NCMA (midterm Flashcards
babies born before 37 weeks of gestation.
Premature infant
it covers the entire back and face, soles few creases, scrotum
little rugae
Lanugo
- a baby delivered after 42 weeks of gestation.
- abundant scalp hair. Visible creases on palms and soles of feet.
Minimal fat deposits - Absence of lanugo
Postmature infant
Infant whose rate of intrauterine growth was slowed and whose birth weight
falls below the 10th percentile on the intrauterine growth chart.
Small for Gestational Age Infants
Causes of IUGR
- Poor nutrition during pregnancy
- Placental defects and complications
- Teenage pregnancies
- Hypertensive mother
how to prevent the IUGR
- Priority nursing care in the first few days of life
- Initiation and maintenance of respirations
- Maintenance of hydration and normal glucose - glucose IVF, thermoregulation,
correct IVF rate, breastfeeding every 3-4 hours - monitor glucose level every 4 hours
- Control of body temperature
- For newborns under radiant warmers – monitor vital signs, keep the newborn
hydrated, assess integrity of the skin. - Maintaining neutral thermal environment permits the neonate to maintain a
normal core temperature with minimal oxygen consumption.
IUGR and SGA newborn
(causes)
- Age – under 18 or over 35 years of age
- Poor nutrition during pregnancy
- Placental defects – perinatal hypoxia
- Maternal condition – HPN, anemia, DM
Definition of Respiratory Distress Syndrome (Hyaline
Membrane Disease)
refers to a condition of surfactant deficiency and physiologic
immaturity of the thorax.
Diagnostic exam in Respiratory Distress Syndrome (Hyaline
Membrane Disease)
X-ray, blood glucose, ABG, Fetal lung maturity
assay ( the fastest)
Diagnostic findings in Respiratory Distress Syndrome (Hyaline
Membrane Disease)
radiographic findings – diffuse granular pattern
like broken glass appearance on chest x-ray, hypoxemia, increased
carbon dioxide and respiratory acidosis on ABG.
Medications in Respiratory Distress Syndrome (Hyaline
Membrane Disease)
artificial surfactant, nitric oxide ( it will dilate
pulmonary bronchus)
Clinical Manifestations of RDS
- Tachypnea 60>
- Flaring nares
- Expiratory grunting,
dyspnea - Chest Retractions –
sternal and subcostal - Seesaw respirations
When does Meconium Aspiration Syndrome occur in newborns?
Meconium Aspiration Syndrome occurs when there is the aspiration of amniotic fluid containing meconium into the fetal or newborn trachea either in utero or at the first breath.
What is the primary time frame for the occurrence of Meconium Aspiration Syndrome in infants?
Meconium Aspiration Syndrome primarily occurs in full-term and post-term infants during the relaxation of the anal sphincter and the passage of meconium into the amniotic fluid, often due to intrauterine stress.
assessment in Meconium Aspiration Syndrome
widened anteroposterior diameter of the chest (barrelchest), greenish stains on the skin, umbilical cord and nails
What is the priority nursing care for a newborn diagnosed with Meconium Aspiration Syndrome?
assist in tracheal suctioning
Nursing care in Meconium Aspiration Syndrome
- Suctioning – oropharyngeal and tracheal
- O2 support (Severe: Extracorporeal
membrane oxygenation) - Exogenous surfactant administration
- IV fluid administration
- Administer systemic antibiotics as
prescribed - Ampicillin
- Gentamycin
- Amikacin
In Sepsis it occurs less than 3 days after birth
- Caused by maternal infection
Early onset
it - occurs on the 4th up to 7th days after birth
- Nosocomial infection
Late onset
Clinical Manifestation in Sepsis
- Pallor, cyanosis, or
mottling - Hypotension
- Tachycardia
- Irregular respirations
- Jaundice
- Dehydration
- Temperature instability
Laboratory and Diagnostic studies in Sepsis
- Blood culture
- Urine and blood culture
and CSF analysis - CBC – WBC increased
- ESR and C-reactive
protein - increased
refers to an excessive level of accumulated bilirubin in the blood and
is characterized by jaundice.
Hyperbilirubinemia
Jaundice in the first 24 hours of life
Pathologic jaundice
Jaundice after 24 hours of life
Physiologic jaundice
possible Complications in Hyperbilirubinemia
Kernicterus
Management in Hyperbilirubinemia
Phototherapy
Nursing care plan in Hyperbilirubinemia
- cover the eyes and genitalia,
- check skin turgor for hydration,
- turn the infant every 2 hours
- Instruct the mother to continue breastfeeding every 2-4 hours
Sudden Infant Death Syndrome ( SIDS)
- Sudden unexpected death of any infant younger than 1
year of age - Death usually occurs during sleep – “CRIB Death”
- Most common cause of death in children ages 1 months
to 1 year - Peak: 2-4 mos., 90% before 6th mos.
NURSING MANAGEMENT IN SIDS
- Teach parents how to
minimize the risk of SIDS - Avoid smoking during and after
pregnancy - Encourage supine position or
side-lying position
Possible Causes (SIDS):
- Co-sleeping
- Soft beddings
- Use of pillows, blankets on the
crib - Maternal smoking
Necrotizing
enterocolitis
- An acute inflammatory disease
of the bowel - Preterm neonates manifesting
abdominal distention and
vomiting.
signs of Necrotizing
enterocolitis
- Poor feeding
- Distended abdomen
- Blood in the stool
- Vomiting
- Apnea
Nursing management in Necrotizing Enterocolitis
- Assessing patient for presence of abdominal distention
- Reporting to the doctor any episodes of gastric residuals
- Placing the patient on NPO as per doctor’s order if symptoms of NEC is
observed
Newborn Screening
- Congenital hypothyroidism
- Phenylketonuria
- G6PD Deficiency
its the procedure to determine if the newborn
infant has a heritable congenital metabolic disorder
Newborn Screening
Results from the absence or lack of development of thyroid gland causing
absence or lack of thyroxine needed for metabolism and growth of the
body and the brain.
Congenital Hypothyroidism
short stature, macroglossia, delayed closure of the fontanelles,
hypotonia
s/s
Manaagement in Congenital Hypothyroidism
medication will be needed throughout the child’s lifetime
Administration of thyroid hormone will prevent problems.
if managed early it will not cause mental retardation
Medication in Congenital Hypothyroidism
Synthroid – taken in the morning. Report signs of tremors
(toxicity)
Deficiency or absence of enzyme needed to metabolize essential
amino acid like phenylalanine
Phenylketonuria
Diagnostic test in Phenylketonuria
Guthrie test
If ____________ it will prevent mental retardation or cognitive
impairment
managed early
goal of treatment in Phenylketonuria
meeting the child’s nutritional needs for
optimal growth.
results to FTT, absence of adequate melanin
pigmentation, unpredictable and erratic behavior
Untreated phenylketonuria
Lack of enzyme resulting to premature destruction of RBC leading to
hemolytic anemia
G6PD Deficiency
Without G6PD, RBC’s undergo _________ when exposed to oxidative
stress.
HEMOLYSIS
Symptoms of G6PD Deficiency
jaundice,. Dark colored urine, back pain, anemia
Complications in G6PD Deficiency
severe anemia, hyperbilirubinemia
Management in G6PD Deficiency
avoid food, drugs, chemicals that cause oxidative
stress
Heart Disorders
*Congenital Heart Disorders
* ASD
* VSD
* PDA
* TOF
* Acquired Heart Disease
* Rheumatic Heart Dse,
* Kawasaki Heart Dse
