1

Post term baby characteristics

Answer 1

very dry, wrinkled skin with peeling
no vernix nor lanugo
very long fingernails
increased creases in sole
increased risk for Meconium stained amniotic fluid, SGA or LGA
Lack of placental  perfusion (SGA)

Question 2

Post term baby complications

Answer 2

MAD
Polycythemia
Hypoglycemia

Question 3

Amniotic Fluid embolism Risk factors

Answer 3

older women
macrocosmic baby
precipitous delivery
C-secontion
Pitocin augmentation
Hypertonic uterine contractions

Question 4

Amniotic fluid embolism S&S

Answer 4

Resp. distress (chest pain, dyspnea, coffe-stained mucus)
Cyanosis
Cardiovascular collapse
DIC

Question 5

Tx of amniotic embolism

Answer 5

CPR
Blood Replacement
Central Venous line
Hemodynamic monitoring
ICU
baby must come out
02

Question 6

S&S of cold stress

Answer 6

tachypnea
low skin temp
tremors
irritable

Question 7

RDS risk factors

Answer 7

Diabetes
Premature <28
Multifetal

Question 8

S&S of RDS

Answer 8

tachypnea/cardia
nasal flaring
retractions
cyanosis
loud grunting on expiration
Rhales in lungs

Question 9

Index used for RDS

Answer 9

Silverman Anderson Index:
the higher the score, the worse the RDS
0,1 or 2 is given in 5 areas.
0: perfect 10: severe resp. distress.

Question 10

Tx of RDS

Answer 10

Artificial surfactant
CPAP
Mechanica vent
Humidified o2 
Daily wt, I&O, BP, thermoregulation

Question 11

Complications of RDS

Answer 11

patent ductus arteriosus

Bronchopulmonary dyspnea

Question 12

kernicterus

Answer 12

bilirubin in brain. CNS problem. Assess motor, cognitive and senses

Question 13

Pathological jaundice cause

Answer 13

Rh incomp
Rh disease
ABO incomp
first 24 hrs

Question 14

Physiological jaundice

Answer 14

kernicterus
can cause mental retardation, blindness, deaf.
tx: bili lights

Question 15

Phototherapy bili lights

NI

Answer 15

Distance from light 18-42 inches
cover genitals and eyes
body exposed
monitor temp
fluid replacement
I&O
daily wts
T&P q2h
No skin lotion
parental support
Clean baby frequently to avoid diaper rashes (loose stools)
take them out of light so mom can feed them

Question 16

Neonatal abstinence syndrome (addicted baby)

fetal risks

Answer 16

Meconium aspiration syndrome (uterine hypoxia) if they go through withdrawal.

Question 17

Addicted mother is also at risk for

Answer 17

preeclampsia
placenta abruptio/previa
baby can be born premie

Question 18

S&S of addicted baby

Answer 18

irritable
restless
hyperactive reflexes
feeding difficulties
high pitch cry

Question 19

NI for Neonatal abstinence syndrome

Answer 19

keep baby in quiet dark environment
put cover over basinet
swaddle baby
minimize handling of baby
meds: Seizure, Valium , muscle relaxants

Question 20

Fetal alcohol syndrome S&S

Answer 20

deformities
smaller jaw and head
no philtrum (groove, curve between the nose and the upper lip)
poor social outcome 
developmental problems
irritability and hypersensitivity
tremors/poor feeding
seizures

Question 21

NI for Fetal alcohol syndrome

Answer 21

Monitor resp. distress, hypoglycemia
Check swallow and suck reflex (decreased)
small feedings
decrease environmental stimuli
Monitor wt and circumference
side laying position (drain secretions)