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OB > High Risk Newborn > Flashcards

High Risk Newborn Flashcards

1
Q

what are some risk factors associated with greater neonatal morbidity and mortality?

A
  • low socioeconomic status
  • no prenatal care
  • exposure to teratogens
  • preexisting maternal conditions
  • age and parity
  • pregnancy complications
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2
Q

what classifies small for gestational age?

A

less than 10th%ile for weight

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3
Q

what does IUGR lead to?

A

advanced gestation with limited fetal growth

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4
Q

what are the 2 IUGR classifications?

A

symmetrical and asymmetrical

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5
Q

describe symmetrical IUGR

A

restricted growth in size of organs, body length, and head circumference d/t long-term conditions

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6
Q

describe assymetrical IUGR

A

birth weight under 10th%ile. however, head/body length remain noral. d/t impaired uteroplacental bloodflow

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7
Q

what are complications of SGA/IUGR newborn

A
  • hypoxia
  • aspiration syndrome (meconium)
  • hypothermia
  • hypoglycemia
  • polycythemia (inc. immature RBCs from stress)
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8
Q

what classifies LGA?

A

weighs more than 90% (top 10)

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9
Q

what are correlations with LGA?

A
  • diabetes
  • genes
  • multiparity
  • male infants
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10
Q

what are complications of LGA?

A
  • trauma (cephalopelvic disproportion)
  • induction
  • c/s
  • hypoglycemia
  • polycythemia
  • hyperviscosity
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11
Q

why would a baby be SGA/LGA with a diabetic mother?

A

SGA= renal disease, has sugar settling in vasculature
LGA= high gluc levels

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12
Q

is SGA or LGA more common with diabetic mothers?

A

LGA

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13
Q

what are complications of a baby with a diabetic mother?

A
  • hypoglycemia
  • hypocalcemia
  • hyperbilirubinemia
  • trauma
  • polycythemia
  • resp distress syndrome (RDS)
  • congenital malformation
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14
Q

what classifies hypoglycemia in a baby?

A

less than 40-45

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15
Q

what are s/sx of hypoglycemia in babies?

A
  • tremors/seizures
  • apnea
  • cyanosis
  • temp instability
  • poor feeding
  • hypothermia/lethargy
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16
Q

When will blood sugar be checked with possible hypoglycemia?

A

at 1 hour

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17
Q

what is done when baby has a sugar less than 40-45?

A

feed
IV dextrose
recheck after

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18
Q

what classifies a premature baby?

A

prior to 38 weeks (need 37 completed weeks)

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19
Q

what % of babies are premature

A

12%

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20
Q

what is the concern with prematurity

A

prematurity of all body systems

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21
Q

what is RDS from involving prematurity?

A
  • inadequate surfactant
  • pulmonary vessels not fully developed
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22
Q

what are cardio complications from prematurity

A
  • at risk for PDA (patent ductus arteriosis)
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23
Q

what causes problems with thermoregulation involving prematurity?

A
  • great body surface area
  • little sub cue fat
  • thin skin
  • less flexion
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24
Q

what are GI/GU complications from prematurity?

A
  • poor sucking/swallowing
  • poor gag
  • small stomach, can’t absorb fat
  • calcium/phos deficient
  • inc. BMR/oxygen needs
  • **immature kidneys
  • GFR dec., cant concentrate urine**
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25
Q

what is necrotizing enterocolitis (NEC)

A

GI/GU complication of prematurity, infection = lose intestine

26
Q

what are the implications for feeding premature newborns?

A

TPN, NG, oral

27
Q

what hepatic complication comes from prematurity

A

hypoglycemia

28
Q

what hematologic complications come from prematurity

A

-low iron stores
-risk for hyperbilirubinemia

29
Q

what immunologic complications come from prematurity

A

risk for infection

30
Q

what neuro complications is the baby at risk for from prematurity?

A
  • intraventricular hemorrhage (IVH)
  • intracranial hemorrhage (ICH)
  • apnea (cessation for at least 20 sec)
31
Q

what are possible long term complications from prematurity

A
  • SIDS
  • resp infection
  • neuro probs
  • auditory probs
  • speech probs
  • retinopathy of prematurity
32
Q

what qualifies as postmaturity?

A

born after 42 completed weeks (43 weeks 1 day)

33
Q

complications of postmaturity?

A
  • hypoglycemia
  • meconium aspiration
  • seizures
  • polycythemia r/t hypoxia
  • congenital abnormalities
  • cold stress
34
Q

complications of substnace-abusing mother?

A
  • congenital anomalies
  • developmental probs
35
Q

what is the appearance of someone with fetal alcohol syndrome

A
  • short stature
  • flat nasal bridge
  • microcephaly
  • thin upper lip/flat
  • thin appearance
36
Q

long term complications of fetal alcohol syndrome (substance abusing mother)

A
  • impulsive
  • cognitive involvement
  • speech probs
  • learning disabilities
37
Q

what are risks to the baby from drug abuse?

A
  • asphyxia
  • infection
  • SGA/LGA
  • low APGAR
  • resp distress
  • congenital anomalies
  • behavioral probs
  • withdraw
38
Q

what is phenylketonuria (PKU)

A

phenylalanine amino acid disorder (can’t convert excess phenylalanine to tyrosine)

39
Q

what is galactosemia?

A

carbohydrate metabolism problem

40
Q

what is homocystinurea?

A

deficiency of cystathionine beta synthase

41
Q

what is RDS from?

A

prematurity and low surfactant

42
Q

what are complications from RDS?

A

hypoxia
resp acidosis
metabolic acidosis

43
Q

what are s/sx of RDS?

A
  • high resp rate
  • high resp effort (Grunt, Flare, Retract)
  • low pulse ox (low 90’s)
44
Q

what is management of RDS?

A
  • prevent preterm birth
  • administer celestone
  • administer surfactant
  • resp support: vent, CPAP, O2
45
Q

what kind of births does transient tachypnea of the newborn (TTN) effect?

A

often term, LGA, and late preterm babies

46
Q

what are risk factors of transient tachypnea of the newborn (TTN)?

A
  • maternal diabetes
  • macrosomia
  • c/s delivery
  • lung fluid
  • male sex
  • fetal hypoxia
47
Q

s/sx of TTN?

A
  • G,F,R breathing
  • cyanosis
  • tachypnea
  • mild resp/met acidosis
  • sx usually resolve in 24 hr
48
Q

describe meconium aspiration syndrome

A
  • fetal relaxation of anal sphincter (d/t lack of o2), results in meconium stool in amniotic fluid
  • may be aspirated during first breaths
49
Q

what are risks of meconium aspiration syndrome

A
  • obstruction of airway
  • pneumonia
  • inactivation of surfactant
  • pulmonary HTN
50
Q

how is meconium aspiration syndrome managed?

A
  • light meconium= not a ton of management
  • thick meconium= baby will not be dry/stim to cry, take to the warmer for suction
51
Q

what is excessive heat loss resulting in compensatory mechanisms to maintian adequate body temperature?

A

cold stress

52
Q

what are the compensatory mechanisms for cold stress?

A
  • increased resps
  • nonshivering thermogenesis
53
Q

are LGA,AGA,or SGA babies most at risk for cold stress

A

SGA

54
Q

what can cold stress result in?

A
  • dec. surfactant
  • metabolic acidosis
  • hypoglycemia
  • hyperbilirubinemia
55
Q

is physiologic jaundice occuring after 24 hours normal?

A

yes

55
Q

when is jaundice concering?

A

when it is detected before 24 hours of life

56
Q

what is unconjugated bilirubin deposited in the brain

A

kernicterus

57
Q

what is anemia, severe edema, and organ failure associated with maternal antibody

A

hydrops fetalis

58
Q

when is jaundice most frequently seen?

A

with alloimmunization, ABO sensitivity

59
Q

management of jaundice?

A
  • phototherapy
  • exchange transfusion

OB (15 decks)

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