High Risk Newborn Pt. 2 Flashcards
How long does it take for transient tachypnea of the newborn to resolve?
1-3 days
How is TTN diagnosed?
X-ray
Why is it important to treat TTN?
it may cause atelectasis
How is TTN treated?
Oxygen supplementation and NG tube feedings
What are s/s of TTN?
retractions, nasal flaring, grunting, mild cyanosis
When does meconium aspiration happen?
in utero
What can happen if meconium aspiration occurs?
complete atelectasis can occur
How can meconium be diagnosed?
chest x-ray that shows hyperexpansion and atelectasis
How is meconium aspiration treated?
intubate and suction immediately, mechanical ventilation/high frequency vent/ECMO, and antibiotics
S/S of meconium aspiration
Tachypnea, cyanosis, grunting, rales, retractions, barrel shaped chest, greenish staining to nails and skin
What does meconium aspiration syndrome casue?
chemical pneumonitis
What is the most effective way to get the meconium out of a baby’s lungs?
A meconium aspirator
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?
intubation
Why are babies with meconium aspiration given antibiotics?
to treat chemical pneumonitis
What may a newborn look like if meconium has been leaking with the amniotic fluid for a while?
greenish stain on skin and nails
3 things to look at if meconium aspiration is suspected?
HR, tone, respiratory effort
What is the number 1 diagnosis for ECMO for a newborn?
meconium aspiration syndrome
What are the two types of jaundice?
physiologic vs pathologic
How is hyperbilirubinemia treated?
it is determined by bilirubin result and age of baby in hours as well as risk factors
What can happen if a baby’s bilirubin gets too high?
kernicterus
What is the main treatment for hyperbilirubinemia?
hydration/phototherapy
Which baby’s are at risk for pathological jaundice?
Rh negative or type O moms that have a baby that is Rh positive or type A/B/AB
What might babies present with pathological jaundice?
hemolytic disease of the newborn, Sepsis, Cold stress, or a blocked bile duct
What might babies present with physiologic jaundice?
increased RBCs, liver immaturity, delayed feeding, and bruising
What is the treatment for an infant with RH disease?
treat anemia, remove sensitized RBC’s that would be destroyed, remove serum bilirubin, and provide bilirubin free albumin
Why is feeding so important to decrease bilirubin levels in newborns?
feedings should make the baby poop, and bilirubin is excreted in the poop
Can babies under phototherapy have lotion on them?
no
What is the nursing care for a baby with hyperbilirubinemia?
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
What is the main bacterial neonatal infection that occurs?
GBS
What are the main viral infections that neonates can transmit?
TORCH, Varicella-Zoster, ZIKA
What is the main fungal neonatal infection?
candidiasis
what is vertical trasmission?
something that is transmitted at birth
What is a TORCH titer?
Toxoplasmosis, Syphilis, CMV, Hep B, HIV, HSV
If a pregnant mom is changing cat litter, what is she putting herself and the baby at risk for?
toxoplasmosis
Where can toxoplasmosis be found?
in cat litter and in soil
When does herpes normally present itself on a newborn?
around 10 days of age
What diagnoses a baby with sepsis?
hypothermia
What swabs are done to diagnose a baby with herpes?
nasal and rectal
What is used to treat HSV?
acyclovir
How can HIV be transmitted to infants?
transplacentally, during birth, or via breastmilk
What decreases the risk of transplacental transfer of HIV for a pregnant mother?
zidovudine
When is HIV-DNA polymerase chain reaction testing done for babies that may have HIV?
1-2 months of age
How long do maternal antibodies last in the infants blood?
up until 15 months of age
HIV infant care for a newborn
Administer zuvodine
assess for infection, weight gain, failure to thrive, GI problems
Use standard precautions and provide standard newborn care
Signs and symptoms of neonatal infections
hypothermia
apnea/bradycardia, retractions, cyanosis, lethargy, poor feed, immature to neutrophil ratio
Which labs are ordered if a baby is suspected of being septic?
CBC with differential, blood cultures/urine/CSF, C-reactive proteins
What is a diagnostic tool used for neonatal infections?
positive blood culture
What is the medical management for neonatal infections?
antibiotics, IV fluids, monitor glucose/electrolytes, ventilation management/oxygenation
What is the minimum and maximum amount of time to administer antibiotics?
minimum: 48 hours and maximum: 21 days
Normally given 10-14 days
What needs to be gotten before antibiotics can be started?
blood culture
Symptoms of neonatal abstinence syndrome
irritable, tremors, increased muscle tone, loose stools
What are non-pharmacologic treatments for an infant suffering from neonatal abstinence syndrome?
swaddle, feed, aromatherapy, music therapy, and massage
What is the pharmacologic treatment for infants suffering from neonatal abstinence syndrome?
narcotics
How do you identify if a neonate has a been exposed to subtances?
cord blood, meconium, urine (1st, according to textbook), and hair
