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NU314 OB > Newborns w/ Special Needs > Flashcards

Newborns w/ Special Needs Flashcards

1
Q

What are some factors that will affect fetal growth?

A

maternal nutrition
genetics
placental functions
environmental factors

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2
Q

What are the common classifications of birth weight and term gestational age?

A

Appropriate for Gestational Age
Small for Gestational Age
Large for Gestational Age

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3
Q

AGA

A

Appropriate for gestational age

-normal

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4
Q

SGA

A

Small for gestational age

  • weight < 2500 g (5 lb 8 oz) at term
  • below 10th percentile
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5
Q

LGA

A

Large for gestational age

  • weight > 4000 g (8 lb 13 oz) at term
  • weight > 90th percentile
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6
Q

What are other terms used for marginal weight but ANY gestational age?

A

Low birth weight
Very low birth weight
Extremely low birth weight

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7
Q

LBW

A

Low birth weight

< 2500 g or 5.5 lb

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8
Q

VLBW

A

Very low birth weight

< 1500 g or 3 lb 5 oz

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9
Q

ELBW

A

Extremely low birth weight

< 1000 g or 2 lb 3 oz

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10
Q

SGA newborns are considered to have what?

A

Fetal Growth Restriction

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11
Q

Fetal Growth Restriction (FGR)

A

the rate of growth does not meet the expected growth pattern?

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12
Q

FGR can result from what?

A

Aneuploidy
Congenital malformations
Infections
Uteroplacental Insufficiency

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13
Q

FGR restriction is usually categorized as what?

A

Asymmetric or Symmetric

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14
Q

Symmetric FGR

A

Fetuses w/ equally poor growth rates of the brain, the abdomen, and the long bones and is thought to result from an early global insult

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15
Q

Symmetric FGR is thought to result from what?

A

An early global insult

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16
Q

Asymmetric FGR

A

infants whose brain growth is spared compared to their abdomen and internal organs

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17
Q

Typical Characteristics of SGA Newborns

A
  • head disproportionately large
  • wasted appearance
  • reduced fat
  • decreased breast tissue
  • scaphoid abdomen (sunken appearance)
  • wide skull sutures
  • poor muscle tone
  • thin umbilical cord
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18
Q

Common problems for SGA Newborns

A 
perinatal asphyxia
difficulty w/ thermoregulation 
hypoglycemia 
polycythemia 
meconium aspiration 
hyperbilirubinemia 
birth trauma
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19
Q

Nursing Management for SGA

A
  • weight, length, and head circumference measurements
  • serial BG monitoring
  • vitals
  • early/frequent oral feedings; IV infusions
  • S/S of polycythemia
  • anticipatory guidance
20
Q

Polycythemia

A

venous hematocrit > 65% and hemoglobin > 20 grams

21
Q

What are the clinical signs to watch for w/ Polycythemia?

A 
respiratory distress
cyanosis 
jitteriness 
jaundice 
ruddy skin color
lethargy
22
Q

Risk Factors for LGA Newborns

A 
Maternal Diabetes 
Multiparity 
History of macrosomnic infant 
Postdates gestation 
Maternal obesity 
Male fetus 
Genetics
23
Q

What fetal birth trauma can result for LGA newborns?

A

Shoulder dystocia
Clavicular fractures
Facial palsies

24
Q

LGA Newborn Common Characteristics

A

large body, plump, full faced
proportional increase in body size
poor motor skills
difficulty regulating behavioral states

25
Q

Common birth problems for LGA newborns are?

A

Birth trauma
Hypoglycemia
Polycythemia
Hyperbilirubinemia

26
Q

Hypoglycemia

A

blood glucose value < 40 mg/dL

27
Q

Nursing Management for LGA

A
  • Vitals/BG monitoring
  • Oral feedings w/ IV glucose prn
  • Monitor for S/S polycythemia/hypoglycemia
  • Hydration
  • Phototherapy for increased bilirubin levels
28
Q

Term

A

born from the first day of 38th week through 42 weeks

29
Q

Preterm

A

born before completion of 37 weeks

30
Q

Late Preterm

A

Born b/t 34 weeks/7 days and 36 weeks/6-7 days

31
Q

Postterm

A

born beyond 42 completed weeks

32
Q

What happens to the placenta after 42 weeks?

A

unable to provide adequate oxygen and nutrients

33
Q

Postterm Newborn Characteristics

A

-dry, cracked, wrinkled skin/possible meconium
-long, thin extremities; long nails; creases cover feet
-wide eyed, alert expression
-abundant hair on scalp
-thin umbilical cord
limited vernix/lanugo

34
Q

Common Problems for Postterm newborns are?

A 
perinatal asphyxia 
hypoglycemia 
hypothermia 
polycythemia 
meconium aspiration
35
Q

Postterm Newborn Nursing Management

A 
Resuscitation 
BG monitoring 
Initiation of feeding; IV Dextrose 
Prevent heat loss
Evaluation of polycythemia 
Parental support
36
Q

What problems can lead to preterm birth?

A

infection/inflammation
maternal/fetal distress
bleeding
stretching

37
Q

Common Problems for Preterm Newborn

A 
respiratory distress 
hemorrhage 
bronchopulmonary dysplasia 
retinopathy 
hyperbilirubinemia 
anemia 
necrotizing entercolitis 
hypoglycemia 
infection/septicemia 
mental/motor delays
38
Q

What problems affect the preterm newborn’s respiratory system?

A
  • Surfactant deficiency
  • unstable chest wall
  • immature respiratory control centers
  • small respiratory passageways
  • inability to clear fluids
39
Q

What is the main problem faced by the preterm newborns cardiovascular system?

A

changing from fetal to newborn circulation pattern

40
Q

What places the newborn at risk for malnutrition and weight loss if preterm?

A

Combination of shunting, ischemia, damage to intestinal wall, and poor sucking ability

41
Q

What will place the preterm newborn at risk for growth and developmental delays?

A 
Small stomach capacity
weak abdominal muscles
compromised metabolic function
limited ability to digest proteins/absorb nutrients 
weak/absent suck and gag reflexes
42
Q

Renal System problems of the preterm infant are?

A

reduced ability to concentrate urine and slow glomerular filtration rate

43
Q

What are the risks from the preterm newborns immature renal system?

A

Fluid retention
Fluid/electrolyte disturbances/increases
Increased risk drug toxicity

44
Q

Common Preterm Characteristics

A 
Weight < 5.5 lb
Scrawny/poor muscle tone/minimal fat
Undescended testes/Prominent labia and clitoris 
Plentiful lanugo/vernix 
Poorly formed ear pinna/Fused eyelids
Thin skin; absent/few creases
45
Q

Preterm Newborn Common Problems

A

Hypothermia
Hypoglycemia
Hyperbilirubinemia
Problems w/ immature body systems

46
Q

Nursing Management for Preterm Newborns

A 
oxygenation 
thermal regulation
nutrition/fluid balance 
infection prevention
stimulation
pain management 
growth/development 
parental support
47
Q

Perinatal Greif/Loss Management

A 
Effect on childbearing fams 
Parent/newborn interaction
Interventions
Sit quietly/observe 
Cultural differences

NU314 OB (21 decks)

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