OB Exam 4

Question 1

Most newborns

Answer 1

• 40 weeks
• weigh 5.5 to 10 pounds
• 18 to 23 inches

Question 2

SGA

Answer 2

Small for gestational age

-fall below the 10th percentile

Question 3

AGA

Answer 3

Appropriate for gestational age

-fall between the 10th and 90th percentile

Question 4

LGA

Answer 4

Large for gestational age

-fall above the 90th percentile

Question 5

LBW

Answer 5

weigh less than 2,500 g

Question 6

VLBW

Answer 6

weigh less than 1500 g

Question 7

ELBW

Answer 7

weigh less than 1000 g

Question 8

Signs of respiratory distress

Answer 8

• nasal flaring
• grunting
• substernal or subcostal retractions

Question 9

Preterm or Premature (wks)

Answer 9

less than 37 weeks gestation

Question 10

Post term or Postmature (wks)

Answer 10

greater than 42 weeks gestation

Question 11

Term (wks)

Answer 11

between 37 and 42 weeks gestation

Question 12

Intraventricular hemorrhage (IVH)

Answer 12

Bleeding in brain

• bulging fontanels
• H&H low
• pale and weak
• increased head circumference
• poor perfusion
• Can result in coma or seizure

Question 13

Retinopathy or prematurity (ROP)

Answer 13

Less than 28 weeks
Retinal nerve isn’t developed enough
-Can cause blindness
-Usually results in glasses

Question 14

Necrotizing enterocolitis

Answer 14

Blockage in bowel resulting in ischemia of bowel

-possible bowel reconstruction or colostomy

Question 15

Do you feed a respiratory distress baby by bottle?

Answer 15

No. Risk of aspiration is too great

Question 16

T or F: Can we feed a baby with a bottle until they stop and then deliver the rest by NG or OG?

Answer 16

T. They burn a lot of calories by sucking on the bottle

Question 17

T or F: Can we flip them prone to supine to prevent skin breakdown?

Answer 17

T as long as they are on continuous O2 and apnea monitor

Question 18

What is one of the characteristics of the preterm newborn?

a. High caloric needs
b. Low caloric needs
c. Extremities are short and appear stunted
d. Extremities appear longer than normal

Answer 18

a. High caloric needs

Rationale: High caloric needs but has a digestive system that may be unprepared to receive and digest food.

Question 19

Predisposing factors of post term newborns

Answer 19

• First pregnancies between the ages of 15 and 19 years
• Women older than 35 years with multiple pregnancies
• Certain fetal anomalies

Question 20

Characteristics of post term babies

Answer 20

• Little lanugo or vernix
• Scalp hair is abundant
• Fingernails are long
• Little subcutaneous fat
• Appears long and thin

Question 21

Complications of post term

Answer 21

• Polycythemia

- Meconium aspiration syndrome

Question 22

Transient tachypnea of the newborn (TTN)

Answer 22

Fast breathing

• give one hour of oxygen support
• let them cry to remove fluid from lung

Question 23

Meconium aspiration syndrome (MAS)

Answer 23

• intubated
• antibiotics
• good nutrition

Question 24

Sudden infant death syndrome (SIDS)

Answer 24

Most causes are unknown

• no extras in crib with baby
• no cosleep
• back to sleep
• don’t over heat the room
• turn on fan
• no smoking

Question 25

Is hemolytic anemia a big risk?

Answer 25

Yes

Question 26

Fetal alcohol syndrome

Answer 26

Occurs when mother ingests alcohol and it causes neuro defects

Question 27

Neonatal substance withdrawal

Answer 27

Occurs when the mother ingests drugs of any kind and the baby is born addicted to the drug
-shrillest high pitch cry
-very easy to wake
-may be given methadone to help
-can seize, go into comas, or die
-Always do a social service call
-Collect the stool to check for drugs
because the meconium can have traces of the drugs