Part 1 Newborn At Risk

Question 1

Common problems in high risk infants (5)

Answer 1

Resp distress syndrome

Meconium aspiration syndrome

Germinal matrix hemorrhage (IVH)

Retinopathy of prematurity

Necrotizing enterocolitis

Question 2

Meconium aspiration syndrome

-sign after rom
-stains what
-increasted what
-CXR shows what

Answer 2

Meconium stained amniotic fluid

Staining nails,skin,umbilical cord

Increases respiratory distress

CXR:
-patchy infiltrates
-atelectasis

Question 3

Meconium aspiration syndrome

Tx

Answer 3

Suction at delivery

Respiratory support

Broad spectrum abx (if aspirated & in resp distress)

Surfactant and inhaled nitric oxide (thru vent)

ECMO

Question 4

Germinal matrix hemorrhage (IVH)

Usually what age
-risk factors
-clinical signs

Answer 4

Usually preterm (<34 wk)

risk factors:
-hypoxia
-perinatal asphyxia
-RDS (resp distress)

Clinical signs:
-decreasing H/H
-full/bulging anterior fontanel
-change in activity
-decreased muscle tone

Question 5

Germinal matrix hemorrhage (IVH)

-TX

-declining incidence

Answer 5

-tx:
-HOB elevated
-swaddling
-cluster care

Declining incidence:
-surfactant and steroid use prior to delivery

Question 6

Retinopathy of prematurity (ROP)

Causes what
Caused by abnormal what
Main cause?

Answer 6

Causes of blindness in premature infants

Abnormal growth of retinal blood vessels

Main cause: high O2 levels or severe fluctuation can cause vasoconstriction

Question 7

Retinopathy of premarturity (ROP)

Prevention

Answer 7

Administer as little O2 as possible
Wean as tolerated

Monitor O2 sats continuously

Question 8

Necrotizing entercolitis

What it is

Assessment

Answer 8

Acute inflammatory disease of GI mucosa
-commonly complicated by bowel necrosis and perforation

Assessment:
-feeding intolerance
-bilious emesis
-abd distention
-blood in stool

Question 9

Necrotizing entercolitis (NEC)

Tx

Answer 9

NPO
NG/OG for gastric decompression
IVF/TPN
Abx
Bowel resection