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OB > HIGH RISK NEWBORN - FINAL EXAM > Flashcards

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
Q

S/S or resp distress

A

grunting, flaring, retractions, decreased breath sounds, tachypnea, hypotonic, tachycardia, gray skin

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25
Q

nursing actions of resp distress

A

maintain patent airway, admin O2, low flow or high flow cannula, maintain NTE

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26
Q

bronchopulmonary dysplasia

A

chronic lung problem form those that have been treated with mechanical ventilation/O2

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27
Q

risk factors

A

neonates that have been on O2 for more than 28 days

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28
Q

S/S of BPD

A

low lung compliance, atelectasis, pulmonary resistance, overdistened lungs

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29
Q

intraventricular hemorrhage

A

bleeding around brain ventricles common in lbw babies

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30
Q

nursing actions of intraventricular hemorrhage

A

supine position, keep hips below head, NTE, minimize crying

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31
Q

sudden change in condition with intraventricular hemorrhage

A

bradycardia, hypotonia, low hematocrit, shock, metabolic acidosis, hyperglycemia, full/tense anterior fontanel

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32
Q

signs that bleeding worsened for intraventricular hemorrhage

A

apnea, low bp, acidosis, seizures, full or tense anterior fontanel, decreased LOC

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33
Q

NEC

A

gastrointestinal disease causing necrosis and inflammation of bowels

34
Q

cause of NEC

A

prolonged ROM w infection, hypoxia, SGA, congential heart disease, anemia

35
Q

prevention of NEC

A

breastmilk

36
Q

S/S of NEC

A

apnea, bradycardia, blood in stool, shock, low UO, abdomen distention, vomit

37
Q

nursing actions of NEC

A

withhold feedings, monitor I/O and blood vol, hydration and prep for surgery

38
Q

retinopathy of prematurity

A

retina is not completely vascularized and susceptible to stress/injury causing blindness

39
Q

risks of retinopathy

A

high O2, prematurity, lbw, sepsis, infection, sterioids

40
Q

decreasing risk of ROP

A

monitor oxygen using pulse ox

41
Q

post term infant

A

infant born after 41 wks

42
Q

risk factors of post term

A

anencephaly, hx of post, 1st preg, grand multiparous

42
Q

s/s of post term

A

dry peeling skin, long nails, thick blood, pronounced creases, green/yellow skin, placental insufficiency

43
Q

complications of post term

A

meconium, hypoxia, hypoglycemia, polycythemia, cold stress, seizures, cephalohematoma

44
Q

cephalohematoma

A

doesnt cross suture line and involves bone with no skin color change that slowly resolves

45
Q

caput succedaneum

A

crosses suture line with ecchymosis and jaundice that resolves spontaneously

46
Q

meconium aspiration

A

aspiration of meconium causing obstruction, low O2, resp failure

47
Q

s/s of meconium

A

low apgar, grunt, flare, retraction, barrel chest, decreased breath sounds

48
Q

complications of meconium

A

pneumothorax, infection, PPHN

49
Q

interventions for meconium aspiration

A

assess resp distress, admin o2, monitor blood glucose, suction/resuscitation

50
Q

patent ductus arteriosus

A

heart murmur from hole in heart that shunts blood away from lungs not allowing them to breath outside utero

51
Q

s/s of PDA

A

bounding/widened pulse, tachycardia, tachypnea, apnea, active precordium

52
Q

PPHN

A

norm vasodilation and relaxation of pulmonary vascular bed doesnt happen leading to hypertension

53
Q

risk factors of PPHN

A

hypoxia, asphyxia, low apgar, RDS, MEC, sepsis, congenital issues

54
Q

s/s of PPHN

A

hypoxia, low CO, hypotension, metabolic acidosis, grunting, cyanosis

55
Q

SGA

A

below the 10th percentile for gestational age

56
Q

symmetric IUGR

A

generalized reduction of parts of infant

57
Q

asymmetric IUGR

A

disproportional reduction of parts of infant

58
Q

risk factors for SGA

A

multi gestation, under 15, over 45, substance use, preeclampsia, hypertension, placental problems (previa, abruption, small)

59
Q

interventions for SGA

A

assess meconium/temp/hypoglycemia, weigh daily, NTE, strict I/O

60
Q

characteristics of IUGR baby

A

large head, little to no hair, weak cry, loose skin

61
Q

complications of IUGR

A

hypothermia, polycythemia, hypoglycemia, asphyxia

62
Q

nursing actions of IUGR/SGA

A

assess resp distress, NTE, early feeds, monitor vitals, weigh daily

63
Q

LGA

A

weight above the 90th percentile for gestation age

64
Q

macrosomia

A

above 4000g at birth

65
Q

risk factors of LGA

A

diabetes, multiparity, hx of LGA, prolonged preg

66
Q

LGA likely causes

A

c/s, OVD, shoulder dystocia, breech, birth trauma, hypoglycemia, hyperbilirubinemia

67
Q

infants of diabetic mothers are at risk for

A

congenital abnl, skeletal defects, placental insufficiency, neuro probs, childhood obesity

68
Q

assessment of infants from diabetic moms

A

macrosomia, fractured clavical, polycythemia, hypotonia, hypoglycemia

69
Q

nursing actions for infants of diabetic moms

A

assess for symptoms of hypoglycemia and resp distress

70
Q

neonatal infection

A

immune system immature placing infant at risk for infection

71
Q

assessment for neonate infection findings

A

resp distress, hypothermia, hypotension, tremors, poor feeding, jaundice, hypoglycemia

72
Q

neonatal abstinence syndrome

A

from maternal substance use

73
Q

neonatal abstinence syndrome s/s

A

grunt, flair, tremors, frantic sucking, sneezing, yawning

74
Q

nursing care of infant withdrawal

A

observe signs of distress, quiet dark room, feed frequently, bonding

75
Q

omphalocele

A

defect in umbilical ring with peritoneal sac covering defect

76
Q

nursing management of omphalocele

A

cover viscera, prone/side lying, prevent water loss

77
Q

gastroschisis

A

hernation of bowel through defect in abdominal wall right of umbilicus leading to swelling/irritation

78
Q

spina bifida

A

neural tube defect where spine doesnt form properly causing bulging sac of CSF and meninges

79
Q

prevention of spina bifida

A

take folic acid

80
Q

cryptorchidism

A

failure of one or both testes to descend

81
Q

assist with grief

A

time w baby, memorabilia, refer by name

OB (9 decks)

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