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Maternity & Women's Health > Newborn Hyperbilirubinemia > Flashcards

Newborn Hyperbilirubinemia Flashcards

1
Q

Causes of NB hyperbilirubinemia?

A
  • hemolysis
  • decreased serum albumin binding
  • Impaired liver function
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2
Q

Condition resulting from a deposition of yellow pigmentation in the basal ganglia of the brain in NB?

A

Kernicterus (bilirubin > 25)

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3
Q

Therapy for hyperbilirubinemia?

A
  • phototherapy
  • hydration
  • protect the eye
  • observe for:
  • dehydration, diarrhea, rashes
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4
Q

The NB presents with dimished Moro reflex, poor sucking, high-pitched cry, setting sun eyes, a sunken anterior fontanel and green stool, what do you suspect?

A

hyperbilirubinemia

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5
Q

How does phototherapy help tx hyperbilirubinemia in a NB?

A

speeds up conjugation of bilirubin

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6
Q

What is Iso-Immunization?

A

development of antibodies against antigens from the same species

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7
Q

What is the medication given to prevent Iso-immunization from Rh factor?

A

Rhogam

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8
Q

What is Erythroblastosis Fetalis?

A

when the fetus produces large amounts of immature erythrocytes to replace those lost due to anemia

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9
Q

What is hydrops fetalis?

A
  • severe form of Erythroblastosis Fetalis
  • fetus has marked anemia, cardiac decompensation, cardiomegaly, and hepatosplenomegaly
  • tx is done in utero with a transfusion via the umbilical cord after 17 weeks of gestation
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10
Q

Why is a COOMBS test done?

A
  • to determine presence of Rh/ABO serum antibodies
  • Direct - tests cord blood
  • Indirect - tests mom’s serum
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11
Q

Why is the Kleihauer-Betke test done?

A
  • measures the amount of fetal hemoglobin transferred to mothers bloodstream
  • to test for the need for RhoGam
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12
Q

When is RhoGam given?

A
  • only if woman is Rh- and not sensitized
  • Anterpartum at 28 weeks
  • Within 72 of:
    • significant 1st or 2nd timester bleeding
    • abortion or miscarriage
    • CVS or amniocentesis
    • birth of Rh+ baby
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13
Q

How long do the effects of Rhogam last?

A

12 weeks

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14
Q

Baby presents with elbow ectended, hand rotated inward, no moros’ reflex and intact grasp in one arm. What do you suspect and how to treat?

A
  • Erb Duchennes palsy

- immobility for 1st week, then passive ROM

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15
Q

What is the vector for toxoplasmosis?

A

cat feces (garden soil) and raw or undercooked beef or pork

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16
Q

How is an infection with toxoplasmosis dx in an NB?

A

elevated cord blood serum IgM

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17
Q

Group B Strep can lead to what in a newborn?o

A

sepsis, pneumonia, meningitis

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18
Q

How long is the NB observational period for GBS?

A

48 hrs after delivery

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19
Q

How is fetal alcohol syndrome diagnosed?

A
  • facial characteristics
  • growth delays
  • CNS
    • developmental delays
    • mental retardation
    • behavioral problems
    • learning disabilities/hyperactivity
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20
Q

FAS facial features?

A
  • microcephaly
  • short palpebral fissures
  • flat midface
  • low nasal bridge
  • epicanthal folds
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21
Q

NB withdrawal symptoms (CNS)?

A
  • irritable
  • jittery
  • high pitched cry
  • vomitting
  • seizure activity
22
Q

NB withdrawal symptoms (Resp)?

A

tachypnea, tachycardia, nasal stuffiness

23
Q

4 defects of the Tetralogy of Fallot?

A
  • pulmonary stenosis
  • right ventricular hypertrophy
  • ventricular septal defect (VSD)
  • over riding aorta
24
Q

Spina bifida; meningocele?

A

exposed sac contains meninges & CSF, no nerves

25
Q

Spina bifida: myelomeningocele?

A

meninges, CSF and nerve

26
Q

When does the neural tube normally close?

A

17-30 days after gestation

27
Q

What is an Omphalocele?

A

abd organs are protruding from umbilicus, but covered by peritoneal membrane

28
Q

What is a Gastroschisis?

A

abd organs are protruding from umbilicus and uncovered

29
Q

The post partum period can last how long?

A

up to 6 weeks

30
Q

What is the avg blood loss during a vaginal delivery and c-section?

A

300 - 500 mL & 500- 1000 mL

31
Q

A positive Hohman’s sign is an indicator of what?

A

thromboembolism

32
Q

Uterus fundal height changes after birth:

1) by 12hr
2) day 1-8
3) day 9
4) by 5-6 weeks

A

1) 1 cm above umbilicus
2) decreases 1 cm / day
3) not palpable
4) near non-pregnant size

33
Q

A “boggy” uterus is a sign of what?

A

internal bleeding

34
Q

What does methergine do?

A

causes sustained uterine contractions

35
Q

What is Lochia?

A

fleshy smelling, vaginal discharge after delivery

36
Q

Lochia color changes:

1) 1st 2-3 days
2) 3 - 10 days
3) 10 - 21 days

A

1) rubra - dark red, some clotts
2) serosa - pink, brown
3) alba - yellow, clear

37
Q

Lochia amounts:

1) scant
2) light
3) moderate
4) heavy

A

1) < 2.5 cm
2) < 10 cm
3) > 10 cm
4) 1 pad saturated w/in 1 hr

38
Q

What is the acronym for the episiotomy scale?

A

REEDA

39
Q

What does REEDA stand for?

A 
Redness
Edema
Ecchymosis
Discharge
Approximation
40
Q

3 types of placental adherent?

A

accreta, increta, percreta

41
Q

Placental penetration into the uterine wall but not through to the muscle

A

placenta accreta

42
Q

placental penetration to the uterine muscle?

A

placenta increta

43
Q

placental penetration through the entire uterine wall and attaches to another organ?

A

placenta percreta

44
Q

Initial care of post partum hemorrhage?

A

massage the fundus

45
Q

What is a cardinal sign of a pp infection?

A

fever on 2 consecutive days during first 10 days pp

46
Q

What is subinvolution?

A

uterus does not return to normal size pp and a major sign of endometritis

47
Q

What is the most common PP infection?

A

endometritis

48
Q

Symptoms of endometritis?

A
  • foul smelling lochia
  • tender, boggy uterus
  • fever (chills)
  • increased pulse
49
Q

Mastitis usually occurs when?

A

2-4 weeks PP

50
Q

How to differentiate mastitis from engorgement?

A

mastitis is unilateral with a fever, engorgement is bilateral without fever

51
Q

PP Mental health?

A

1) baby blues = 2-10 days

2) PPD = sadness persists beyond 2 wks PP

Maternity & Women's Health (18 decks)

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