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MIH Final review > MIH Chapter 35 > Flashcards

MIH Chapter 35 Flashcards

1
Q

What are acquired problems of the newborn?

A

conditions resulting from environmental rather than genetic factors.

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2
Q

Birth trauma definition

A

physical injury sustained by a neonate during labor and birth

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3
Q

risk factors for birth trauma

A

Maternal age <16 or >35
Primigravida
Uterine dysfunction - not contracting enough or too much
Preterm or postterm labor
Cephalopelvic disproportion
Oligohydramnios
Macrosomia
Multifetal gestation
Abnormal or difficult presentation
Obstetric birth techniques

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4
Q

Types of soft tissue injuries

A

Erythema and ecchymosis
Petechiae
Abrasions and lacerations
Edema
Forceps injury
Accidental lacerations
subconjunctival or retinal hemorrhage
caput succedeneum
cephalhematoma
subgaleal hemorrhage

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5
Q

erythema definition

A

superficial reddening of skin, in patches, results of injury or irritation, inflammation of capillaries and blood vessels

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6
Q

what is petechiae

A

pinpoint round spots. Appear on skin as result of bleeding, appear in clusters and look like rash, not blanchable

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7
Q

What are important considerations for petechiae in newborns ?

A

as long as they go away within 48 hrs and don’t reoccur they are benign
Have to document to ensure it wasn’t an abuse situation, be specific in documentation, important to relay info in report

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8
Q

what can cause petechiae and bruising?

A

fast labors and pushing

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9
Q

what causes abrasions and lacerations

A

forceps, scalpel, vacuum

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10
Q

what is a subconjunctival hemorrhage

A

bright red patch on sclera of eye, should not cause change in vision, no discharge or pain

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11
Q

Describe a retinal hemorrhage

A

may result in partial or Total loss of vision, typically heals itself

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12
Q

what is caput succedaneum

A

swelling of the head, involving serosanguineous, subcutaneous extreperiosteal fluid collection, poorly defined margins, can extend across suture lines, looks like pitting edema

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13
Q

what causes caput succedaneum

A

caused by a tourniquet effect from head being up against cervix

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14
Q

what is a Cephalohematoma

A

a collection of blood in between baby scalp and skull, damaged blood vessels release blood and the blood pools between scalp and skull
Does not cross sutures, distinct margins, initially firm, more fluctuant in 48 hrs, rarely severe, jaundice is likely

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15
Q

what is a subgaleal hemorrhage

A

rare but potentially lethal condition caused by rupture of emissary veins, blood pools outside of the baby’s skull extracranially,

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16
Q

what are potential newborn complications for subgaleal hemorrhage

A

potential to drain significant amount of blood from newborn, puts baby at risk for neonatal encephalopathy, seizures, or death

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17
Q

what is the most common bone fractured during birth?

A

clavicle

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18
Q

types of peripheral nervous system injuries

A

Brachial plexus injury
Upper plexus injury
Erb-Duchenne palsy
Lower plexus injury
Klumpke’s palsy
Phrenic nerve injury
Component of brachial plexus injury
Facial paralysis (palsy)

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19
Q

what is a brachial plexus injury

A

nerves between neck and shoulder are stretched, compressed, or torn during birth

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20
Q

what is an upper plexus injury

A

injury to the upper trunk C5/C6 nerves, occurs from shoulder dystocia

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21
Q

What is Klumpke’s palsy

A

rare type of injury to nerves around shoulder, affects movement of lower arm and hand

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22
Q

what is a phrenic nerve injury

A

primary motor support to diaphragm, won’t be able to breathe appropriately

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23
Q

types of central nervous system injuries

A

Intracranial hemorrahage:
subdural hemorrhage
subarachnoid hemorrhage
spinal cord injuries

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24
Q

what is subdural hemorrhage

A

usually present with apnea, unequal pupils, tense fontanel, ands even coma

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25
Q

what is a subarachnoid hemorrhage

A

Occurs in term infants as a result of trauma and in preterm infants as a result of hypoxia

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26
Q

what is the most common type of brain bleed in newborns

A

subdural

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27
Q

what is hyperinsulinemia

A

Increased amounts of glucose cross the placenta and stimulate the fetal pancreas to release insulin

28
Q

most common anomalies related to diabetic mothers

A

cardiac, renal, musculoskeletal, and CNS

29
Q

does fetus have increased or decreased insulin production

A

increased

30
Q

does insulin or glucose cross the placenta

A

glucose does, insulin does not

31
Q

what occurs more often in infants of diabetic mothers

A

birth trauma and perinatal hypoxia

32
Q

what is a complication related to macrosomia

A

Excessive shoulder size in these infants often leads to dystocia.

33
Q

what causes respiratory distress syndrome in newborns

A

Maternal hyperglycemia can affect fetal lung maturity.

34
Q

what is the reason for late term amniocentesis

A

to check for fetal lung maturity in infants of diabetic mothers

35
Q

What is hypoglycemia in newborns

A

Blood glucose levels less than 40 mg/dl in term infants

36
Q

what are symptoms of hypoglycemia in a newborn

A

jitteriness, apnea, tachypnea, and cyanosis

37
Q

when do hypocalcemia and hypomagnesemia show up in newborns

A

not present until 48-72 hrs after birth

38
Q

what is cardiomyopathy and what types

A

Disease affecting the structure and function of the heart
hypertrophic and nonhypertrophic

39
Q

what is the cause of hyperbilirubinemia in infants

A

Increased number of red blood cells to be hemolyzed increases the potential bilirubin load that the neonate must clear

40
Q

Presence of microorganisms or their toxins in blood or other tissues

A

sepsis

41
Q

why is the infant susceptible to infection

A

because of the immature immune system

42
Q

interventions for sepsis in newborn

A

breastfeeding
med administration (antibiotics)

43
Q

types of infections related to fetus and labor

A

choreoamnionitis , GBS, maternal infection, PROM is the most common cause

44
Q

what should you frequently assess with PROM

A

check temp frequently

45
Q

Signs of infection in newborn

A

tachycardia (even in utero), decreased variability in utero, low Apgar scores, pale, tachypnea

46
Q

ways to prevent infection in newborns

A

handwashing
standard precautions
erythromycin ointment in eyes

47
Q

an acronym that is often used to describe maternal infections during early pregnancy associated with various congenital malformations and disorders

A

torch infections

48
Q

What does torch stand for

A

T - toxoplasmosis
O - other agents
R - rubella
C - CMV
H - herpes

49
Q

types of transplacental infections

A

Toxoplasmosis
Gonorrhea
Syphilis
Varicella-zoster
Hepatitis B virus (HBV)
CMV
enterovirus
parvovirus B19
Hepres simplex
HIV/AIDS

50
Q

syphilis symptoms

A

copper colored, macular rash on palms, around mouth, and anus

51
Q

what education is important with rubella injection

A

do not get pregnant for 4 weeks after injection

52
Q

what infection is a leading cause of neonatal morbidity and mortality in US

A

GBS

53
Q

when is the GBS test performed

A

around 36 wks

54
Q

Type of bacterial infections

A

Group B strep
Escherichia coli
Staphylococcus aureus
Listeriosis
Chlamydia infection

55
Q

type of fungal infections

A

candidiasis (Candida albicans)

56
Q

what is the treatment for candidiasis

A

anti fungal ointment like nystatin or miconazole , applied 3 times a day for 7-10 days

57
Q

How does the use of tobacco during pregnancy affect the fetus

A

Results in deficits in intellectual ability, emotional development, and behavior

58
Q

which substance is the most common cause of cognitive impairment

A

alcohol

59
Q

what are characteristics of an infant with Fetal alcohol syndrome

A

small for gestational age, thin upper lip, microcephaly

60
Q

What are the complications associated with heroin use during pregnancy

A

Many of the medical complications attributed to heroin result from prematurity

61
Q

how is heroin addiction treated

A

Methadone, a synthetic opiate, has been the therapy of choice for heroin addiction since 1965

62
Q

complications related to marijuana use during pregnancy

A

Shortened gestation and a higher incidence of IUGR

63
Q

complication related to cocaine use during pregnancy

A

Recognized cause of placental abruption
Neonates do not experience withdrawal but rather show neurotoxic effects of the drug, increase HR and BP

64
Q

what are complications related to methamphetamines use during pregnancy

A

higher incidence of placental abruption, preterm birth, and intrauterine growth restriction (IUGR)

65
Q

what is the recommended amount of caffeine a pregnant woman can have per day

A

200 mg/day

66
Q

can SSRIs be taken during pregnancy

A

Use should be determined by a risk-benefit analysis of the risks to the fetus or neonate with use of the medication weighed against risks of not treating the mother’s psychiatric condition.

Baby can have withdrawals and symptoms can occur until 72 hrs after birth

MIH Final review (16 decks)

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