Neonatal Complication (Finals) Flashcards
1
Q
During the 38th - 40th week, the placenta ____________
A
Degenerates (Lacking oxygen and nutrients)
2
Q
What are the 4 P’s in Dystocia?
A
Power, Person, Passenger, passageway
3
Q
This occurs after fetal hypoxic stress
A
Meconium Aspiration
4
Q
Abnormally low levels of blood sugar
A
Hypoglycemia (Usually happens to babies with SGA)
5
Q
If hypoglycemia, not treated immediately. what will happen?
A
Brain Damage
6
Q
It is the assessment findings that determines that there is an increased in brain pressure
A
Weak Cry
7
Q
What percentage of IV glucose is ordered in hypoglycemia?
A
10% or 25%
8
Q
______ is a good manifestation of feeding
A
Sucking
9
Q
What blood sugar level should be maintain for neonate with hypoglycemia?
A
More than 45/100 ml
10
Q
There is a presence of edematous fluid in the presenting part.
A
Caput Succedaneuym
11
Q
There is a presence of blood between the periosteum and flat bones of the skull
A
Cephalhematoma
12
Q
Presence of subdural hemorrhage, a clotting of the blood and may lead to the compress of the brain and the newborn will develop an increase ICP
A
Intracranial Hemorrhage
13
Q
_________ along with high pitched cry/shrill cry
A
Vomiting
14
Q
What are the precipitating factors of Head Injuries?
A
- Forcep Delivery
- Precipitate Labor
- Premature Birth
15
Q
What reflex is absent if there is a positive ICP?
A
Moro Reflex
16
Q
The nursing intervention to conduct to a head injured neonates
A
- Decrease environmental stimuli
- Minimal/gentle
- Avoid trendelenburg position
17
Q
What should be the position for a head injured neonates?
A
Fowlers’ Position or Elevated head for about 20 - 30 mins each hour
18
Q
What number is facial nerve?
A
Cranial Nerve 7
19
Q
Complete paralysis of one side of the face
A
Bell’s Palsy
20
Q
Provide care to what part of the face in Bell’s Palsy
A
Affected Eye (Because of the Open Eyelids)
21
Q
It is the most common neurologic injury in newborns
A
Brachial Nerve Paralysis or Upper Paralysis/ERB Duchenne Paralysis
22
Q
There is an asymmetry in ________ with neonates with brachial nerve paralysis
A
- Asymmetry in arm movements
- Incomplete tonic neck reflex
- Asymmetrical moro reflex
23
Q
It is generalized infection in the newborn, a clinical syndrome of systemic illness accompanied by bacteremia
A
Neonatal Sepsis
24
Q
This is an infection in the bloodstream of the infant
A
Bacteremia
25
What type of WBC is attacked in neonatal sepsis
Neutrophils
26
What is the nursing implementation in neonatal sepsis case?
- Isolate newborn
- Administer antibiotics
- Maintain nutrition andnhydration
27
A hereditary coagulation defect transmitted by a asymptomatic mother through a sex-linked recessive gene to the son or there is a missing clotting factor.
Hemophilia
28
When we say clotting factors it means
Protein
29
True or False: The X chromosome contains many genes that are not present on the Y chromosome. Thus, males only have one copy (XY) whereas females have two copy (XX)
True
30
A type of hemophilia where the missing clotting factor is factor IX (9)
Hemophilia B
31
A type of hemophilia where the missing clotting factor is factor VIII
Hemophilia A
32
A type of hemophilia where the missing clotting factor is factor XI
Hemophilia C
33
What is the sign and symptoms of a neonatal hemophilia
- Ecchymotic Patches (Pasa)
- Spontaneous Hematuria
34
This is the hallmark of hemophilia
Hemarthrosis (bleeding in joint spaces and may lead to bone deformities)
35
What are the diagnostic test in hemophilia
Blood Test:
- Clotting factor VIII Detection
- Partial Thromboplastin Time (PTT)
- Platelet count
36
What is the treatment for Hemophilia
- Bedrest during the acute phase of bleeding
- Pain relief with sedatives and narcotics
- Control bleeding
37
What is the drug contraindicated for treatment of hemophilia?
Aspirin because it thins the blood therefore this can be susceptible to further bleeding.
38
A malignant disorder of blood-forming tissue characterized by abnormal proliferation of immature WBC, causing decreased levels of mature WBC, RBC, Hgb, and platelets
Leukemia "Acute Lymphocytic Leukemia"
39
What is the mature WBC?
Leukocytes
40
What is the immature WBC?
Lymphoblasts
41
What is common in children with down syndrome
Chromosomal Aberrations
42
This is the leading cause of death in leukemia
Leukopenia
43
This is the signs and symptoms of Leukemia
Elevation of WBC, Neutropenia = Low Grade Fever
44
What is the diagnostic tests of Leukemia
- CBC
- Blood Smear
- Bone Marrow Biopsy/Aspiration
- Chest X-ray
- Lumbar puncture
45
Combination of drugs before chemotherapy that chemotherapeutic reinforcement
Vincristine per IV and prednisone per orem
46
After remission another agent is administered in chemotherapy
Asparanginase is given for linger remission
47
During the systemic continuation therapy in chemotherapy, what drug is given for about 2 and a half years to 3 years?
Mercaptopurine and Methotrexate
48
What is the intrathecal administration of triple chemotherapy
- Methotrexate
- Hydiocortisone
- Cytosinearabinoside
49
There is an alteration in the circulation of the blood due
Congenital Disorders of the Heart
50
Conditions that interfere with the normal blood flow through the heart by slowing it down and shunted from left side of heart to the right side of the heart that causes
Acyanotic (Left - right heart)
51
Conditions that allow unoxygenated blood to flow into the systemic circulation or allow the blood shunted from the right side of the heart to the left side
Cyanotic (Right - left heart)
52
(Acyanotic) Increased pulmonary blood flow within the heart with 3 of these conditions/defects
- ASD
- VSD
- PDA
53
(Acyanotic) this condition causes obstruction to blood flow from ventricles
COA
54
(Cyanotic) Decreased pulmonary blood flow in this condition
TOF
55
(Cyanotic) Mixed blood flow because of this condition
TOGV
56
If this remains open, this would lead to ASD. The blood from right atrium to left atrium and it shunts the oxygenated blood that bypasses the lungs and functionally closes with the initiation of the neonatal breathing
Foramen Ovale
57
If this remains open after delivery, this would lead to to PDA. This shunts oxygenated blood from pulmonary artery to the aorta bypassing the lungs within a few weeks
Ductus Arteriosus
58
Failure to close the ductus arteriosus and allows the abnormal blood flow between the aorta and pulmonary artery. This may lead to congestive heart failure
Patent Ductus Arteriosus
59
PDA is distinguished by the following signs and symptoms
- Machinery heart murmur
- Wide pulse pressure
- Palpable radial pulse
60
What are the normal pulses that are easy to palpitate?
Brachial and Femoral
61
This medicine promote closure of the ductus arteriosus
Indomethacin
62
What is the surgery that is done with congenital heart disease neonates
Open Chest and Close Heart (In this case, best conducted at 1 year old)
63
Most common congenital heart disorder as there is a hole in between the right and left ventricles. There is a harsh loud systemic murmur between the 3rd and 4th intercostal spaces
VSD
64
Open chest and close heart surgery is done to patient with VSD best at what age?
3 to 4 years of age
65
What is necessary to a VSD patient?
Cardiopulmonary Bypass
66
The failure of foramen ovale to close, thus, the right side of the heart is enlarged. There is also a harsh loud systemic murmur between 2nd and 3rd ICS
ASD
67
What infection happens when there is a complication in congenital heart diseases?
Endocarditis
68
There is a congenital narrowing or constricting aorta. Decrease of blood supply in lower body and increase in upper body. Absence of femoral pulse
COA
69
Types of COA: Increased blood pressure in upper part thus leads to warp upper body, headache and epistaxis, palpable radial pulse and vertigo
Ascending COA
70
Types of COA: Decreased blood pressure in lower part thus leads to cool and week lower extremities
Descending COA
71
The conclusive symptoms that there is a COA in descending limb
Absence of Femoral Pulse
72
The surgical resection of narrowed portion is conducted to COA cases and done best at what year?
4 years old
73
Although congenital, neonate may be cyanotic at birth because of
Fetal polycythemia (reserves of RBC)
74
Four manifestation of tetralogy of fallot
POVR
P - Pulmonary Stenosis
V - Ventricular Septal Defect
O - Overriding of the Aorta
R - Right Ventricular Hypertrophy
75
Usually the signs and symptoms of a tetralogy of fallot are
- Tet Spells (Choking Spells)
- Hand/foot Syndrome (Clubbing of the fingers and toes)
- Position Knee Chest (Squatting Position)
76
What is surgery for a tetralogy of fallot
Blalock Taussig Shunt
Rationale: This will increase the blood flow to the lungs.
77
This defect of the heart causes for aorta and pulmonary artery to exchange of their functions
Transposition of Great Vessel
78
What is the surgical procedure for transposition of great vessel?
Rashkind Procedure/Septostomy
79
What position is recommended for acyanotic cases?
Orthotic
80
This medicine treats the spasm of the heart and decrease workload
Propranolol
81
Increase intake of what nutrients?
- Iron
- Vit. C
- Fiber
82
What should be in lesser intake?
Sodium
83
Moderate intake
Calorie
84
This medication is a prophylaxis
Penicillin (Prevents Diseases)
85
This medication slows down the heart beat
Digitalis
Slows down the heart beat = increases the pumping heart rate thereby increase cardiac output
86
What is the contraindication of giving digitalis
Check first the apical pulse rate and if below normal
= DO NOT GIVE DIGITALIS
87
What are the digitalis toxicity signs'
Arrhythmia (Irregular Heartbeat)
Nausea (Feeling of Vomiting)
Anorexia (No Appetite)
But the sure sign is Vomiting
88
This medication slows down the heart work load
Diuretics
89
What is the normal urine specific gravity for infants?
1.003 - 1.004
90
What is the normal urine specific gravity for adults?
1.007 - 1.030
91
Observe for hypokalemia meaning?
Low Potassium
High Potassium source: Banana, Orange
92
This disorder is acquired by the heart based on the previous condition and damages to the heart valves resulting to regurgitation, obstruction, narrowing or stenosis. An autoimmune disease caused by group a beta hemolytic streptococcal infection
Rheumatic Heart Disease/Fever
93
From what infection does the rheumatic heart disease/fever comes from?
Group A beta Hemolytic Streptococcal Infection
94
What are the four affected human body parts in acute systemic inflammatory diseases?
1. Heart
2. Joints
3. CNS
4. Subcutaneous Tissues
95
How many times does having a frequent sore throat to be a candidate for tonsillectomy
5 - 6 times in a year
96
How many minor manifestations should determine if a neonate is positive for rheumatic heart disease?
2 confirm minor manifestations
97
This increase of blood test determines that there is an infection
Elevation in WBC
98
This increase of blood test determines that there is an inflammation
Increase in ESR (Erythrocyte Sedimentation Rate)
99
This increase of blood test determines confirmation of the presence of streptococcal infection
Increase in ASO (Anti-Streptolycene O'titer)
100
How many major manifestation should determine if a neonate is positive for rheumatic heart disease?
3 confirm major manifestations
101
This problem in CNS has a sudden rapid purposeless movement of extremities
Sydenham's Korea
102
In monitoring the apical pulse in a rheumatic heart disease/fever, how many increase should we watch for and may result to cardiac compensation if not treated immediately?
Increase by 20 apical pulse than normal
103
This problem is about the immune complex disease resulting from antigen antibody reaction to previous complication with Beta hemolytic streptococcus A to inflammation of glomeruli of kidneys.
Acute Glomerulonephritis (AGN)
104
What is the prognosis of AGN in neonates?
Very Good; Usually children with AGN can recover completely; Recurrence Rare
105
How many days should be streptococcal infection be treated before turning into AGN will will lead to a complication of Acute Cardiac Decompensation
10 - 14 Days
106
Clinical Manifestation of AGN
- Periorbital Edema
- Gross Hematuria (Tea colored urine the nto smoky urine)
107
The laboratory data for AGN
- Creatinine in Urine
- Elevated BUN (Blood Urinated Nitrogen)
108
Synonymous with nephrosis and a chronic renal disorder characterized by an alteration in glomerular basement membrane allowing increased glomerular basement membrane to plasma protein.
Nephrotic Syndrome
109
The duration of acute phase of nephrotic syndrome
4 Weeks
110
The clinical manifestations of nephrotic syndrome
- Anasarca (Generalized Edema)
- Severe Proteinuria
- Oliguria
111
What is the percentage of nephrotic syndrome from having relapse or recurrence?
20% recurrence rate
112
This is a form of cancer in kidney that is characterized by solitary growth that is encapsulated occurring in any part of the kidney. Although malignant and can be Asymptomatic
Nephroblastoma/Wilm's Tumor
113
Family history of __________ may predispose a neonate with this tumor.
Hemiathrophy (A disease that causes seizures and mental retardation)
114
60% of the cases of nephroblastoma has
Hypertension
HPN = Renal Ischemia = Congestive Cardiac Failure
115
This laboratory data identifies intrarenal origin of tumor which points out neuroblastoma and detects the extent of the tumor; evaluate the opposite kidney
Computed Tomography (CT Scan)
116
In chemotherapy of nephroblastoma, these drugs are used.
Vincristine and Docurubicin
117
In intervention of nephroblastoma, this is the most important thing to do
Do not palpate the abdomen because it can rupture the tumor capsule in the kidney and break and might metastasis
118
Nephroblastoma is best diagnosed at age of
2 years old
119
This condition affects motor development as it is not progressive. A neuromuscular disorder characterized by lack of control of voluntary muscles and abnormal muscle tone
Cerebral Palsy / Anorexia in the Brain (The most common developmental disability in children)
120
What are the 2 prenatal factors in CP
- Hereditary
- Exposure to radiation
121
What are the 4 intranatal factors in CP
- Dystocia
- Birth Trauma and Injury
- All causes of fetal anoxia
- Anesthesia
122
What are the 2 postnatal factors in CP
- Development of brain anomalies
- CNS trauma and infection (Meningitis/Cephalitis)
123
The most common type of cerebral palsy
Spactic
124
What is hallmark of cerebral palsy?
Scissors gait
125
What are the other signs and symptoms of Spastic type of CP
- Exaggeration of Deep Tendon Reflexes
- Walking on Toes
- Impaired fine (small muscles) and gross (Big muscles) motor skills
126
This wormlike movements and aggravated by stress and only diminished if he/she is at sleep, involuntary movements and drooling is what type of CP?
Athetoid/Dyskinetic
127
A type of CP that has lack of leg movement during infancy, disturbed balance, incoordination in arms, cerebellar function cant be performed and tremors as signs and symptoms
Ataxic
128
What do you the exaggerated arching of the back or abnormal posturing
Opisthotonic
129
What is the most important nursing care for neonate/patient with CP?
- Promote maximum mobility and development of self-help skills
- Teach them proper body alignment and teach them the range of motion and speech therapy
130
The goal for patient/neonates with CP is to
Early recognition and intervention to maximize the child's abilities
131
What system is tonsil part of?
Lymphatic System
132
This is a condition happens with part of lymphoid tissues are inflamed?
Tonsilitis
133
The pharynx and Waldeyer's ring is inflamed and is caused by group a beta hemolytic streptococcus
Tonsilitis
134
The initial signs of tonsilitis
Sore throat, Low grade fever, Foul Odor
135
Laboratory data that shows positive sign for tonsilitis
Throat Culture and elevated of leukocyte and neurocyte
136
Most frequent complication of tonsillectomy
Hemorrhage
137
What are the four positions recommended after tonsillectomy
1. Prone
2. Semi-Prone
3. Side-Lying
4. Upright Position
138
What should be avoided in interventions of tonsilitis
Suctioning of oropharynx and giving of aspirin
139
Under this age are not yet ready for tonsillectomy
5 - 6 years old
140
The rule for ketoplasty is that
2 - 3 months age of infants
10 grams of hemoglobin
10 pounds in weight
141
The rules of Cheiloplasty are
At least 2 - 3 months of age in infants
10 grams of Hgb
10 lbs. in weight
142
What surgical procedure is done to patients with Cleft Lip
Cheiloplasty
143
What surgical procedure is done to patients with Cleft Palate
Palatoplasty
144
What nutrient is lacking with the conditions of cleft lip and cleft palate?
Folic Acid
145
Folic Acid prevents ________ in infants
Neural Tube Defect
146
In interventions of cleft lip, it is recommended to use what size of syringe during feeding?
Small
147
In interventions of cleft palate, it is recommended to use ______ during feeding?
Paper Cup
148
For cleft lip, what should be the position?
Side Lying ; Never Prone
149
For cleft palate, what should be the position?
Prone ; Never Supine
150
It is important to do these in conduction of interventions in cleft lip and cleft palate
- Avoid sucking the thumb
- Minimize crying
- Never use pacifiers
151
This is a congenital/acquired increase in the enlargement of the head due to excessive accumulation of CSF (CerebroSpinal Fluid)
Hydrocephalus
152
The first variable in terms of etiology of hydrocephalus
Inadequate Reabsorption of CSF
153
The second variable in terms of etiology of hydrocephalus
Obstruction of CSF circulation
154
The third variable is terms of etiology of hydrocephalus
Choroid plexus increased production of CSF
155
These two infection may lead to infection
Meningitis or encephalitis
156
Other predisposing factors of hydrocephalus
Spina Bifida (NTD and happens if neural tube does not close all the way)
157
The head growth in infants increases how many inch per month?
1 inch (increase rate varies from 0.5 to 1 inch) per month
158
What is the hallmark of hydrocephalic child
Sunset/Setting Sun Sign (Eyes appear driven downward bilaterally)
159
Assessment of a hydrocephalus child
- Headlag of 4 months
- Macewen Sign (cracked-pot sound through percussion)
160
The first sign of an increased ICP
Shrill cry/High pitched cry
161
2 surgical procedures of hydrocephalus
1. Ventriculoperitoneal shunt (VP shunt)
2. Atrioventricular shunt (AV shunt)
162
The most common used shunt in children which connects the lateral ventricle of the brain to the peritoneal cavity. Does not require frequent revisions and is easier to revise
VP shunt
163
This connects the lateral ventricle to right atrium of the heart
AV shunt
164
In providing post-operative care, what should be the proper positioning
flat on bed for first 24-48 hours, do not cuddle no lifted even if they cry
165
This congenital Anomaly also known as congenital aganglionosis or megacolon
Hirschsprung's Disease
166
What nerve cells is responsible for defacation?
Ganglionic nerve cells
167
Where are the ganglionic nerve cells absent in parts of the body?
Sigmoid Colon and and Rectum
168
What is the hallmark of megacolon or Hirschsprung's Disease?
Chronic constipation (Infants and in older children)
169
What tests does confirms the hirschsprung's disease?
Rectal Biopsy
170
Surgery for patients with hirschsprung's disease?
Bowel resection with temporary colostomy
171
What is solution is used in providing bowel cleansing/enema?
Isotonic solution
172
Telescoping of the intestine along any point of the intestinal tract resulting in intestinal obstruction and interference with the passage of intestinal contents. Cecum eats the Ilium due to increased hyperperistatlsis
Intussusception
173
Upon palpation at the right upper quadrant, what is palpated and this is the common sigh of intussusception?
Sausage-Shaped Mass
174
This is considered to be a dangerous sign of peritonitis or suggest perforation
Currant-jelly like stool (blood and mucoid in stool)
175
This is the diagnostic procedure in getting the laboratory data in intussusception
Barium Enema
176
It is a progressive hypertrophy (increase in size) of circular muscles of the pylorus (thickens thereby causing obstruction)
Pyloric Stenosis
177
What are the initial manifestations of pyloric stenosis?
- non bile stained
- acidic
- palpable olive-shaped mass (right side of the rib cage)
178
The metabolic alkalosis when the acid content goes out?
alkalosis
179
If the client has diarrhea, what goes out is alkalotic
Acidosis
180
What is the surgery for pyloric stenosis?
- Fredet-Ramstedt/Pyloromyotomy
181
An infectious process of the CNS caused by bacteria and viruses. Lumbar puncture which shows pressure, cloudy CSF, high protein and glucose
Meningitis
182
This occurs in epidemic form and is the only type readily transmitted by droplet infection from nasopharyngeal secretion
Meningococcal meningitis
183
What is the manifestation of meningitis aside from having abrupt onset of high fever?
Petechiae (tiny spots of bleeding over the face and extremities)
184
This will cause ________ within few hours of onset of infection
Death
185
Infection of the middle ear
Otitis Media
186
Lessening of pain in otitis media indicates
Rupture of the tympanic membrane
187
Administer what medicine to patients with otitis media
Steroids and antibiotics
188
Lateral curvature of the spine and incidence rate is high in pre-adolescence
Scoliosis
189
C-curve type
No need for surgery
190
S-curve type
Progressive does need of surgery
191
Instruct to wear _____________ to patients with scoliosis?
Milwaukee or boston brace
192
How many hours a day of wearing the brace?
23 hours a day for 3 years
193
X-ray of the spine will be every how many months
3 - 6 months
194
In preparation of the surgery of the patient, what should be inserted?
Harrington rod inserted in posterior spinal concave portion of the spine
195
This is a sudden, transient alterations in brain function resulting from excessive levels of electrical activity in the brain
Seizure disroders
196
This is a CNS defect that occurs as a result of neural tube failure to close during embryonic development. A congenital disunion of the spinal column
Spina Bifida
197
A type of spina bifida that is covered with tuft hair, dimpling along the spine between lumbar 5 and sacrum 1. The spinal cord remains intact and usually is not visible
Occulta
198
A type of spina bifida that has the presence of sac along the spine and protrusion of the spinal cord or its meninges
Cystica
199
A subtype of SB cystica that has 25% of the cystica type and neurological deficits are usually not present
Meningocele
200
A subtype of SB cystica that has 75% of the cystica type and the neurological deficit are evident
Myelomeningocele
