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Sophomore 1 Test 3 > Newborn at Risk > Flashcards

Newborn at Risk Flashcards

1
Q

What is late preterm?

A

34-36 weeks

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2
Q

Early preterm?

A

Before 34 weeks

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3
Q

Classification of high risk infants

A
  1. AGA
  2. LGA
  3. SGA
  4. IUGR
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4
Q

What is IUGR?

A

Intrauterine growth resolution
- Placenta was not sufficient
“They have grown as much as they can in utero”
- They have a lot of trouble staying warm

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5
Q

Causes of IUGR

A
  1. Chronic diseases (HTN)
  2. Low socioeconomic status (poor nutrition)
  3. Substance abuse
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6
Q

Types of IUGR

A
  1. Asymmetrical - head continued to grow in utero

2. Symmetrical - riskier; head grows at same rate as the rest of the body

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7
Q

Possible Causes of preterm birth

A
  1. Highest incidence in lower socioeconomic groups
  2. Maternal infection
  3. Multifetal pregnancy
  4. Smoking
  5. No prenatal care
  6. Lack of birth spacing
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8
Q

Risk for Preterm Infants

A
  1. Respiratory distress syndrome
  2. PDA and PFO
  3. Suck, swallow, breathe
  4. Premature renal systems
  5. Highly susceptible to infections
  6. Impaired thermoregulation
  7. Intraventricular hemorrhage (IVH)
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9
Q

Respiratory distress syndrome

A
  1. Not enough surfactant

2. Apnea prematurity; “they forget to breathe”

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10
Q

Premature Renal Systems

A

Its difficult for them to process all of the meds they get as well as TPN

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11
Q

Why do premature infants have a difficult time thermoregulating?

A

Premature infants don’t have brown fat

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12
Q

IVH

A

Intraventricular Hemorrhage

  • A brain bleed in the ventricles
  • Try to keep the environment unstimulated
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13
Q

Risks for Late Preterm Infants (34-37 weeks)

A
  1. Thermoregulation
  2. Hypoglycemia
  3. Feeding issues
  4. Hyperbilirubinemia
  5. Sepsis
  6. Respiratory Distress
  7. Apnea
  8. Developmental delays
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14
Q

Describe Postterm Infants

A
  1. Born beyond 42 weeks
  2. Cause unknown
  3. Associated with placental insufficiency
  4. Meconium staining
  5. Long hair and nails
  6. Absent vernix
  7. Peeling skin
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15
Q

What is transient tachypnea of newborn (TTN)?

A

TTN occurs when all amniotic fluid is removed slowly or incompletely from baby’s lungs
- Common after cesarean birth

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16
Q

What does TTN look like?

A
  1. Observe for s/sx of respiratory distress within few hours of birth
  2. Within 6 hours, RR may be 100-140 bpm
    - IVF or enteral feedings until resolves
17
Q

How long does it take for TTN to resolve?

A

Should resolve by 72 hours

- They are always sent to the NICU because you can not PO feed a baby that is breathing so fast

18
Q

Risk factors for TTN

A
  1. Smoking mom
  2. Asthmatic mom
  3. Macrosonia
  4. C-section
  5. Lower gestational age
  6. Male sex
19
Q

Meconium Aspiration Syndrome (MAS)

A

Intrauterine fetal distress with passing of meconium before delivery

  • Can be mild to severe
  • May develop pneumonia and/or pneumothorax
20
Q

Mild MAS Symptoms

A

Tachypnea

21
Q

Severe MAS Symptoms

A
  1. Poor PO intake
  2. Respiratory distress
  3. Weak
  4. Floppy baby
  5. Neuro deficits from hypoxia
  6. Metabolic acidosis
22
Q

Necrotizing Enterocolitis (NEC)

A

Happens due to stress in utero or out where baby was hypoxic and the gut wasn’t getting oxygen.

23
Q

S/Sx of NEC

A
  1. Abdominal distention
  2. Bloody stools
  3. Feeding intolerance
  4. Bilious vomiting
24
Q

Lab tests to confirm NEC

A

An abdominal x-ray to demonstrate dilated bowel loops, abnormal gas patterns, air bubbles that occur from bacteria, and thickened bowel walls
- KUB to confirm air in bowel wall

25
Q

Treatment of NEC

A
  1. Bowel rest (First thing - hold feeding)
  2. Antibiotics
  3. IV fluids
  4. Surgery
26
Q

Normal BG after birth

A

50-60

27
Q

When to intervene with BG

A

If less than 30

28
Q

Treatment of hypoglycemia

A
  1. Feedings

2. IV dextrose

29
Q

S/Sx of hypoglycemia

A
  1. Sweating
  2. Poor feeding
  3. Lethargy
  4. Poor muscle tone
30
Q

What is the single most important factor influencing fetal well-being?

A

The euglycemic status of the mother

31
Q

Infants of Diabetic Mothers can result in what?

A
  1. Macrosomia
  2. RDS (4-6 times more likely)
  3. Hypoglycemia
  4. Hyperbilirubinemia
32
Q

Physiologic S/Sx Withdrawal

A
  1. Hyperactivity and irritability
  2. Nasal congestion with flaring
  3. Tachypnea
  4. Sweating
  5. Temp greater than 37.5 C
  6. Diarrhea
  7. LBW
  8. Seizures
33
Q

Withdrawal Symptoms (WITH)

A

W - wakefulness
I - irritability
T - temperature variation, tachycardia, tremors
H - hyperactivity

34
Q

Physiological Jaundice

A

(Normal Jaundice)

  1. Considered benign, manifests within 24 hours to 3 days
  2. Bilirubin may lead to hazardous conditions
  3. Increasing intake will aid to increase output
  4. Kernicterus
35
Q

Kernicterus

A

Bilirubin-induced neurologic damage that is preventable

36
Q

ABO incompatibility

A

It occurs if the fetal blood type is A, B, or AB and the maternal type is O.

  • Results in physiological jaundice
  • Treated with phototherapy
37
Q

Phototherapy

A
  1. Banked lights above infant or Bili blanket
  2. Infant uncovered as much as possible
  3. Cover eyes and genitals
  4. Monitor temp and UOP closely

Sophomore 1 Test 3 (4 decks)

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