High Risk Newborn (Week 8) Flashcards
high risk infants are classified on
BW
gestational age
predominant pathophysiologic problems
SGA %
10
AGA %
10-90 %
LGA %
90%
why might we place a baby in a bag
thermoregulation
majority of high risk infants are how old
- why
<37 weeks
organ systems are still immature
- thermo and respiratory
low BW
below 2,500
very low BW
below 1500
extremely low BW
below 1000
signs of resp distress
grunting, flaring, retracting
apnea vs periodic breathing
apea is more than 20 seconds and/or desat and/or bradycardia
MEN
- minimal enteral nutrition
few mL to prime gut to stool to prevent increase bili
if a infant gets an infection what happens to the temp
goes down
discharge criteria
cry when hungry
gain wt
normal neuro resp
corrected age
age of preterm infant is corrected by adding gestational age and postnatal age
corrected until 2 1/2
why give betamethasone prior to birth
mature lungs
if we are bag and valve mask what do we use
room air since its not an oxygenation thing
how long does it take for a baby to get to normal sat
awhile, like 10-20 min
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
nonnutritive suck
pacifier when feeding through NG/OG
is vernix good
yes benefits
- doesn’t dry out skin
s/s of infant who is overstimulated
push hand away
hiccups
avert gaze
finger spray
apnea
Brady
desat
who’s at risk for RDS
c/s with out labor
2nd twin since they aren’t squeezed as much
gestational diabetes
Caucasian males
ROP
preterm
O2 and ventilation causes retinal damage
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
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
