Module 1 and 2 Flashcards
APGAR SCORING
determines how well the baby tolerated the birthing
process.
1 minute score
APGAR SCORING
tells the doctor how well the baby is doing outside the
mother’s womb.
5 minute score
This score means severely depressed
0-3
This score means the baby is good or healthy.
7-10
This score means the baby is moderately depressed
4-6
SILVERMAN – ANDERSEN INDEX - NEONATAL RESPIRATORY DISTRESS GRADING
What grade is no respiratory distress
0
SILVERMAN – ANDERSEN INDEX - NEONATAL RESPIRATORY DISTRESS GRADING
What grade is with moderate distress
4-6
SILVERMAN – ANDERSEN INDEX - NEONATAL RESPIRATORY DISTRESS GRADING
What grade is with severe distress
7-10
This assessment represents the neuromuscular and physical maturation of the fetus.
Ballard Maturational Assessment
delivered at 37 to 40 weeks of development in the uterus
Full-term infant
delivered before 37 weeks of development in the uterus
Pre-term infant
Weight of a preterm infant?
less than 5½ pounds (2.5 kg)
Erythropoiesis decreases after birth as a result of increased tissue oxygenation due to the onset of breathing and closure of the ductus arteriosus, and a reduced production of erythropoietin
Anemia of prematurity
What supplement can assist in
formation of RBCs
Vitamin E
What therapeutic management will help anemia of prematurity.
a. DNA recombinant erythropoietin
b. Vitamin E supplement
c. Blood transfusion (RBC
transfusion)
d. Iron supplement
refers to short episodes of stopped breathing in babies who were born before they were
due.
APNEA OF PREMATURITY
What therapeutic management is done for apnea?
a. Gently stimulate during periods when breathing stops
b. Give caffeine preparation to help stimulate their breathing
c. Suction children with apnea
d. Change the position
e. Use a bag and mask to help them breathe
f. Slower feeding time
g. Give oxygen
Causes blood vessels to grow abnormally and randomly in the eye.
RETINOPATHY OF PREMATURITY (ROP)
This may be effective in preserving sight of those with retinopathy.
Cryosurgery or laser therapy
This promotes the
growth of bifidobacterial.
Breastfeeding
What is expected from the mother to prevent prematurity?
- Eat nutritious diet
- Avoid alcohol, tobacco, and drugs unless they are needed to treat a medical condition
- Receive early and regular prenatal care for early recognition and treatment of complications
of pregnancy
This will help Severely premature infants who have underdeveloped lungs
Glucocorticosteroids
This delays delivery beyond 24–48 hours to allow for transfer and give administered
corticosteroids the possibility to reduce neonatal organ immaturity.
Tocolysis
This can delay delivery by 2–7 days
Calcium-channel blockers and an oxytocin antagonist
This delays delivery by 48 hours but carry more side effects.
β2-agonist drugs
Infants that are born of a gestation that extends beyond
40 weeks
POST TERM (POST MATURE INFANTS)
This is usually recommended when infants are significantly overdue.
Induction of labor
What do you do if a post term infant is lethargic because of
meconium aspiration
Intubate to suction as much meconium
For post term, this may be needed to support breathing
Mechanical Ventilator
What treatment is advised if the post term infant is hypoglycemic
- Give glucose solutions by IV
- frequent breast milk or formula feedings
What is the appropriate weight for a full-term infant?
heavier than 2,500 grams (about 5.5 lbs.) and lighter than 4,000 grams (about
8.75 lbs.)
Small for gestational age (SGA) infants are small for their age because they have experienced _____?
Intrauterine growth
restriction or retardation (IUGR)
What do you call when Birth weight falls below the 10th percentile
on intrauterine growth curves.
SMALL FOR GESTATIONAL AGE (SGA)
An infant whose birth weight falls above the 90th percentile
on intrauterine growth charts; also termed Macrosomia
LARGE FOR GESTATIONAL AGE (LGA)
an overgrowth
syndrome, affected infants are larger than normal
(macrosomia) and continue to grow and gain weight at
an unusual rate during childhood.
Beckwith-Wiedemann syndrome
Cerebral Gigantism, extraordinary physical
growth in children in the first 2 to 3 years of their life, accompanied
with subtle mental retardation, autistic behavior, motor skills delays, cognitive disorder, muscle tone and dysarthria. Large at birth, taller, have more weight, and also tend to have larger hands and feet
Sotos’ syndrome
- A condition of surfactant deficiency and physiologic immaturity of the thorax
- Also known as “Hyaline Membrane Disease”
RESPIRATORY DISTRESS SYNDROME
is a slippery substance produced by cells in the airways and
contains phospholipids and proteins.
Surfactant (Between 24 and 28 weeks of gestation, a fetus begins producing “surfactant” in his or her lungs)
by what week does a
fetus has developed enough
surfactant for his or her lungs to
function normally.
35 weeks
- the first intestinal discharge from newborns
- a sterile viscous, dark-green substance
composed of lanugo, swallowed
amniotic fluid, and intestinal
secretions (eg, bile); 85-95% is water, the major liquid constituent
Meconium
When a mother has __________, there is a lack of adequate blood flow to the baby, which can cause fetal distress, leading
to the untimely passage of meconium.
Placental insufficiency
This is when the placenta does not carry adequate oxygen and nutrition for the fetus due to maternal underperfusion
Preeclampsia
When the placental membranes are ruptured and amniotic fluid infection occurs
chorioamnionitis
This leads to passage of meconium from neural
stimulation of a maturing gastrointestinal system.
Fetal Hypoxia
This is essential in order to confirm the diagnosis of meconium aspiration syndrome (MAS)
Chest radiography
Refers to a generalized bacterial infection in the bloodstream that occurs in an infant
younger than 90 days old
SEPSIS NEONATORUM (SEPTICEMIA)
TYPES OF SEPSIS
- (less than 3 days after birth)
- acquired in the perinatal period
- Infection can occur from direct contact with organisms from the maternal GI and genitourinary tracts.
Early-onset sepsis
TYPES OF SEPSIS
- 1 to 3 weeks after birth or Day 8 and 9 of NB
- primarily nosocomial
Late-onset sepsis
- Jaundice of the newborn
- Neonatal hyperbilirubinemia
- Bili lights – jaundice
HYPERBILIRUBINEMIA
This is associated with an increased incidence of jaundice.
Breast-feeding
This type of jaundice begins at 2 to 4 days of age and occurs in approximately 12% to 13% of breast-fed
newborns.
Breast-feeding—associated jaundice (early-onset jaundice)
This therapy is done to manage hyperbilubinemia.
Phototherapy
COMPLICATIONS OF HYPERBILIRUBINEMIA
- indirect bilirubin levels as high as 20 mg/100ml
Kernicterus
- a sudden, unexpected death of an infant younger than 1 year old (between 2 months
and 4 months) which may occur during sleep, whilst awake, or just after exercise. - Occur between the hours of 10 at night and 10 in the morning
SUDDEN INFANT DEATH SYNDROME (SIDS)
Is a chronic lung disease in which there is airway obstruction, airway inflammation & airway hyper responsiveness or spasm of the bronchial smooth muscle.
Asthma
is an inherited tendency to develop allergies
Atopy
This is when a person develop asthma because of contact with
certain chemical irritants or industrial dusts in the workplace
Occupational asthma
This test is to measure how sensitive the airways are
Bronchoprovocation test
This test is to check how the lungs are working. This test measures how much air a
person can breathe in and out. It also measures how fast you can blow air out.
Spirometry
This is to help find out whether a foreign object in the airways or another disease might
be causing the symptoms
Chest x ray or an EKG (electrocardiogram)
initially mild respiratory alkalosis from hyperventilation then subsequently
respiratory acidosis
Arterial blood gas
➢ Inflammation of lung parenchyma
➢ Classified according to etiologic agent
➢ Classified according to location and extent of pulmonary involvement
PNEUMONIA
Location and Extent of Pneumonia
– involve segment of one or more lobe
Lobar Pneumonia
Location and Extent of Pneumonia
– terminal bronchioles and involve nearby lobules
Bronchopneumonia
Location and Extent of Pneumonia
– confined to alveolar walls, peribronchial and interlobular
tissues.
Interstitial pneumonia
From the failure of the ductus arteriosus to close after birth
PERSISTENT PATENT DUCTUS ARTERIOSUS
Neurodevelopmental problems have been linked to lack of maternal thyroid
hormones at a time when their own thyroid is unable to meet postnatal needs
PERIVENTRICULAR / INTRAVENTRICULAR HEMORRHAGE
What Therapeutic Management is done for PERIVENTRICULAR / INTRAVENTRICULAR HEMORRHAGE
Cranial ultrasound
specific IgG production is delayed in newborns, and 33% of VLBW neonates have substantial hypogammaglobulinemia,
NECROTIZING ENTEROCOLITIS
Management for Necrotizing enterocolitis:
Encourage all mothers to initially provide
breastmilk for their preterm neonates
usually recommended when infants are significantly overdue.
Induction of labor
Management for SGA:
- exchange transfusions to dilute the bloods
- IV solution to sustain blood sugar
What secretes the surfactant?
Alveolar epithelium
This inability to maintain lung expansion produces
widespread _____?
Atelactasis
MINOR SIDE EFFECTS OF PHOTOTHARAPY
- Increased tanning due to use of oily lubricants or lotions on the skin
Frying effect
MINOR SIDE EFFECTS OF PHOTOTHARAPY
- Infants develop a dark, gray-brown discoloration of skin, urine,
and serum due to the accumulation of porphyrins and other metabolites
Bronze baby syndrome
