High Risk Newborn Care Flashcards
LBW
low birth weight, under 2500g
VLBW
very low birth weight, under 1500g
ELBW
extremely low birth weight, under 1000g
s/s of anemia of prematurity
low H&H, pallor, lethargy, tachypnea, tachycardia
treatment of bilirubin encephalopathy
phototherapy, exchange transfusion
tx of PDA
indomethacin, acetaminophen, infuse fluids slowly,
nursing interventions for intraventricular hemorrhage
avoid lifting legs, I&Os
retinopathy of prematurity treatment
laser surgery, opthalm eye exams before d/c
s/s of respiratory distress in prematures
nasal flaring, expiratory grunting, retractions, tachypnea
interventions for resp distress in prematures
ventilation, supplemental O2, prone, administer surfactant
what can a surfactant deficiency cause
RDS, exhaustion, hypothermia, hypoglycemia
IV caffeine
CNS stimulant, can help remind prematures to breathe
s/s of hypothermia
temp below 36.5, apnea, bradycardia, cyanosis, hypoglycemia, lethargy, irritability
interventions for hypothermia
skin to skin, heated isolette/incubator, monitor temp more frequently
s/s of dehydration
oliguria, weight loss, dry membranes, no turgor, depressed fontanel
s/s of overhydration
polyuria, weight gain, edema, crackles
how can you decrease stimulation in the NICU
cluster cares, gentle touch, dim lighting, quiet environment, cover isolette
skin care
gently soap, infrequent baths, daily skin checks, rotate pulse ox sites, careful with tape
benefits of skin to skin
thermoregulation, oxygenation, reduces stress, improves attention and movement, bonding
s/s of infection in premature
thermal instability, lethargy, irritability, cyanosis, high or low HR and RR, glucose instability
requirements for NICU d/c
oral feedings, maintain temp, 2kg, car seat test, SIDS edu, follow up
interventions for resp distress
maintain ventilation & oxygenation, D5 fluids, maintain acid base balance
s/s of MAS
meconium stained fluids @ rupture, hypoxia, acidemia, hyper then hypoventilation
interventions for MAS
oxygenation - may need surfactant, ventilation, nitric, ECMO
causes of hyperbilirubinemia
immature infant liver, isoimmunization
when does jaundice present
3-5 days if d/t immature liver, before 24 hours if d/t isoimmunization
treatment for hyperbilirubinemia
frequent feedings, phototherapy, exchange transfusion
phototherapy nursing interventions
eye shield, proper positioning/repositioning, maintain hydration & thermoregulation, no lotions/ointments
complications of NEC
impaired digestion, paralytic ileus
s/s of NEC
distention, hypoactive, bloody stools, bilious emesis, loopy bowels
what can GBS cause
sepsis
complications of GDM
higher risk of RDS, birth injury, hypoglycemia (<45)
when do NAS symptoms start
12 hours - 3 days, up to 3 weeks if on methadone
s/s of NAS
shrill cry, disturbed sleeping & feeding, tremors, sneezing, tachypnea, n/v/d
NAS tx
given morphine or methadone depending on scale 3 hr after birth - eat, sleep, console or Finnegan
s/s of FAS
wide set eyes, no cupids bow, big ears, irritability, weak cry, tremors
risks of FAS
growth restriction, cognitive challenges, microcephaly, cerebral palsy
