Neonate Complications Flashcards
How does a subtle seizure present in an infant?
Subtle seizure- sucking, blinking, pedalling of legs, eye deviation
How does a tonic seizure appear in infants?
-Extension of limbs or flexion of arms and tension of legs
-more common in infants especially if they have had intraventricular hemorrhage
How does a focal closing seizure appear in infants?
Clonic localized jerking
Seen in term or premature infants
How does a myclonic seizure appear in infants?
Either singularly or series of repetitive. Flexion jerking
Causes of seizures?
Hypoxic ischemic encephalopathy
Intracranial infections (meningitis)
Hypoglycemia
Other metabolic disturbances
Epileptic syndromes Intracranial hemorrhage
Development defects
Hypocalcemia
Jitteriness of infants?
Sometimes mistaken for seizures
Myoclonic, dysconjugate eye movements or sucking movements
What is Hypoxemic ischemic encaphaopathy?
-second at to perinatal asphyxia
- single most common cause of seizures
- characteristically occur in the first 24 hours
What does Hypoxemic ischemic encaphalopathy lead to?
-often leads to severe developmental or cognitive delays
-motor impairments that become more apparent as the child continues to develop.
What is thermoregulation?
Responsible for balancing heat production and heat loss; maintains normal body temperature.
-limited in newborns
What is the average normal Temperature of a newborn?
36.6-37.2 degrees
How does most heat loss occur?
Evaporation
How quickly can core body temperature drop 1 degree from its original temperature?
Within minutes
What is non shivering thermogenesis
Production of heat by metabolism
-primary source of heat production in neonates
-brown fat is a thermogenic tissue unique to the newborn(after 28 weeks?)
In comparison to white fat, What is brown fat?
Brown adipocytes contain numerous smaller droplets and a much higher umber of mitochondria which makes it brown.
-brown fat also has more capillaries than white fat since it has a greater need for oxygen storage than most tissues.
Where is brown fat stored?
Scapula
Kidney
Adrenal glands
Neck and axilla
How would you prevent eat loss in a neonate?
-dry newborn immediately
-skin to skin contact with parents and a blanket covering the baby’s back and head.
- swaddle the infant and cover the head if skin to skin contact is not possible
Maintain room temperature around 23-24 degrees Celsius
-close all windows and doors
What should. You observe when a fever is suspected in a neonate?
-observe for rashes
-obtain a careful history
-obtain the newborns vital signs
-Remove additional layers of Clothing and improve environmental ventilation
-enquire if infant. Has received infant acetaminophen or ibuprofen within 4 hours prior to ems arrival
What is hypothermia considered in neonates?
Drop in body temperature -<36 degrees Celsius
Can occur in all climates
Increased risk in low birth weight infants
Why can being hypothermic case a neonate To develop hypoglycaemia or hypoxia?
Because of the increase in their metabolic function due to overcoming the heat loss
8 risk factors of hypothermia in Neonates
-all neonates during the first 12 hours after birth
-home delivery
-prolonged resuscitation
-infant who is small for gestational age
-infant with central nervous system problems
-prematurity
-sepsis
-inadequate measures to keep the infant warm During transport
Since Neonates Do not shiver when they’re cold, what signs should you look for Instead?
- pale
-skin cool to touch
-acrocyanosis or central cyanosis
-respiratory distress or apnea
-Bradycardia
-Irritability changing to lethargy later
What is considered a low BGL for newborns?
Less than 2.6 mmol/l
How long do glycogen stores typically last in newborns?
8-12 hours
How can hypoglycaemia affect the brain?
It’s catastrophic for brain cells and can lead to severe permanent damage in a SHORTER time frame than adults.
Which infants are more susceptible to getting hypoglycaemic?
-premature infants
-smaller twin
-diabetic mothers
-low infant birth weight
Symptoms of hypoglycaemia in infants?
-cyanosis
-apnea
-irritability
-poor. Tone
-poor sucking or feeding
-hypothermia
-lethargy
-tremors
-seizures
-coma
-may also have tachycardia, tachypnea or vomiting
What %of newborn vomit during the first week of life? And 6 weeks of age?
85% during. The first week
10% by 6weeks of age
Most vomiting episodes are benign, when can it be cause for concern?
Persistent vomiting can be a warning sign
vomit containing blood is a sign of a life threatening illness
In cases of diarrhea, what signs in combination can make it severe?
-poor vital signs
-capillary refill of greater than 2seconds
-dry mucous membranes
-absent tears
-weight loss
-low urine output
