NICU Medical Complications (Except for RDS) Flashcards
What is BPD and what is the cause?
Bronchopulmonary Dysplasia; results from abnormal healing of lung disease during neonatal period.
Prolonged mechanical ventilation can cause what from a baby after 28 days?
Thickened, hyper-reactive airways, decreased lung compliance and increased airway resistance– Increases correlation with developmental delay
Give the name of the syndrome where there is meconium in the amniotic fluid that the baby breathes in perinatally.
Meconium Aspiration Syndrome
What is the result of MAS?
Because meconium is toxic to the lungs is causes a decrease in 02 to the brain and compromised lung function.
What is the cause of periventricular Leukomalacia (PVL)?
Symmetrical non-hemorrhagic ischemic lesion to brain near the lateral ventricles caused by decreased 02 to the brain perinatally
What is the cause of PVL and how would you treat it?
Cause: Decreased O2 to brain perinatally
Treatment: Address primary cause to minimize damage
How would you identify and diagnose a child with PVL?
Early Signs: poor suckling hypertonicity of Bilat. LE
Diagnosed: Cranial US/MRI
What is the result of PVL?
Spastic diplegia CP
Give the name of the complication that begins with hemorrhage occurring in the germinal matrix and extends the intraventricular space and results in brain damage due to decreased 02.
Germinal Matrix- IVH
Where is the matrix in GMIVH located? How common is it for a preemie to have this?
Matrix is located near branches of ant. and middle cerebral artery and internal carotid
This is the most common lesion for a preemie
Explain the 4 grades of germinal matrix- IVH.
I: isolated germinal matrix hemorrhage
II: IVH with normal ventricular size
III: IVH with ventricular dilation
IV: IV dilation with parenchymal hemorrhage
What are the risk factors and complications of germinal matrix- IVH?
Risks: <1500 g, Pneumothorax, tracheal suctioning, poor breathing
Complications: Neurological disabilities (CP), vision deficits, learning disabilities, and seizures.
What is the cause and result of Patent Ductus Arteriosis (PDA)?
Failure of the ductus arteriosus to close after birth
Results in blood flow between aorta and pulmonary artery
Explain the process of fetal circulation.
Blood enters RA-> RV-> Pulmonary artery-> ductus arteriosus-> descending aorta-> perfuses LE
Blood enters RA-> LA via foramen ovale-> LV-> aorta-> brain and UE
T/F A patent foramen oval is always dangerous and should be immediately addressed.
False; a patent foramen ovale may not ever be an issue
Give the steps for a normal first breath
- Lungs open & pulmonary vascular resistance decreases
- Lungs release bradykinin to constrict smooth mm of DA
- Withdrawal of maternal prostaglandins also contributes to DA closing
- DA should close 12 hrs- 1 week of life
What is the result of PDA?
Blood from the aorta is shunted through the DA to the pulmonary artery to the lungs (lungs have to work extra)
Give the signs and treatment for PDA.
Signs: difficulty breathing and failure to thrive/gain weight
Treatment: Sx to close after 2 weeks
In a preemie what else can delay the closure of the DA?
Hypoxia
Give the other name and cause of jaundice in babies.
Hyperbilirubinemia (physiological jaundice due to excessive amounts of bilirubin)
-Caused by immature hepatic function or increased hemoglobin through bruising
What are the results and treatment of Hyperbilirubinemia?
Results: decreased activity and arousal
Treatment: Phototherapy and biliblanket
If jaundice goes untreated it is called what?
Kernicterus: deposits of unconjugated bilirubin in brain that leads to neuronal injury (highly associated with athetoid CP)
Describe GERD.
Gastroesophageal reflux disease- movement of gastric contents in a retrograde fashion into the esophagus
GERD is attributed to what causes and is diagnosed with what symptoms?
Causes: Lower esophageal sphincter relaxed
S/S: Poor feeding, excessive crying, oral aversion, apnea, and spit up
What are some of the risk factors associated with GERD?
Preemie, perinatal stress, delayed gastric emptying, diaphragmatic defects, NG tube
Motor patterns associated with GERD include what?
Increased cervical and trunk extension and not happy in prone (can lead to torticollis)
Treatment of GERD includes?
Elevating head of bed and meds
What is the most common cause of death to infants during and after surgery?
Necrotizing Enterocolitis (acute inflammatory disease of the immature intestines resulting in acute intestinal necrosis)
What is the cause of NEC and what symptoms are associated with it?
Cause: Mucosal injury to the intestinal tract (often post sx)
Symptoms: Respiratory distress, bradycardia, distention and tenderness in the abdomen
How would you treat NEC?
NPO, gastric suction, antibiotics, and surgery
What is ROP and what does it stand for?
Retinopathy of Prematurity; abnormal blood vessel development in the retina of the eye (in a preemie)
Risk factors for ROP include?
Supplemental O2 (#1), <30 weeks GA, hypoxia, IVH, RDS, PDA, and vitamin E deficiency
What are the symptoms for ROP? How many stages are associated with ROP?
Symptoms: Abnormal movements of the eye, cross eyed, white looking pupils
Stages: There are 5, I - mild and V-Total bilat. retinal detachment
How would you prevent or treat ROP?
Prevent by keeping O2 between 50-70 mm Hg
Treatment with surgery
Prenatal cocaine Exposure increases a babys risk for?
Premature labor, spontaneous abortion, placental abruption, fetal distress, cardiac problems, low APGAR scores, cerebral damage
Symptoms of withdrawal cause problems after birth and later in life. Describe those problems.
After birth: difficulty sleeping, tremors, irritability, inconsolable crying, poor motor skills
Later in Life: Behavior problems, language delay, poor information processing, impaired motor planning, attention deficits, and sensory integration dysfunction
