MAS, Neonatal Septis, TORCH Flashcards
1
Q
A condition in which there is obstruction, chemical pneumonitis and air trapping caused by meconium in the lungs
A
MECONIUM ASPIRATION SYNDROME (MAS)
2
Q
MECONIUM ASPIRATION SYNDROME (MAS) occurs often in
A
post-term infants, small for gestational age (SGA) and those compromised with placental insufficiency (decreased amniotic fluid and cord compression)
3
Q
Meconium staining occurs approximately ____________ of all births, and _____________ of these births, newborns will aspirate enough meconium to cause MAS
A
10% to 20%; 2% to 4%
4
Q
Obstruction of airways may be
A
complete or partial
5
Q
COMPLETE obstruction causes
A
ATELECTASIS
6
Q
allows entry of air but prevents its escape from the alveoli
A
PARTIAL obstruction
7
Q
bronchioles expand slightly as air flows
A
Inhalation
8
Q
passages constrict and meconium blocks movement of air out of the lungs
A
Exhalation
9
Q
MECONIUM ASPIRATION SYNDROME SIGNS AND SYMPTOMS
A
- Radiology shows patchy infiltrates, atelectasis, consolidation and hyper expansion from air trapping
- Yellow-green stain on infant’s nails, skin, umbilical cord
10
Q
Minimal meconium in amniotic fluid means
A
respiratory problems usually don’t develop
11
Q
More meconium means:
A
- mild to severe respiratory distress with tachypnea
- cyanosis
- retractions
- nasal flaring
- grunting
- rales
- barrel-shaped chest
12
Q
After delivery of the infant’s head but before shoulders:
A
suction oropharynx
13
Q
If THICK meconium, after delivery of the infant’s body
CRYING:
A
- stimulate
- Suction with bulb syringe
14
Q
If THICK meconium, after delivery of the infant’s body
NOT CRYING:
A
- Do NOT stimulate
- Visualize the vocal cords and provide direct suction with endotracheal tube THEN stimulate
15
Q
If THIN meconium,
A
no visualization performed
16
Q
MECONIUM ASPIRATION SYNDROME THERAPEUTIC MANAGEMENT
A
- Suctioning via endotracheal tube to remove meconium
- Regulate temperature
- Maintain adequate oxygenation and ventilation
- Surfactant lavage
17
Q
Severe MAS Therapeutic Management
A
Extracorporeal membrane oxygenation (ECMO)
18
Q
It is the oxygenation of the blood while bypassing the lungs (similar to heart-lung machine)
A
Extracorporeal membrane oxygenation (ECMO)
19
Q
MECONIUM ASPIRATION SYNDROME NURSING MANAGEMENT
A
- Notify physician immediately once meconium is noted in the amniotic fluid
- Ensure equipment such as oxygen and suction function properly and assist with care at delivery
- Closely observe infant for signs of infection
- Thermoregulation and decrease stimulation
20
Q
is a bloodstream infection in infants under 90 days old
A
Neonatal sepsis
21
Q
acquired BEFORE or during birth from the mother
A
VERTICAL infection
22
Q
Neonatal sepsis can be caused by
A
bacteria, viruses, or fungi
23
Q
infections that may pass through the placenta
A
Rubella, Cytomegalovirus, Syphilis, HIV and Toxoplasmosis
24
Q
VERTICAL infection can occur in several ways:
A
- Transplacental transfer
- Ascending infection
- Intrapartal exposure
25
acquired AFTER birth from the hospital staff or contaminated equipment or from family members/visitors
HORIZONTAL infection
26
HORIZONTAL infections may be caused by
bacteria, viruses, fungus, yeast, spirochetes and protozoa
27
Refers to generalized bacterial infection in the blood stream
Systemic Infection (Sepsis)
28
SYSTEMIC INFECTION ONSET OF SEPSIS
Early onset
- Occurs WITHIN the first 7 days of life
- Vertical transmission
29
SYSTEMIC INFECTION ONSET OF SEPSIS
Late onset
Occurs AFTER 7 days of life
30
SYSTEMIC INFECTION ONSET OF SEPSIS
Very late
- Affects premature, VLBW infants after 3 months of age
- Long-term use of equipment
31
SYSTEMIC INFECTION (SEPSIS) CLINICAL MANIFESTATIONS
General signs:
- Infant generally “not doing well”
- Poor temperature control
32
SYSTEMIC INFECTION (SEPSIS) CLINICAL MANIFESTATIONS
Circulatory system
Pallor
Cyanosis or mottling
Cold clammy skin
Hypotension
Edema
Irregular heartbeat
33
SYSTEMIC INFECTION (SEPSIS) CLINICAL MANIFESTATIONS
Respiratory system
Irregular repiration
Cyanosis
Grunting
Dyspnea
Retractions
34
SYSTEMIC INFECTION (SEPSIS) CLINICAL MANIFESTATIONS
Gastrointestinal system
Poor feeding
Vomiting
Diarrhea or decreased stooling
Abdominal distention
Hepatomegaly
(+) occult blood
35
SYSTEMIC INFECTION (SEPSIS) CLINICAL MANIFESTATIONS
Hematopoietic system
Jaundice
Pallor
Petechiae
Ecchymosis
Splenomegaly
36
SYSTEMIC INFECTION (SEPSIS) CLINICAL MANIFESTATIONS
Central Nervous System
- Diminished activity: lethargy, hyporeflexia, coma
- Increased activity: irritability, tremors, seizures
- Full fontanel
- Increased or decreased tone
- Abnormal eye movements
37
SYSTEMIC INFECTION (SEPSIS) THERAPEUTIC MANAGEMENT
Monitor for clinical signs of infection
Diagnostic Testing:
- CBC with differential to evaluate WBC
- Microbial cultures of blood, urine and CSF for definitive
diagnosis
- C-reactive protein (CRP) to detect inflammation associated
infection
- Polymerase Chain Reaction (PCR) testing for bacterial or viral DNA for identification of specific bacterial or viral gene segment
- Antibiotic therapy
- Administer intravenous fluid and parenteral nutrition
- Monitor glucose and electrolytes
- Ventilatory support as indicated
- Prevent Infection
- Provide Antibiotics
- Provide supportive care
- Watch out for (WOF): signs of complications
- Supporting parents
38
to detect inflammation associated infection
C-reactive protein (CRP)
39
testing for bacterial or viral DNA for identification of specific bacterial or viral gene segment
Polymerase Chain Reaction (PCR)
40
is a group of infections that can be passed from a mother to her fetus.
TORCH complex
41
TORCH meaning
- Toxoplasmosis
- Others
Syphilis
Hepatitis B
- Rubella
- Cytomegalovirus
- Herpes Simplex II
- HIV
42
It is a PROTOZOAN infection among pregnant woman through contact with raw or under cooked meals and handling cat feces in soil or cat litter.
TOXOPLASMOSIS
43
Toxoplasmosis is cuased by
Toxoplasma gondii
44
Effects of Toxoplasmosis on the FETUS
blindness, deafness, convulsions, microcephaly, hydrocephaly, severe mental impairment
45
Prevent of infection for Toxoplasmosis
- instruct pregnant patients to avoid uncooked meat
- pregnant should avoid changing the cat litter or garden soil with cat feces
- reinforce proper handwashing after handling uncooked meat
46
is a sexually transmitted infection (STI)
SYPHILIS
47
is a syphilis that occurs when a mother with untreated syphilis passes the infection to her baby during pregnancy or at birth
Congenital syphilis
48
Congenital syphilis is caused by
Treponema pallidum bacteria
49
Sign and symptoms of Syphilis in newborn
rhinitis, excoriated upper lip, red rash around mouth and anus, copper colored rash of face, palms and soles; irritability, edema, cataract
50
Treatment for Syphilis
- Culture orifices
- Isolation
- Penicillin
51
is an infection of the liver caused by hepatitis B virus
Hepatitis B
52
Transmission of Hepatitis B
Placental, Birth, Breast milk
53
Sign and symptoms of Hepatitis B in newborn:
Often asymptomatic at birth, but may include jaundice (yellowing of skin and eyes), lethargy, poor feeding, abdominal distention, and clay-colored stools in severe cases.
54
Treatment of Hepatitis B
- Hepatisis B vaccine
- Hepatitis B immunoglobulin (HBIg)
55
If the mother is known to have active hepatitis B, the baby should also receive ______ shortly after birth
HBIg
56
during pregnancy, can cause miscarriage, stillbirth, or birth defects.
Rubella (German measles)
57
Rubella (German measles), during pregnancy, can cause
miscarriage, stillbirth, or birth defects.
58
Rubella is especially dangerous during the _________________ of pregnancy
first trimester
59
It is a highly contagious disease that can be transmitted to a fetus during pregnancy.
Rubella (German measles)
60
Sign and symptoms of Rubella in newborn:
- Congenital cataracts
- Deafness
- Congenital heart defects
- Can be fatal
61
Prevention for Rubella
MMR Immunization - given when NOT pregnant
62
is a virus that can infect newborns and cause serious health problems.
Cytomegalovirus (CMV)
63
Cytomegalovirus (CMV) is a virus that can infect newborns and cause
serious health problems.
64
Transmission of Cytomegalovirus (CMV)
Crosses placental barrier, Direct contact at birth, breast milk
65
S/S of Cytomegalovirus in newborn
Severe neurological problems, Eye abnormalities, hearing loss, Microcephaly, Hydrocephaly, cerebral palsy, Mental delays
66
CYTOMEGALOVIRUS
Treatment
- Treatment depends on the baby's age, symptoms, and overall health
- Some babies may be treated with antiviral medicine
- Healthcare providers usually don't treat newborns without symptoms
67
Prevention of Cytomegalovirus
Washing hands with soap and water can help prevent the spread of CMV
68
can cause serious birth defects and other health problems for pregnant women and their babies.
Herpes simplex virus type 2 (HSV-2)
69
HSV-2 is a sexually transmitted disease (STD) that causes
genital herpes
70
Transmission of Herpes
through the placenta, direct contact at birth, perinatally through blood or vaginal secretions
71
S/S of Herpes Newborn
Microcephaly, Mental delays, Seizures, Retinal dysplasia, Apnea, Coma
72
HIV meaning
Transplacentally, Exposure at birth, Breast milk
73
Nursing interventions for HIV
- Protect self from body fluids
- Labs - + antibody titer
- Administer AZT as prescribed
- Provide care like that of any other newborn
74
