High Risk Newborn (Week 8) Flashcards by Lani Manners

high risk infants are classified on

BW
gestational age
predominant pathophysiologic problems

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SGA %

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AGA %

10-90 %

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LGA %

90%

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why might we place a baby in a bag

thermoregulation

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majority of high risk infants are how old
- why

<37 weeks
organ systems are still immature
- thermo and respiratory

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low BW

below 2,500

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very low BW

below 1500

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extremely low BW

below 1000

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signs of resp distress

grunting, flaring, retracting

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apnea vs periodic breathing

apea is more than 20 seconds and/or desat and/or bradycardia

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MEN
- minimal enteral nutrition

few mL to prime gut to stool to prevent increase bili

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if a infant gets an infection what happens to the temp

goes down

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discharge criteria

cry when hungry
gain wt
normal neuro resp

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corrected age

age of preterm infant is corrected by adding gestational age and postnatal age

corrected until 2 1/2

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why give betamethasone prior to birth

mature lungs

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if we are bag and valve mask what do we use

room air since its not an oxygenation thing

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how long does it take for a baby to get to normal sat

awhile, like 10-20 min

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why does asphixa influence the belly/GI

asphyxia is when the blood is shunted to the brain and heart and the GI is not perfused and they dont tolerate feedinfs

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nonnutritive suck

pacifier when feeding through NG/OG

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is vernix good

yes benefits
- doesn’t dry out skin

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s/s of infant who is overstimulated

push hand away
hiccups
avert gaze
finger spray
apnea
Brady
desat

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who’s at risk for RDS

c/s with out labor
2nd twin since they aren’t squeezed as much
gestational diabetes
Caucasian males

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ROP

preterm
O2 and ventilation causes retinal damage

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BPD

preterm ventilation surfactant issue

Patent ductus arteriosus

mottling cyanosis stress can reopen

Germinial matrix hemoorgafe

intrventituclar hemmorrge

Germinial matrix hemoorgafe s/s

full fontanel hypotone activity label change

NEC

infalmatiory disease of the GI mucosa - intestinal ischemia bacterial colonization

NEC is rare in

breast fed babies

late preterm risks

RDS = not all surfactant thermoreg = decrease brown fat coldstress nutritional = no suck swallow breathe hypoglycemia = due to low temp

what is the most frequent reason of readmission

hyperbili

post term risks

Mecomonia aspiration placental insuff = fetal distress

growth restricted infants are at risk for

perinatal asphyxia hypoglycemia heat loss

LGA risks

injury should rsytocia cardiac defects

when does discharge begin

on admission

which one crosses

caput

what is the bone that is most often fractured in birth

clavicle

damages of the nervous system

brachial plus facial paralysis

why are infants susceptible to infection

immature immune system

what might sepsis be caused by in an infant

GBS

what is he time frame for an acquired infection of a newborn

7-30 days

med of choice for GBS

penicillin

how many doses do we want to penicillin

at least 2 q4 but can have up to 3

herpes 1st outbreak during 3rd tri

increase risk of baby

s/s of sepsis in baby

lethargic poor feeding temp instability

tobacco

LBW

acohol

FAS

learning dis behavioral problems speech langue issues hyperactivity lip to nose Is larger thin lip upper lip bump eyes are wider broad nasal bridge upturned nose

NAS

clinical signs of withdrawal from opioids - ex: sneezing, stuffy nose, loose stool

breast feeding for ANS

can be good! if relapse not good

cocaine

placental abruption IUGR

NAS score greater than 12

get morphine

new way to manage NAS

eat sleep console mom learns about baby and allows them to go home earlier

SSRI what med is good

Zoloft

can we narcan NAS babies

no it can lead to seizure

NAS enviornment

low stim

Rh imcompat

mother forms antibodies that then destroy fetal red blood cells

how to treat Rh imcompat

rofolac 28weeks 72 hours after deliver

most common hemolytic issue

ABO incomp

ABO incom

fetal blod type is A, B, AB and mom is O

major congenital anomalies that cause serious problems in neonates are

congenital heat disease neural tube cleft L/P club foot developmental dysplasia

CHD

95% or above less than 2% change right hand and either feet

neural tube defect nursing interventions

cover with sterile moist nonadehering dressing

choanal atresia

congenital blockage of the posterior nares by a bony or soft tissue obstruction

choanal atresia s/s

pink color when crying and screming calm blue and dusky

congenital diagrammatic hernia

abdomina organs are displaced into the thoracic cavity

congenital diagrammatic hernia s/s

bowel sounds in chest

cleft L/P

haberman nipple - long nipple

esophageal stress

esophagus isn't connected or might be contected to trachea cannot swallow

omphalocele

abdominal content in cord genetic chromosomal

gastrocehsis

intenstines born outside

hydrosapdias

ventral

bladder extrophy

bladder outside body

ambiguois gentialia

underdeveloped penis or over developed clitoris - cannot fully tell