High Risk Newborn Care

Question 1

LBW

Answer 1

low birth weight, under 2500g

Question 2

VLBW

Answer 2

very low birth weight, under 1500g

Question 3

ELBW

Answer 3

extremely low birth weight, under 1000g

Question 4

s/s of anemia of prematurity

Answer 4

low H&H, pallor, lethargy, tachypnea, tachycardia

Question 5

treatment of bilirubin encephalopathy

Answer 5

phototherapy, exchange transfusion

Question 6

tx of PDA

Answer 6

indomethacin, acetaminophen, infuse fluids slowly,

Question 7

nursing interventions for intraventricular hemorrhage

Answer 7

avoid lifting legs, I&Os

Question 8

retinopathy of prematurity treatment

Answer 8

laser surgery, opthalm eye exams before d/c

Question 9

s/s of respiratory distress in prematures

Answer 9

nasal flaring, expiratory grunting, retractions, tachypnea

Question 10

interventions for resp distress in prematures

Answer 10

ventilation, supplemental O2, prone, administer surfactant

Question 11

what can a surfactant deficiency cause

Answer 11

RDS, exhaustion, hypothermia, hypoglycemia

Question 12

IV caffeine

Answer 12

CNS stimulant, can help remind prematures to breathe

Question 13

s/s of hypothermia

Answer 13

temp below 36.5, apnea, bradycardia, cyanosis, hypoglycemia, lethargy, irritability

Question 14

interventions for hypothermia

Answer 14

skin to skin, heated isolette/incubator, monitor temp more frequently

Question 15

s/s of dehydration

Answer 15

oliguria, weight loss, dry membranes, no turgor, depressed fontanel

Question 16

s/s of overhydration

Answer 16

polyuria, weight gain, edema, crackles

Question 17

how can you decrease stimulation in the NICU

Answer 17

cluster cares, gentle touch, dim lighting, quiet environment, cover isolette

Question 18

skin care

Answer 18

gently soap, infrequent baths, daily skin checks, rotate pulse ox sites, careful with tape

Question 19

benefits of skin to skin

Answer 19

thermoregulation, oxygenation, reduces stress, improves attention and movement, bonding

Question 20

s/s of infection in premature

Answer 20

thermal instability, lethargy, irritability, cyanosis, high or low HR and RR, glucose instability

Question 21

requirements for NICU d/c

Answer 21

oral feedings, maintain temp, 2kg, car seat test, SIDS edu, follow up

Question 22

interventions for resp distress

Answer 22

maintain ventilation & oxygenation, D5 fluids, maintain acid base balance

Question 23

s/s of MAS

Answer 23

meconium stained fluids @ rupture, hypoxia, acidemia, hyper then hypoventilation

Question 24

interventions for MAS

Answer 24

oxygenation - may need surfactant, ventilation, nitric, ECMO

Question 25

causes of hyperbilirubinemia

Answer 25

immature infant liver, isoimmunization

Question 26

when does jaundice present

Answer 26

3-5 days if d/t immature liver, before 24 hours if d/t isoimmunization

Question 27

treatment for hyperbilirubinemia

Answer 27

frequent feedings, phototherapy, exchange transfusion

Question 28

phototherapy nursing interventions

Answer 28

eye shield, proper positioning/repositioning, maintain hydration & thermoregulation, no lotions/ointments

Question 29

complications of NEC

Answer 29

impaired digestion, paralytic ileus

Question 30

s/s of NEC

Answer 30

distention, hypoactive, bloody stools, bilious emesis, loopy bowels

Question 31

what can GBS cause

Answer 31

sepsis

Question 32

complications of GDM

Answer 32

higher risk of RDS, birth injury, hypoglycemia (<45)

Question 33

when do NAS symptoms start

Answer 33

12 hours - 3 days, up to 3 weeks if on methadone

Question 34

s/s of NAS

Answer 34

shrill cry, disturbed sleeping & feeding, tremors, sneezing, tachypnea, n/v/d

Question 35

NAS tx

Answer 35

given morphine or methadone depending on scale 3 hr after birth - eat, sleep, console or Finnegan

Question 36

s/s of FAS

Answer 36

wide set eyes, no cupids bow, big ears, irritability, weak cry, tremors

Question 37

risks of FAS

Answer 37

growth restriction, cognitive challenges, microcephaly, cerebral palsy