Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OB > High risk newborn (unit 3) > Flashcards

High risk newborn (unit 3) Flashcards

1
Q

caput succedaneum

A
  • soft tissue injury sustained during birth
  • FLUID edema of scalp
  • benign
  • DOES cross suture line
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

cephalhematoma

A
  • soft tissue injury sustained during birth
  • collection of BLOOD b/t skull bone and periosteum
  • does NOT cross suture line
  • usually after vert delivery
  • benign
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

subconjunctival & retinal hemorrhages

A
  • soft tissue injury sustained during birth
  • d/t increased ICP
  • benign
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

lacerations during birth

A
  • soft tissue injury sustained during birth
  • scalpel from C/S
  • episiotomy on scalp, butt, thigh
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

skeletal injuries during birth

A
  • skull (linear/depressed)
  • clavicle- most common
  • humerus/femur
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Erb-Duchenne

A

•paralysis of upper portion of arm d/t upper plexus injury during birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Klumphke

A

•paralysis of lower portion of arm d/t lower plexus injury during birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

phrenic nerve injury during birth

A
  • diaphragmatic paralysis
  • cyanosis, irregular thoracic movements
  • vent support for 1st few days
  • may spontaneously resolve or need surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

subarachnoid hemorrhage during birth

A
  • most common intracranial hemorrhage
  • causes seizures
  • vent support, IV, monitor ICP, minimal stim
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

infants of diabetic mothers r/o

A
  • congenital anomalies
  • IUGR
  • heart anomalies (cardiomyopathy)
  • respiratory distress
  • hypoglycemia
  • hypocalcemia
  • hypomagnesemia
  • polycythemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

hypoglycemia onset

A 
•BS < 40 mg/dl (term)
•BS < 25 (preterm)
•jittery
•RDS
•apnea
•lethargy
•poor suck
•seizures
*w/in 1-3 hrs after birth
-d/t inc. insulin production in utero
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

hypertrophic cardiomyopathy (HCM)

A
  • hypercontractile

* thickened myocardium (-> LHF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

nonhypertrophic cardiomyopathy (non-HCM)

A
  • poorly contractile
  • over stretched
  • tx w/ digoxin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

polycythemia

A
  • Hct > 65%
  • inc. blood viscocity
  • impaired circulation/oxygenation
  • inc. RBC to be hemolized
  • additional birth trauma if macrosomia (inc. cephalhematoma/bruising)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

neonatal sepsis

A
  • microorganisms/toxins (bacteria, virual, fungi) in blood/tissues
  • perinatal- HSV, CMV
  • during birth- GBS
  • postnatally
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

bacterial neonatal infection

A 
•early onset
-congenital
-rapid progression (24-72 hr)
-hypothermia common
•late onset
-acquired
-slow progression (1-2 wk)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

neonatal group beta strep bacterial infection

A
  • most common
  • early onset indicates vertical transmission
  • RDS, pneumonia, sepsis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

neonatal e. coli bacterial infection

A

•amp resistant strain contracted during labor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

neonatal listeriosis bacterial infection

A
  • detected in meconium in amniotic fld < 37 wks
  • granulomas, liver dz, meningitis (late onset)
  • mom may not have s/sx, but newborn will
  • found in dirt, water, unpaturized, uncooked, and ready-made
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

neonatal clamydia bacterial infection

A
  • opthalmia neonatorum
  • conjunctivitis
  • reason for erythromycin in eyes at birth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

neonatal fungal infections

A
  • candidiasis (thrush)

* mouth/diaper most common site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

heroin/methadone neonatal effects

A
  • IUGR
  • LBW
  • SGA
  • w/d
  • risk of SIDS 5-10x higher
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

marijuana neonatal effects

A
  • lowered response to light sim
  • tremors
  • high pitched cry
  • small head
  • hyperactive
  • impulsive
  • delinquency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

cocaine neonatal effects

A
  • pre-term
  • LBW
  • short
  • small head
  • piercing cry
  • low Apgar
  • irritable/hypersensitive
  • poor feeding/sleeping
  • high HR/RR
  • tremors/startling
  • dec. verbal reasoning/attention
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

methamphetamine neonatal effects

A
  • poor growth
  • LBW
  • small head
  • PTB
  • placental problems
  • w/d s/sx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

tobacco neonatal effects

A
  • UPI (vasoconstriction)
  • SAb
  • placental separation
  • LBW
  • PTL
  • intellectual disabilities (ADHD)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

fetal alcohol syndrome (FAS)

A
  • poor habituation
  • irritability/jittery
  • feeding/sleep difficulties
  • poor muscle tone
  • sensitive to light/sound
  • excessive crying
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

physiologic jaundice

A
  • hyperbilirubinemia
  • appears after 1st 24 hrs
  • benign- not normal, but common
  • s/sx 2nd-3rd day of life
  • usually resolves by day 4
  • bili < 12 (unless PT or BF)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

pathologic jaundice

A
  • hyperbilirubinemia
  • appear w/in 1st 24 hrs
  • r/t abnormalities that cause excessive RBC destruction (ABO/Rh incompatibility)
  • bili levels higher and remain high
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Kernicterus

A
  • hyperbili (>25)
  • long term neurological damage
  • ½ infants survive
  • never present at birth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

choreoathetoid cerebral palsy

A
  • extrapyramidal movement disorder resulting from kernicterus
  • s/sx: jerking, tick twitch, slow writing
  • tx: phototherapy; exchange transfusion
32
Q

encephalocele

A
  • rare neural tube defect characterized by sac-like protrusions of brain and meninges
  • caused by failure of neural tube to close completely
  • developmental delay, vision problems, mental/growth retardation
33
Q

choanal atresia

A

•septum b/t nose and pharynx

34
Q

omphalocele

A
  • intestine or other abdominal organs stick out of the navel and are covered only by a thin layer of tissue and can be easily seen
  • type of hernia.
35
Q

gastroschisis

A

•birth defect in which an infant’s intestines stick out of the body through a defect on one side of the umbilical cord

36
Q

imperforate anus

A

•opening to the anus is missing or blocked

37
Q

teratoma

A
  • embryonal tumor
  • may be solid, cystic, or mixed
  • 80% benign
  • if not resected before 1-2 months more likely to become malignant
38
Q

preterm infant appearance

A
  • disproportionately large head
  • dec. muscle tome
  • little fat
  • skin thin w/ visible blood vessels (-> fld loss/dec. thermo)
  • abundant lanugo/vernix
  • absent plantar creases if < 32 wks
39
Q

respiratory issues of preterm

A
  • surfactant deficiency
  • periodic resp./apnea
  • RD (tachy, retractions, flaring, grunting)
  • cyanosis
40
Q

nutritional issues of preterm

A
  • miss all/part of 3rd trimester transfer of nutrients, glycogen, Fe
  • fat stores minimal
  • glucose reserved used quickly
  • smaller stomach capacity
  • GI immaturity
41
Q

preterm nutritional needs

A
  • 150 kcal/kg/day
  • more protein, Fe, Ca, P
  • can’t suck-swallow-breathe until 34 wks and 1500g
42
Q

signs of readiness to PO feed

A 
•rooting
•sucking
•+ gag
•RR < 60
•tolerate being held
*start PO feed slow
43
Q

assessing tolerance of enteral feeds

A
  • residuals
  • vomiting
  • abd distention
  • stools
  • suck-swallow-breathe coordination
  • fatigue
  • VS
44
Q

preterm renal issues

A
  • insensible fld. loss (warmer, RR rate)
  • kidney can’t concentrate, dilute, or conserve electrolytes
  • more immature -> need more fld.
45
Q

preterm expected UOP

A
  • 1-3 mL/kg/her

* 1 g= 1cc (diaper)

46
Q

assessing preterm renal fxn

A
  • UPO
  • urine specific (1.005-1.015)
  • weight
  • turgor/edema
  • anterior fontanelle
  • Na, hct, BUN
47
Q

preterm hematologic issues

A
  • inc. cap friability
  • inc. clotting time (bleed)
  • dec. erythropoiesis
  • dec. blood vol.
  • dec. RBC life
48
Q

transient tachypnea of newborn (TTN)

A

•delay in abs. of fetal lung fld
•risk if C/S, maternal GDM, smoker, SGA
•s/sx: RR > 60; grunt; flare; retraction; circumoral cyanosis
*resolves 24-72 hr

49
Q

meconium aspiration syndrome (MAS)

A
  • caused by vagal stimulation or hypoxia, resulting in meconium passage before birth
  • can lead to pneumonia, obstruction of airway, and air trapping
  • s/sx: RD, cyanosis, coarse sounds, barrel chest
  • tx: O2 vent
50
Q

hyaline membrane disease (HMD)/respiratory distress syndrome (RDS)

A 
•most common cause is IDM
•inc. incidence/severity w/ dec. GA
•surfactant deficiency causes atelectasis
•onset w/in 1st hour of life
-Nasal flaring
-Cyanosis
-↓ breath sounds 
-grunting
-Opaque “ground glass” X-ray
51
Q

HMD/RDS tx

A 
•surfactant
•O2 
-hood or NC
-CPAP
-mechanical/high freq vent
-ECMO
52
Q

when to use hood O2 therapy

A

•if baby can breathe on its own

53
Q

went use CPAP O2 therapy

A

•can breathe on own, but have apnea > 15 sec
•forces breath
*nose breathers

54
Q

when to use mechanical ventilator O2 therapy

A
  • baby can’t breathe on own

* placed in trachea and set at specific breath/min

55
Q

when to use high freq. ventilator

A
  • extremely preterm
  • frequent, small puff of air
  • no pressure to lungs (passive diffusion of O2)
  • vibrating chest movement
56
Q

extracorporeal membrane oxygenation therapy (ECMO)

A

•artificial heart/lung machine that oxygenates blood and returns it to the heart
•allows lungs to rest
*only available @ level II hospitals

57
Q

bronchopulmonary dysplasia

A
  • O2 still required 28 days after birth or 36 wks post-conceptual age
  • scarring of lungs, decreasing elasticity and causing chronic lung dz
58
Q

persistent pulmonary hypertension of newborn

A
  • increased pulmonary vascular resistance causes RHF
  • caused by intrauterine hypoxia and birth asphyxia
  • can also be caused by ASA or NSAIDs in 3rd trimester
59
Q

persistent pulmonary hypertension of newborn s/sx and tx

A
  • onset w/in 24 hrs
  • RDS (w/o retrations)
  • cyanosis
  • tachypnea that worsens with handling
  • O2, NO vent.
60
Q

periventricular-intraventricular hemorrhage

A
  • s/sx: lethargy, hypotonia, resp distress, ↓hct, full or bulging fontanels, seizure
  • tx: shunts
  • long term issues: neurologic abnormalities, developmental delay, cerebral palsy, hydrocephalus
61
Q

retinopathy of prematurity

A
  • blood vessels form where they shouldn’t, leading to retinal detachment, glaucoma, blindness
  • tx w/ laser surgery or cryotherapy
62
Q

patent ductus arteriosus (PDA)

A
  • closing failure of ductus arteriosus b/t L pulm artery and descending aorta
  • s/sx: cyanosis, murmur, bounding peripheral pulse, tachy, crackles, CHF
  • tx: PDA ligation; time
63
Q

necrotizing enterocolitis (NEC)

A 
•accumulation of gas in the submucosal layers of the bowel wall→necrosis & bowel perforation & sepsis
•S/S: Onset approx 2 weeks after birth
-Abdominal distension
-Blood in stool
-Retention of feeds 
•Treatment
-antibiotics
-NPO with parenteral nutrition
-gastric decompression and serial -X-rays
-Surgery
64
Q

postmature maturity syndrome

A
  • aging placenta causes dec. O2 and malnutrition
  • s/sx: ↓fetal growth; meconium staining; polycythemia; little subQ fat; little lanugo or vernix; abundant hair; long nails; dry, cracked, peeling skin
65
Q

small for gestational age (SGA)

A

•BW < 10% (5.5# lb for term)

66
Q

asymmetric growth restriction

A
  • head and length unaffected, but weight is (disproportional)
  • recover w/ adequate postnatal nourishment
  • d/t MID PG complications
67
Q

symmetric growth restriction

A
  • weight, length, and head circumference affected
  • may have long-term growth issues
  • d/t EARLY PG complications
68
Q

large for gestational age (LGA)

A
  • BW > 90%
  • risk for: longer labor, birth injury, shoulder dystocia, clavicle fracture, brachial plexus injury, facial nerve palsy, bruising, hypoglycemia, polycythemia, C/S
69
Q

infants response to pain

A
  • increase in levels of stress hormones (cortisol, catecholamines)
  • affects growth, won healing, complications, length of stay
70
Q

infant pain assessment

A 
•HR
-inc. in normal
-dec. in compromised
•BP
•RR
•Skin- pallor, redness, cyanosis
•palmar sweating
•dilated pupils
•hyperglycemia
71
Q

NIPS

A
  • neonatal infant pain scale
  • facial expression
  • crying
  • arm movement
  • leg movement
  • state arousal
72
Q

CRIES

A 
*neonatal pain scale
•crying 
•requires
•oxygen to maintain O2 stat >95%
•increased VS
•Expression
•sleepless
73
Q

FLACC

A

•UAMS pain scale
•5 criteria worth 2 puts each
*0 is pain free

74
Q

infant nonpharmacologic pain management

A
  • dec. stim
  • position like in uterus
  • swaddle/frogs
  • non-nutritive suctin
  • Sweet-ease
  • rocking
  • kangaroo care
75
Q

infant pharmacologic pain management

A
  • acetaminophen
  • morphine, fentanyl (narcan ready)
  • sedatives (chloral hydrate, midazolam)

OB (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions