Newborn complications pp

Question 1

A type blood
Antibody is?

Answer 1

B

Question 2

B type blood
Antibody is?

Answer 2

A

Question 3

O type blood
Antibody is?

Answer 3

A, B

Question 4

SGA
percentile?

Answer 4

NB whose birth weight is at or below the 10 percentile and has intrauterine growth restriction

Question 5

Sally
1st at 39 weeks
2nd at 38 week
she had an early miscarriage between the two pregnancies

35 weeks and 5 days
states her water might have broken yesterday
No contractions
baby is 10th percentile

What else do you need to know?

Answer 5

Has the mother been given any antibiotics?
GBS status?
Fluid color?
Has she had anatomy U/S?
Mom’s temp?
FHR tracing?
How accurate is the due date?

Question 6

What is the first action when a baby born?

Answer 6

Dry!!!
Suction
Evaluate respiratory assistance

Question 7

Apgar Score
a) 0-3
b) 4-6
c) 7-10

Answer 7

a) severe distress
b) moderate
c) normal

Question 8

Apgar Score
At one-minute, she has a weak cry
a pale body with blue hands and feet
heart rate of 180
only grimaces with suctioning and has weak muscle tone.

Answer 8

weak cry, -1
pale body with blue hands and feet, -0
heart rate of 180, -2
only grimaces with suctioning -1
weak muscle tone -1

Question 9

Apgar Score
At five minutes
a pink trunk with blue hands and feet
she is breathing regularly and fast,
heart rate is 170
arms and legs are flexed,
pulls away from stimulation such as suctioning.

Answer 9

A 1
P 2
G 2
A 2
R 2
= 9

Question 10

How does hypoxia affect the respiratory system?

Answer 10

Hypoxia induces a breathing pattern of rapid and shallow breaths

Question 11

What is the risk of hypoxia at 1 mints life of NB?

Answer 11

Return to fetal circulation
Increased risk of respiratory distress
Increased risk of hypoglycemia and physiologic jaundice

Question 12

What are some risk factors for SGA?

Answer 12

Infection,
hypothermia,
hypoglycemia,
physiologic jaundice,
respiratory distress

Question 13

What nursing interventions while the baby is still in the birth room?

Answer 13

Collect cord blood
Erythromycin ointment to eyes
Vitamin K injection
Blood glucose reading within the first hour
Observing vital signs and evaluating the need for transfer to NICU

Skin-to-skin with mom Educating S-T-S, breastfeeding, stabilizing infant’s temp, glucose

Question 14

Breastfeeding education

Answer 14

More digestible(easy)
Protective antibodies
Decreases allergic response
Increased bonding
Protect from bacterial contamination

Question 15

Sally refused to breastfeed to Mia
T – 97.9 axillary
P – 152
R – 56
Blood glucose with heel stick – 38
What nurse’s action?

Answer 15

Feed the baby formula
Maintain a neutral thermal environment
Decrease stimuli
Recheck BG after feeding
Notify the physician

Question 16

What does the physician caring for Mia need to know about her?

Answer 16

-Gestational age (confirmed by Ballard)
-Birth weight
-SGA status
-Current Vital signs
-Current Blood glucose level & amount of feeding

-Mom’s blood type to check against cord blood

Question 17

What symptoms would indicate that Mia is becoming infected?

Answer 17

Any signs of respiratory distress!!!
tachypnea
cyanosis
grunting, retracting, nasal flaring,
tachycardia
poor color

Question 18

What does the nurse need to do before starting the antibiotics?

Answer 18

Obtain cultures!!!
DO not forget this!!

Question 19

Nursing care for mom whose baby is in NICU
What nurse to do?

Answer 19

Answer questions!!!
Encourage mom to visit as often as she is able.
Encourage mom to touch and hold a baby(kangaroo care)
Let mom be involved in as much of the care as possible.

Question 20

At 12 hours of age
Mia becomes fussy with frequent sneezing and jittery movements.
She doesn’t want to eat, is stiff when the nurse tries to console her and won’t go back to sleep.
Her lab values do not indicate a current infection, her blood glucose was 52 and her blood type is A+
a)
What is Mia’s behavior indicative of?
b)
What actions by the nurse are appropriate at this time?

Answer 20

a) Neonatal withdrawal syndrome
b) Notify physician, request urine or meconium drug screen

Question 21

A drug test was positive, what nursing actions need to for NAS?

Answer 21

Finn score before feeding
Position to prevent aspiration
I&O
Pacifier
Dark, quiet area of the NICU
Social services consult
Clustered care

Question 22

Now 36 hours old and has visible jaundice on her face and trunk.

What assessments does Mia need related to this finding?

Answer 22

Bilirubin blood test
Weight
Intake & Output

Question 23

Mia’s birth weight was 3lbs, 6oz.
Her weight at 24 hours is 3lbs, 1oz. What percent of her birth weight has she lost?

Answer 23

1lb=16oz
54 oz – 49 oz= 5 oz
5/54 = .09 = 9%

This is TOO much

Question 24

What is poor feeding in babies?

.

Answer 24

“Poor feeding in infants” is a term used to describe an infant with little interest in feeding

Question 25

What is contributing to Mia’s weight loss?

Answer 25

NAS & poor feeding
NAS symptoms is poor feeding
Prematurity contributing to weak suck and poor absorption of oral intake

Question 26

What are some nursing interventions to improve her outcome?

Answer 26

Semi-elevated, side-lying position
Tube feedings
Special formulas
IV fluids
Consultation with speech therapist

Question 27

Mia’s bilirubin level comes back in the “at risk” zone and bili lights are ordered. What contributed to her bilirubin level being so high at her age?

Answer 27

ABO incompatibility
Mom O+
Mia A+
Prematurity,
NAS stress
IUGR status