High Risk Newborn Flashcards
1
Q
Preterm (Premature) Newborn
A
- Respiratory Problems:
- Cardiac Problems
- Thermoregulation
- GI alterations: smaller gi/ difficulties sucking/swallowing
- Renal: immature/ can’t compensate for acid-base balance issues/ can’t concentrate urine/ unable to excrete drugs
- Behavioral states: altered wake and sleep pattern
- Management of nutrition & Fluid Requirements
- Long term problems: apnea, congenital heart defects, preterm infants: Bronchopulmonary dysplasia (BPD)/ retinopathy of prematurity (ROP)
2
Q
Assessment of Respiratory Distress
A
- Skin color
- Respiratory System
— Rate
— Labored respirations
— Auscultation of chest
— Cardiovascular System: urinary output (1-2 ml/kg/ hr)
— Hypothermia
— Muscle tone
3
Q
Bronchopulmonary Dysplasia (BPD)
A
- Bronchopulmonary Dysplasia (BPD)
- Chronic lung disease
- Infant requires oxygen 28 days after birth and inability to be weaned
- Caused by preterm, mechanical ventilation, high levels of O2, PDA (patent ductus arterioles) and lung infection
- decrease alveoli in lungs/ thick alveoli sac; non compliant
- treatment: caffeine; stimulate respiratory response in brain/ diaphragm
4
Q
Meconium Aspiration Syndrome
A
- Meconium in the amniotic fluid indicates a potential hypoxic insult
- Triggers chemical pneumonitis which can lead to a bacterial pneumonia, prevents O2 intake/ CO2 release
- Severity of symptoms depends on extent of aspiration
- green amniotic fluid
5
Q
Meconium Aspiration Syndrome
Treatment
A
- Intrauterine saline flushes
- Initial suctioning
- Resuscitation; based on Apgar score
- Ventilation
- Surfactant replacement therapy
- Med: Curosef- synthetic surfactant given through endotracheal tube
- Stimulate lung growth
- Nitric oxide: vasodilator
6
Q
Intraventricular Hemorrhage (IVH)
A
- Bleeding in and around ventricles
- 30% of preterms weighing less than 1500gm (3lb 5oz)
- Caused by fluctuation in BP, mechanical ventilation, asphyxia
7
Q
Intraventricular Hemorrhage (IVH)
Nursing intervention
A
- Avoid crying, overstimulation
- Neuro check
- Measure head circumference; enlarged= hemorrhage
8
Q
Retinopathy of Prematurity (ROP)
A
- High levels of O2 injure blood vessels in eye which leads to abnormally developed vessels which lead to blindness
- Preterm, LBW (low birth weight)
- Laser Surgery
9
Q
Necrotizing Enterocolitis (NEC)
A
- Inflammation & death of intestinal mucosa Preterm Feeding to early or quickly
- Treatment
— Antibiotics, NPO, suction, TPN, surgery, abdominal girths
10
Q
Newborns with Infection
Signs & Symptoms
A
- Subtle behavioral changes
- Temperature instability
- Feeding intolerance
- Hyperbilirubinemia
- Initially Tachycardia, spells of apnea or bradycardia (later)
11
Q
Transient Tachypnea of the Newborn (TTN)-
A
- Occurs in babies who are term
- Little or no difficulty breathing at birth
- Shortly after, expiratory grunting, tachypnea, nasal flaring, cyanosis.
- Due to maternal oversedation, bleeding, prolapsed cord, breech, maternal diabetes or c-section.
- Resolves on its own 24-48 hours
- Treatment: treat symptoms/ o2 if needed
12
Q
Infant of Diabetic Mother: Complications
A
- LGA Birth Trauma
- Hypoglycemia
- Hypocalcemia
- Hyperbilirubinemia
- Polycythemia
- RDS
- Congenital Birth Defects
13
Q
Infant HYPOGLYCEMIA
A
- Intervention when glucose 40mg/dl / or when symptomatic
- Most common metabolic disorder of IDM, SGA and LGA
- Screened within 1st 30 minutes to 2 hours of birth
- Treatment: formula/ Dextrose IV
14
Q
NAS s/s
A
- high pitched/ cat like cry
- Irritable
- Seizures
- Sleep deprivation/ fragmentation
- Tachypnea
- Hypertension
- Tachycardia
- *Diarrhea
- Excessive weight loss
- Vomiting
- *Sneezing
- Excessive sucking
- Poor or excessive feeding
- Yawning
- Hyperthermia
- Hypertonia
- Tremors
15
Q
NAS Treatment
A
find out what the substance is:
- Opiod: methadone
- Stimulant (cocaine): let it pass out of body
- Cluster care
- Keep lights low
- Social case worker
