New born complications vice over

Question 1

The nursing goals for NB?

Answer 1

Pink
Warm
Sweet (not hypoglycemia)
Blood glucose > 45mg/d

Question 2

Infants of Diabetic Mothers (IDM)
If the mother’s blood glucose is NOT well controlled….
She may produce a baby who is
The abrupt discontinuation of the high glucose leaves cause?

Answer 2

LGA- Large for Gestational Age
baby increases insulin d/t cover the high level of BG from the mother.

The abrupt discontinuation of the high glucose leaves the infant with too much-circulating insulin and can result in life-threatening drops in BG

Question 3

Infants of Diabetic Mothers (IDM)
If the mother’s diabetes has caused arterial damage and hypertension, the baby may be

Answer 3

SGA due to poor perfusion to the placenta.

Question 4

IUGR?

Answer 4

The baby is not as big as would be expected for the stage of the mother’s pregnancy.

Question 5

The placenta ages, what is happening?
Commonly?

Answer 5

The baby begins to deplete his subcutaneous fat 使い果たす
glycogen reserves to make up for the placenta deficit

Commonly postpartum

Question 6

Hypoglycemia
a) risk baby
b)solution

Answer 6

a)
IDM
SGA
Preterm babies
b)
Feeding the baby
Skin-to-skin with the mother
risk of the baby should feed within the first 30-60 minutes of life

Question 7

Hyperbilirubinemia
a) abnormal level
b) when it occurs?

Answer 7

a) unconjugated bilirubin levels > 5mg/dL
b) n the first 7 days of life
usually 2nd to 3rd day

If the bilirubin is not passed quickly through the bowels, it can be reabsorbed, converted back to the unconjugated state, and further overwhelm the liver.

Question 8

Pain management in newborns

Answer 8

Breastfeeding or
skin-to-skin during the procedure
a pacifier

Question 9

Phototherapy

Answer 9

Unconjugated bilirubin levels > 5mg/dL
Occurs in up to 80% of healthy newborns in the first 7 days of life

Question 10

Phototherapy
considerations

Answer 10

Protect eyes with eye mask
Expose as much skin(only diaper to wear)
Assess for dehydration and diarrhea

Question 11

LGA from IDM and SGA from poor perfusion
Which jaundice is at high risk?

Answer 11

physiologic jaundice r/t polycythemia.

Question 12

physiologic jaundice

Answer 12

A newborn’s immature liver often can’t remove bilirubin quickly enough
due to these normal newborn conditions
typically appears on the second or third day of life

Question 13

How jaundice develop?

Answer 13

bilirubin in the blood (yellow pigment) increased
Old RBCs recycle pattern, mom placenta do this for the baby but now the baby have to this his own (usually, poo out)

Question 14

Why jaundice so common at NB?

Answer 14

High number of RMCs
Shorter RBCs lifespan
Slower liver conjugation

Question 15

If preterm delivery anticipated?

Answer 15

Magnesium sulfate given
-decrease uterine contractions and stop cervical dilation

Betamethazone IM for fetal lung maturity

Question 16

preterm infants
#1 urgent health problem?
What are the causes?

Answer 16

Respiratory
Lungs are not fully mature

Question 17

Respiratory distress
What do we see?
Nursing considerations?

Answer 17

Cyanosis or pallor
tachypnea, retractions
flaring, grunting

Respiratory Assessment
Ability of infant to breathe
Maintain respiratory function
Energy consumption
Risk for aspiration
DO NOT bottle feed a baby in respiratory distress!

Question 18

RDS
What causes it?
Who is at risk?

Answer 18

Lack of sufficient surfactant causes the NB to work harder to breathe

Premature newborns and infants of diabetic mothers (IDM)

Question 19

RDS
Interventions

Answer 19

Need some O2 mechanical assistance
The longer oxygen and respiratory support is required, the greater the risk that the infant will develop Bronchopulmonary Dysplasia or Retinopathy of Prematurity=blind

Question 20

Transient Tachypnea of the Newborn
TTN?

Answer 20

A failure of the lungs to clear the amniotic fluid
resolves quickly thus decreasing the chance of the complications that go with long-term respiratory support

Question 21

TTN
Who is at risk?
Nursing considerations?

Answer 21

LGA and late preterm
IDM
c-section NB

Initiating oxygen therapy
IV fluids
Restricting oral feedings until respiratory status improves

Question 22

An immature gut
Problem?
What can we encourage?

Answer 22

Poor sucking, small stomach capacity

BREASTFEEDING!
broken down easier

Question 23

Premature newborns have
a) less what? 2
b) decreased what?
c) skin?

Answer 23

a) subcutaneous fat
less brown fat
b) glycogen stores
c) Thinner

Question 24

Premature newborns
cold stress sets up?

Answer 24

Hypoglycemia
Pulmonary vasoconstriction
Hyperbilirubinemia
Respiratory distress
Metabolic acidosis

Question 25

Neonatal Sepsis
Findings

Answer 25

cool, clammy skin
Hypothermia

Question 26

1 causes of Neonatal Sepsis

What to do?

Answer 26

Group B strep
Ampicillin IV during labor every 4 hr until delivery

Question 27

What are common antibiotics for NB? 2

Answer 27

Ampicillin and Gentamycin
Be sure all cultures are collected before antibiotics are started if possible.

Question 28

NAS baby?

Answer 28

Neonatal abstinence syndrome

Question 29

NAS babies care?

Answer 29

A lot of time just to comfort and control their agitated behaviors
Offer a pacifier
Encourage the parents in the plan of care(they have poor coping skill)
Avoid judgmental actions and comments
Position on right side or semi-Fowler to avoid aspiration with regurgitation or vomiting