mgmt of special need newborn

Question 1

SGA contributing factors

Answer 1

-maternal nutrition
-htn
-smoking
-pre-e
-infections
-chromosomal abnormalities
-congenital malformations

Question 2

SGA assessment

Answer 2

-<2500 grams (5lb, 8oz)
-head larger than body
-wasted, sunken appearance
-decreased subq fat stores
-loose, dry skin
-scaphoid abdomen
-thin umbilical cord
-jittery
-poor muscle tone
-unstable temp regulation

Question 3

SGA mgmt

Answer 3

-observe s/s, obtain labs
-glucose checks
-frequent oral feedings
-neutral thermal environment

Question 4

SGA at risks for

Answer 4

-hypoglycemia
-temp. instability
-asphyxia
-polycythemia

Question 5

LGA risk factors

Answer 5

-maternal diabetes
-multiparity
-prev. macro baby
-postterm gestation
-maternal obesity
-paternal height
-gestational weight gain
-male
-genetics

Question 6

LGA assessment

Answer 6

-large plump body, weight >4000g (8lb 3oz)
-proportionate increase in body size
-poor motor skills
-difficulty regulating sleep wake cycle

Question 7

LGA mgmt

Answer 7

-assess for birth trauma, neuro exam
-monitor vitals, dextrose levels
-initiate oral feedings, iv supplementation if needed
-monitor s/s of polycytemia & hypoglycemia
-promote hydration

Question 8

LGA at risks for

Answer 8

-birth trauma: cervical fracture, hematoma, skull fracture
-c/s birth
-hypoglycemia
-polycythemia
-asphyxia

Question 9

polycythemia

Answer 9

-hct >65% between 6-12 hrs
-s/s: resp. distress, cyanosis, feeding diff., hypoglycemia, jitteriness, jaundice, ruddy skin, seizures, lethargy
-increase fluid volume (iv or oral)
-monitor hct levels

Question 9

polycythemia

Answer 9

-hct >65% between 6-12 hrs
-s/s: resp. distress, cyanosis, feeding diff., hypoglycemia, jitteriness, jaundice, ruddy skin, seizures, lethargy
-increase fluid volume (iv or oral)
-monitor hct levels