PAGE UPTO 9 Flashcards
What is the gestational age for a term newborn?
37 to 42 weeks AOG.
What is the gestational age for a preterm newborn?
Less than 37 weeks AOG.
What is the gestational age for a postterm newborn?
Greater than 42 weeks AOG.
What age range defines a neonate?
Birth to 28 days.
What period in childhood has the highest mortality rate?
The neonatal period.
When is the greatest risk of mortality for a neonate?
In the first several days after birth.
What is the 1st priority for a newborn after birth?
Initiation and maintenance of respirations.
What is the 2nd priority for a newborn after birth?
Establishment of extrauterine circulation.
What is the 3rd priority for a newborn after birth?
Maintenance of fluid and electrolyte balance.
What is the 4th priority for a newborn after birth?
Control of body temperature.
What is the 5th priority for a newborn after birth?
Intake of adequate nourishment.
What is the 6th priority for a newborn after birth?
Establishment of waste elimination.
What is the 7th priority for a newborn after birth?
Prevention of infection.
What is the 8th priority for a newborn after birth?
Establishment of an infant–parent/caregiver relationship.
What is the 9th priority for a newborn after birth?
Institution of developmental care.
How soon should respirations be established after birth?
Immediately.
What can develop by 2 minutes without respirations?
Severe acidosis.
What factors put a newborn at risk for acidosis at birth?
Asphyxia in utero
What happens if fetal circulatory shunts fail to close?
Persistent right-to-left shunting.
What are the 3 main steps of newborn resuscitation?
(a) establish airway
(b) expand the lungs
(c) initiate and maintain effective ventilation
When are chest compressions done in a newborn?
If HR is below 60 bpm.
What is often enough to initiate breathing in a term newborn?
Warming
How is a newborn positioned if they fail to breathe?
Sniffing position under a radiant warmer.
Do meconium-stained newborns who are breathing need suctioning?
No suctioning is needed if they are breathing well.
What if the meconium-stained newborn has poor tone and breathing?
Resuscitation and positive pressure ventilation.
When is mechanical suctioning indicated?
Only if there is an obstruction.
What is primary apnea in a newborn?
Pause in breathing > 20 seconds with bradycardia.
What follows primary apnea?
Secondary apnea and asphyxia.
What does a crying newborn indicate?
Good lung expansion.
What rate should bag and mask ventilation be administered?
40 to 60 breaths per minute.
How should oxygen be delivered to a newborn?
Warmed (32°–34°C) and humidified (60%–80%).
What is an orogastric tube used for in newborn resuscitation?
To deflate the stomach and improve ventilation.
What tool monitors oxygen saturation in a newborn?
Pulse oximetry.
Is skin color a reliable indicator of oxygenation?
No
What are early signs of respiratory compromise?
Increased RR
How should the newborn be positioned for optimal breathing?
On their back with the mattress head elevated 15°.
When should chest compressions be started?
If HR is < 60 bpm.
How are chest compressions performed on a newborn?
Thumbs on sternum
When should compressions be stopped?
If HR rises > 60 bpm but continue ventilations if HR < 100 bpm.
What causes hypoglycemia after resuscitation?
Increased glucose utilization during breathing effort.
What IV fluid is given for hypoglycemia?
10% dextrose in water.
What indicates inadequate fluid intake?
Urine output < 2 ml/kg/hr or specific gravity > 1.015–1.020.
What are signs of hypovolemia?
Tachypnea
How is hypovolemia treated?
Isotonic solution and vasopressors like dopamine.
Why keep a newborn in a neutral thermal environment?
To minimize metabolic demands.
What happens if a newborn gets too cold?
Increased O2 demand → hypoxia → acidosis → kernicterus.
What methods prevent hypothermia?
Cap
How are premature newborns fed initially?
Gavage or gastrostomy.
Why is breast milk preferred?
Provides immune protection.
What is a benefit of pacifier use?
Reduces the risk of SIDS.
Who should NOT use a pacifier?
Infants too immature to suck or awaiting surgery for TEF.
What is expected within 24 hours of birth?
Voiding and stool passage.
What does urination during resuscitation suggest?
Improved kidney perfusion and BP.
What infections are contracted in utero?
Cytomegalovirus
Toxoplasmosis
What perinatal infections occur during birth?
HSV-2
What pathogens cause early-onset sepsis?
GBS
What pathogens cause late-onset infections?
Staphylococcus aureus
How can bonding be encouraged in NICU?
Orient parents
What defines prematurity?
Birth before 37 weeks or weight < 2500 g.
What race has the highest rate of prematurity?
African American infants.
What complications are premature infants at risk for?
RDS
What factors increase prematurity risk?
Poor nutrition
How do preterm infants typically look?
Small
What reflexes are diminished in preterm infants?
Sucking
What is anemia of prematurity?
Normochromic
What can cause kernicterus?
High indirect bilirubin and acidosis.
What is a treatment for PDA?
Indomethacin or ibuprofen.
What is intraventricular hemorrhage?
Bleeding due to fragile cerebral vasculature.
What defines a postterm infant?
Born after 42 weeks gestation.
What are signs of postterm syndrome?
Dry
What complications can postterm infants face?
Hypoglycemia
What causes SGA?
Placental insufficiency
How does an SGA baby appear?
Wasted
What is the primary risk in infants of diabetic mothers?
Hypoglycemia.
What congenital malformations are common in infants of diabetic mothers?
Cardiac defects
What is macrosomia?
Birth weight > 4000g.
What complication is common with macrosomia?
Birth trauma.
What is hyperbilirubinemia?
Excessive bilirubin in the blood.
What is physiologic jaundice?
Jaundice that occurs after 24 hours of birth.
What is pathologic jaundice?
Jaundice that occurs within the first 24 hours.
What is kernicterus?
Bilirubin-induced brain dysfunction.
How is hyperbilirubinemia treated?
Phototherapy.
What is the purpose of phototherapy?
Convert bilirubin to a water-soluble form.
What is RDS?
Respiratory Distress Syndrome.
What causes RDS?
Lack of surfactant.
What are symptoms of RDS?
Grunting
How is RDS treated?
Surfactant replacement therapy.
What is NEC?
Necrotizing Enterocolitis.
What causes NEC?
Intestinal ischemia and bacterial invasion.
What are signs of NEC?
Abdominal distension
How is NEC treated?
Bowel rest
What is BPD?
Bronchopulmonary Dysplasia.
What causes BPD?
Prolonged oxygen therapy and mechanical ventilation.
What is IVH?
Intraventricular Hemorrhage.
What are signs of IVH?
Bulging fontanelle
What is ROP?
Retinopathy of Prematurity.
What causes ROP?
Abnormal retinal vascular development due to oxygen therapy.
How is ROP managed?
Regular eye exams
What is sepsis neonatorum?
Neonatal sepsis.
What are signs of neonatal sepsis?
Temperature instability
How is neonatal sepsis treated?
IV antibiotics.
What is TTN?
Transient Tachypnea of the Newborn.
What causes TTN?
Delayed clearance of fetal lung fluid.
What are signs of TTN?
Rapid breathing
How is TTN managed?
Supportive care
What is MAS?
Meconium Aspiration Syndrome.
What causes MAS?
Aspiration of meconium-stained amniotic fluid.
What are signs of MAS?
Respiratory distress
How is MAS treated?
Suctioning
What is hypoglycemia in neonates?
Blood glucose < 40 mg/dL.
What are signs of neonatal hypoglycemia?
Jitteriness
How is neonatal hypoglycemia treated?
Early feeding or IV glucose.
