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MCN 2 Fall 2017 > New Born Care and Complications > Flashcards

New Born Care and Complications Flashcards

1
Q

fetal circulation

A

changes when the cord is clamped

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2
Q

risks of C/S

A

fluid in lungs because no compression like VB

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3
Q

fetal apnea birth

A

normal less then 10 seconds

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4
Q

first urine voids

A

pink urine acid crystals is normal

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5
Q

immunoglobulin

A

IgG abundant

IgM first to respond

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6
Q

V-K

A

shot given an hour after birth because they can’t make normal flora in abdomen until a week which is where its made from

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7
Q

stomachs

A

can expand thats why they will spit up

holds 10-20mL first 24 hours

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8
Q

APGAR

A 
1 minute then 5 minutes after birth 
appearance 
pulse 
grimace 
activity 
RR
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9
Q

VS

A

Temp 97.7-99.5
RR 30-60
HR 110-160

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10
Q

NTE

A

keep it at the temp 97.7-99.5

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11
Q

Erythromycin prevents

A

chaylmidia and gonnrhea

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12
Q

Milia

A

epistein pearls in mouth

or unopened sebaceous glands nose

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13
Q

stork bites

A

salmon patches

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14
Q

harlequin sign

A

half red face where blood vessels are dilated

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15
Q

nevus flames

A

port wine stain

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16
Q

nevus vasculosus

A

strawberry mark

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17
Q

caput succedaneum

A

edema that crosses suture lines

can be pitting as well

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18
Q

cephalhematoma

A

localized effusion that does not cross suture lines

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19
Q

Hep B vaccine

A

HBIG within 12 hours of birth
hep B at birth
both given before breast feeding

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20
Q

PKU

A

have to get protein first before test done

21
Q

thermoregulation

A 
thin skin
rely on environment 
few subcutaneous fat 
few brown fat 
can't shiver or generate heat through muscles
22
Q

heat loss in newborn- 4 ways

A

conduction: contact with object
evaporation- water
convection- air currents
radiation- near cold surface

23
Q

Voiding

A

expect a void in < 8 hrs
1 stool and void first 24 hrs
formula less frequent stools and larger
breast more frequent and less

24
Q

AGA
SGA
LGA

A

appropriate for gestational age 10-90%
small for gestational age <2500g (5lbs 8oz)
large for gestational age >4000g (8lbs 10oz)

25
Q

factors affecting growth

A

maternal- HTN, smoking, diabetes, weight gain, drug use
placental- calcification ( from aging), previa, abruption
fetal- sex (males larger), multiple gestations, anomalies, fetal infection

26
Q

SGA

A

< 10%
assessment findings: large head, thin extremities and trunk, reduced subcutaneous fat, thin umbilical cord, loose dry skin.
perform blood glucose frequently because hypoglycemia can occur since they don’t have enough energy stores
obtain weight, head, length circumference
screen for polycythemia >65% because of stress

27
Q

LGA

A 
>90% macrosomia 
poor motor skills
difficult to arouse 
not as alert 
concerns: traumatic birth injuries 
hypoglycemia (<40mg)- they had a lot glucose in the placenta because of the mother taking in so much sugar so when the baby comes out their sugar drops because its making so much insulin. 
hyperbilirubinanemia
28
Q

Pre- term
health issues
effects on prematurity
assessment

A 
20-37.6 weeks 
RDS- respiratory syndrome 
BPD- bronchuopulmonary dysplasia 
respiratory- < surfactant 
cardiovascular- persistent fetal circulation 
immune- IgG deficiency 
thermoregulation- hypoglycemia
males- undescended testes
plentiful langue and vernix 
poorly framed ear pinna 
fused eyelids 
no creases on soles and palms
29
Q

pre term management

A 
monitor for dehydration <1 ml/kg/hr
over dehydrations >3ml/kg/hr 
monitor RR status 
radiant warmer 
kangaroo care 
nutrition and fluid balance 
will sleep on their stomach to expand
30
Q

Post Term

A

42 weeks
placental issues: decreased O2 nutrient supply
wasting of fetus due to using stored nutrients
stops working after 40 weeks. R/F placental insufficiency

31
Q

post term assessment

A 
dry, cracked, and peeling skin
will vernix or lanugo 
thin umbilical cord 
meconium stained skin and nails 
long nails
32
Q

post term management

A

cord compression
placental dysfunction
screen polycythemia and hyperbilrubinaanemia

33
Q

asphyxia

A 
acidosis 
can occur from placental abruptio 
cord abruption 
HTN
meconium aspiration
34
Q

TTN- transient tachypnea of newborn

A

self limiting respiratory disorder
causes retention in lungs and transient pulmonary edema
fluid from lungs doesn’t empty completely
resolves by 72 hours
more common C/S
IV fluids or gavage feedings
Tx: PEEP: pressurized ventilation to keep alveoli open

35
Q

opposite of hypothermia

A

hypoglycemia

36
Q

hypoglycemia

A

listless, lethargic, weak, poor, feeding, tremors, irritability, SEIZURES, apnea, cyanosis, HYPOTHERMIA
Txt feedings q2h

37
Q

FAS

A 
fetal alcohol 
effects: growth, craniofacial structure malformations
thin upper lip 
microcephaly
missing philtrum 
narrow forehead 
micrognathia   
low nasal bridge
poor hand eye coordination 
cardiac defects
38
Q

marijuana

A 
high pitched cry 
tremulouslessness 
hyper irritability 
sleep abnormalities 
photophobia
39
Q

cocaine

A 
piercing cry 
irritability 
hypersensitivity 
poor feeding 
decreased responsiveness 
congenital anomalies
40
Q

NAS- neonatal abstinence syndrome

A 
test only those at risk 
CNS, GI effects 
wakefullness 
shrill cry 
apnea
diarrhea 
lacrimation 
hypoglycemia 
RR distress
41
Q

NAS management

A

low stimulation

low lighting

42
Q

hyperbilirubinanemia

A

bilirubin is a byproduct of RBC hemolysis

immature liver, fetal RBC shorter lifespan, delay in meconium excretion

43
Q

physiologic jaundice

A

1-7 days after birth
increased bili load
caused by short RBC life
>10 mg/dL

44
Q

pathologic jaundice

A 
occurs in FIRST 24 hrs yellow skin 
LIFE THREATENING  
increased RBC breakdown 
severe polycythemia, blood incompatibilities (rh -/+) , or systemic acidosis 
>17 mg/dL
kernicterus- brain jaundice/ damage
45
Q

physic jaundice tx

A 
photothearpy - blacklight 
eye shield 
no lotions 
starts to head then down to feet  
heals feet to head
46
Q

pathological jaundice tx

A

phototherapy

exchange transfusion

47
Q

newborn infections assessment

A 
hypothermia- can't regulate temp 
pallor 
hypotonia 
RR distress 
poor weight gain
irritability 
hypoglycemia 
seizures
48
Q

neonatal sepsis

A

presence of viral, microorganisms, most common is GBS

presents as septicemia, (blood infection) pneumonia, meningitis

MCN 2 Fall 2017 (10 decks)

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