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HIGH RISK NEWBORN - FINAL EXAM Flashcards

1
Q

preterm infants

A

born less than 37 wks with immature organ systems and lack of nutrients

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2
Q

high risk infants are classified according to

A

birth wt, gestational age, pathophysiologic problems

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3
Q

extremely lbw

A

1000 g/2.2 lbs or less

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4
Q

very lbw

A

less than 1500 g/ 3.3 lbs

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5
Q

lbw

A

2500/5.5 lbs

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6
Q

very premature

A

less than 32 wks

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7
Q

late premature

A

born btw 34-37 wks

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7
Q

premature

A

born btw 32-34 wks

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8
Q

tone and flexion assessment

A

increases with gestation, hypotonic and extended tone and posture

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9
Q

skin assessment

A

translucent, transparent, red

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10
Q

subcut fat assessment

A

decreased fat leading to thermoregulation issues

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11
Q

lanugo assessment

A

present btw 20-28 wks and then will disappear

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12
Q

foot creases assessment

A

not present until 28-30 wks

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13
Q

eye assessment

A

eyelids fused in very preterm and open btw 26-30wks

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14
Q

overriding sutures assessment

A

common among prematures, lbw

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15
Q

pina assessment

A

thin, soft, flat, folded

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16
Q

respiratory and cardiovascular support for neonate

A

maintain patent airway and thermal environment, assess vitals, labs I/O

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17
Q

nursing action for preterm neonates

A

NTE, nutrition, fluid/electrolytes, test

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18
Q

cardiovascular support includes evaluation of

A

HR, rhythm, skin, murmurs, pulses, cap refill, BP, hemoglobin/hematocrit, blood transfusions

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19
Q

maintain fluid and electrolyte imbalances

A

monitor I/O, IV fluids, determine hydration, add humidity

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20
Q

nutrition needs for preterm

A

monitor blood glucose, breastfeeding, bonding, feedings

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21
Q

respiratory distress synddrome

A

alveoli underdeveloped and lifethreatening

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22
Q

L/S ration

A

determines lung maturity with 2 phospholipids detected in liver

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23
Q

PG test

A

synthesized from mature alveoli to determine lung maturity

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24
S/S or resp distress
grunting, flaring, retractions, decreased breath sounds, tachypnea, hypotonic, tachycardia, gray skin
25
nursing actions of resp distress
maintain patent airway, admin O2, low flow or high flow cannula, maintain NTE
26
bronchopulmonary dysplasia
chronic lung problem form those that have been treated with mechanical ventilation/O2
27
risk factors
neonates that have been on O2 for more than 28 days
28
S/S of BPD
low lung compliance, atelectasis, pulmonary resistance, overdistened lungs
29
intraventricular hemorrhage
bleeding around brain ventricles common in lbw babies
30
nursing actions of intraventricular hemorrhage
supine position, keep hips below head, NTE, minimize crying
31
sudden change in condition with intraventricular hemorrhage
bradycardia, hypotonia, low hematocrit, shock, metabolic acidosis, hyperglycemia, full/tense anterior fontanel
32
signs that bleeding worsened for intraventricular hemorrhage
apnea, low bp, acidosis, seizures, full or tense anterior fontanel, decreased LOC
33
NEC
gastrointestinal disease causing necrosis and inflammation of bowels
34
cause of NEC
prolonged ROM w infection, hypoxia, SGA, congential heart disease, anemia
35
prevention of NEC
breastmilk
36
S/S of NEC
apnea, bradycardia, blood in stool, shock, low UO, abdomen distention, vomit
37
nursing actions of NEC
withhold feedings, monitor I/O and blood vol, hydration and prep for surgery
38
retinopathy of prematurity
retina is not completely vascularized and susceptible to stress/injury causing blindness
39
risks of retinopathy
high O2, prematurity, lbw, sepsis, infection, sterioids
40
decreasing risk of ROP
monitor oxygen using pulse ox
41
post term infant
infant born after 41 wks
42
risk factors of post term
anencephaly, hx of post, 1st preg, grand multiparous
42
s/s of post term
dry peeling skin, long nails, thick blood, pronounced creases, green/yellow skin, placental insufficiency
43
complications of post term
meconium, hypoxia, hypoglycemia, polycythemia, cold stress, seizures, cephalohematoma
44
cephalohematoma
doesnt cross suture line and involves bone with no skin color change that slowly resolves
45
caput succedaneum
crosses suture line with ecchymosis and jaundice that resolves spontaneously
46
meconium aspiration
aspiration of meconium causing obstruction, low O2, resp failure
47
s/s of meconium
low apgar, grunt, flare, retraction, barrel chest, decreased breath sounds
48
complications of meconium
pneumothorax, infection, PPHN
49
interventions for meconium aspiration
assess resp distress, admin o2, monitor blood glucose, suction/resuscitation
50
patent ductus arteriosus
heart murmur from hole in heart that shunts blood away from lungs not allowing them to breath outside utero
51
s/s of PDA
bounding/widened pulse, tachycardia, tachypnea, apnea, active precordium
52
PPHN
norm vasodilation and relaxation of pulmonary vascular bed doesnt happen leading to hypertension
53
risk factors of PPHN
hypoxia, asphyxia, low apgar, RDS, MEC, sepsis, congenital issues
54
s/s of PPHN
hypoxia, low CO, hypotension, metabolic acidosis, grunting, cyanosis
55
SGA
below the 10th percentile for gestational age
56
symmetric IUGR
generalized reduction of parts of infant
57
asymmetric IUGR
disproportional reduction of parts of infant
58
risk factors for SGA
multi gestation, under 15, over 45, substance use, preeclampsia, hypertension, placental problems (previa, abruption, small)
59
interventions for SGA
assess meconium/temp/hypoglycemia, weigh daily, NTE, strict I/O
60
characteristics of IUGR baby
large head, little to no hair, weak cry, loose skin
61
complications of IUGR
hypothermia, polycythemia, hypoglycemia, asphyxia
62
nursing actions of IUGR/SGA
assess resp distress, NTE, early feeds, monitor vitals, weigh daily
63
LGA
weight above the 90th percentile for gestation age
64
macrosomia
above 4000g at birth
65
risk factors of LGA
diabetes, multiparity, hx of LGA, prolonged preg
66
LGA likely causes
c/s, OVD, shoulder dystocia, breech, birth trauma, hypoglycemia, hyperbilirubinemia
67
infants of diabetic mothers are at risk for
congenital abnl, skeletal defects, placental insufficiency, neuro probs, childhood obesity
68
assessment of infants from diabetic moms
macrosomia, fractured clavical, polycythemia, hypotonia, hypoglycemia
69
nursing actions for infants of diabetic moms
assess for symptoms of hypoglycemia and resp distress
70
neonatal infection
immune system immature placing infant at risk for infection
71
assessment for neonate infection findings
resp distress, hypothermia, hypotension, tremors, poor feeding, jaundice, hypoglycemia
72
neonatal abstinence syndrome
from maternal substance use
73
neonatal abstinence syndrome s/s
grunt, flair, tremors, frantic sucking, sneezing, yawning
74
nursing care of infant withdrawal
observe signs of distress, quiet dark room, feed frequently, bonding
75
omphalocele
defect in umbilical ring with peritoneal sac covering defect
76
nursing management of omphalocele
cover viscera, prone/side lying, prevent water loss
77
gastroschisis
hernation of bowel through defect in abdominal wall right of umbilicus leading to swelling/irritation
78
spina bifida
neural tube defect where spine doesnt form properly causing bulging sac of CSF and meninges
79
prevention of spina bifida
take folic acid
80
cryptorchidism
failure of one or both testes to descend
81
assist with grief
time w baby, memorabilia, refer by name

OB (9 decks)

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