High Risk Newborn Pt. 2

Question 1

How long does it take for transient tachypnea of the newborn to resolve?

Answer 1

1-3 days

Question 2

How is TTN diagnosed?

Answer 2

X-ray

Question 3

Why is it important to treat TTN?

Answer 3

it may cause atelectasis

Question 4

How is TTN treated?

Answer 4

Oxygen supplementation and NG tube feedings

Question 5

What are s/s of TTN?

Answer 5

retractions, nasal flaring, grunting, mild cyanosis

Question 6

When does meconium aspiration happen?

Answer 6

in utero

Question 7

What can happen if meconium aspiration occurs?

Answer 7

complete atelectasis can occur

Question 8

How can meconium be diagnosed?

Answer 8

chest x-ray that shows hyperexpansion and atelectasis

Question 9

How is meconium aspiration treated?

Answer 9

intubate and suction immediately, mechanical ventilation/high frequency vent/ECMO, and antibiotics

Question 10

S/S of meconium aspiration

Answer 10

Tachypnea, cyanosis, grunting, rales, retractions, barrel shaped chest, greenish staining to nails and skin

Question 11

What does meconium aspiration syndrome casue?

Answer 11

chemical pneumonitis

Question 12

What is the most effective way to get the meconium out of a baby’s lungs?

Answer 12

A meconium aspirator

Question 13

If the baby is gasping, is tachypnic, cyanotic, grunting, and retracting, and the amniotic fluid was stained with meconium, what is the next thing that would be done?

Answer 13

intubation

Question 14

Why are babies with meconium aspiration given antibiotics?

Answer 14

to treat chemical pneumonitis

Question 15

What may a newborn look like if meconium has been leaking with the amniotic fluid for a while?

Answer 15

greenish stain on skin and nails

Question 16

3 things to look at if meconium aspiration is suspected?

Answer 16

HR, tone, respiratory effort

Question 17

What is the number 1 diagnosis for ECMO for a newborn?

Answer 17

meconium aspiration syndrome

Question 18

What are the two types of jaundice?

Answer 18

physiologic vs pathologic

Question 19

How is hyperbilirubinemia treated?

Answer 19

it is determined by bilirubin result and age of baby in hours as well as risk factors

Question 20

What can happen if a baby’s bilirubin gets too high?

Answer 20

kernicterus

Question 21

What is the main treatment for hyperbilirubinemia?

Answer 21

hydration/phototherapy

Question 22

Which baby’s are at risk for pathological jaundice?

Answer 22

Rh negative or type O moms that have a baby that is Rh positive or type A/B/AB

Question 23

What might babies present with pathological jaundice?

Answer 23

hemolytic disease of the newborn, Sepsis, Cold stress, or a blocked bile duct

Question 24

What might babies present with physiologic jaundice?

Answer 24

increased RBCs, liver immaturity, delayed feeding, and bruising

Question 25

What is the treatment for an infant with RH disease?

Answer 25

treat anemia, remove sensitized RBC's that would be destroyed, remove serum bilirubin, and provide bilirubin free albumin

Question 26

Why is feeding so important to decrease bilirubin levels in newborns?

Answer 26

feedings should make the baby poop, and bilirubin is excreted in the poop

Question 27

Can babies under phototherapy have lotion on them?

Answer 27

no

Question 28

What is the nursing care for a baby with hyperbilirubinemia?

Answer 28

expose as much skin as possible and keep under lights except for feedings, frequent feedings, eye protection, frequent diaper changes, monitor I & O's, remove eye protection at feedings and promote bonding, check bili levels are ordered, monitor temperature

Question 29

What is the main bacterial neonatal infection that occurs?

Answer 29

GBS

Question 30

What are the main viral infections that neonates can transmit?

Answer 30

TORCH, Varicella-Zoster, ZIKA

Question 31

What is the main fungal neonatal infection?

Answer 31

candidiasis

Question 32

what is vertical trasmission?

Answer 32

something that is transmitted at birth

Question 33

What is a TORCH titer?

Answer 33

Toxoplasmosis, Syphilis, CMV, Hep B, HIV, HSV

Question 34

If a pregnant mom is changing cat litter, what is she putting herself and the baby at risk for?

Answer 34

toxoplasmosis

Question 35

Where can toxoplasmosis be found?

Answer 35

in cat litter and in soil

Question 36

When does herpes normally present itself on a newborn?

Answer 36

around 10 days of age

Question 37

What diagnoses a baby with sepsis?

Answer 37

hypothermia

Question 38

What swabs are done to diagnose a baby with herpes?

Answer 38

nasal and rectal

Question 39

What is used to treat HSV?

Answer 39

acyclovir

Question 40

How can HIV be transmitted to infants?

Answer 40

transplacentally, during birth, or via breastmilk

Question 41

What decreases the risk of transplacental transfer of HIV for a pregnant mother?

Answer 41

zidovudine

Question 42

When is HIV-DNA polymerase chain reaction testing done for babies that may have HIV?

Answer 42

1-2 months of age

Question 43

How long do maternal antibodies last in the infants blood?

Answer 43

up until 15 months of age

Question 44

HIV infant care for a newborn

Answer 44

Administer zuvodine assess for infection, weight gain, failure to thrive, GI problems Use standard precautions and provide standard newborn care

Question 45

Signs and symptoms of neonatal infections

Answer 45

hypothermia apnea/bradycardia, retractions, cyanosis, lethargy, poor feed, immature to neutrophil ratio

Question 46

Which labs are ordered if a baby is suspected of being septic?

Answer 46

CBC with differential, blood cultures/urine/CSF, C-reactive proteins

Question 47

What is a diagnostic tool used for neonatal infections?

Answer 47

positive blood culture

Question 48

What is the medical management for neonatal infections?

Answer 48

antibiotics, IV fluids, monitor glucose/electrolytes, ventilation management/oxygenation

Question 49

What is the minimum and maximum amount of time to administer antibiotics?

Answer 49

minimum: 48 hours and maximum: 21 days Normally given 10-14 days

Question 50

What needs to be gotten before antibiotics can be started?

Answer 50

blood culture

Question 51

Symptoms of neonatal abstinence syndrome

Answer 51

irritable, tremors, increased muscle tone, loose stools

Question 52

What are non-pharmacologic treatments for an infant suffering from neonatal abstinence syndrome?

Answer 52

swaddle, feed, aromatherapy, music therapy, and massage

Question 53

What is the pharmacologic treatment for infants suffering from neonatal abstinence syndrome?

Answer 53

narcotics

Question 54

How do you identify if a neonate has a been exposed to subtances?

Answer 54

cord blood, meconium, urine (1st, according to textbook), and hair