Newborn complications pp Flashcards
A type blood
Antibody is?
B
B type blood
Antibody is?
A
O type blood
Antibody is?
A, B
SGA
percentile?
NB whose birth weight is at or below the 10 percentile and has intrauterine growth restriction
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?
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?
What is the first action when a baby born?
Dry!!!
Suction
Evaluate respiratory assistance
Apgar Score
a) 0-3
b) 4-6
c) 7-10
a) severe distress
b) moderate
c) normal
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.
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
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.
A 1
P 2
G 2
A 2
R 2
= 9
How does hypoxia affect the respiratory system?
Hypoxia induces a breathing pattern of rapid and shallow breaths
What is the risk of hypoxia at 1 mints life of NB?
Return to fetal circulation
Increased risk of respiratory distress
Increased risk of hypoglycemia and physiologic jaundice
What are some risk factors for SGA?
Infection,
hypothermia,
hypoglycemia,
physiologic jaundice,
respiratory distress
What nursing interventions while the baby is still in the birth room?
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
Breastfeeding education
More digestible(easy)
Protective antibodies
Decreases allergic response
Increased bonding
Protect from bacterial contamination
Sally refused to breastfeed to Mia
T – 97.9 axillary
P – 152
R – 56
Blood glucose with heel stick – 38
What nurse’s action?
Feed the baby formula
Maintain a neutral thermal environment
Decrease stimuli
Recheck BG after feeding
Notify the physician
What does the physician caring for Mia need to know about her?
-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
What symptoms would indicate that Mia is becoming infected?
Any signs of respiratory distress!!!
tachypnea
cyanosis
grunting, retracting, nasal flaring,
tachycardia
poor color
What does the nurse need to do before starting the antibiotics?
Obtain cultures!!!
DO not forget this!!
Nursing care for mom whose baby is in NICU
What nurse to do?
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.
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?
a) Neonatal withdrawal syndrome
b) Notify physician, request urine or meconium drug screen
A drug test was positive, what nursing actions need to for NAS?
Finn score before feeding
Position to prevent aspiration
I&O
Pacifier
Dark, quiet area of the NICU
Social services consult
Clustered care
Now 36 hours old and has visible jaundice on her face and trunk.
What assessments does Mia need related to this finding?
Bilirubin blood test
Weight
Intake & Output
Mia’s birth weight was 3lbs, 6oz.
Her weight at 24 hours is 3lbs, 1oz. What percent of her birth weight has she lost?
1lb=16oz
54 oz – 49 oz= 5 oz
5/54 = .09 = 9%
This is TOO much
What is poor feeding in babies?
.
“Poor feeding in infants” is a term used to describe an infant with little interest in feeding
What is contributing to Mia’s weight loss?
NAS & poor feeding
NAS symptoms is poor feeding
Prematurity contributing to weak suck and poor absorption of oral intake
What are some nursing interventions to improve her outcome?
Semi-elevated, side-lying position
Tube feedings
Special formulas
IV fluids
Consultation with speech therapist
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?
ABO incompatibility
Mom O+
Mia A+
Prematurity,
NAS stress
IUGR status
