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N330 > Part 2 On Final (Newborn Risk) > Flashcards

Part 2 On Final (Newborn Risk) Flashcards

1
Q

Soft tissue injuries

A

Ecchymosis & petechiae
Abrasions & lacerations
Edema
Scleral & retinal hemorrhages
Cephalhematoma
Forceps injury

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2
Q

Skeletal and nervous system injuries

A

Clavical : supportive care and pin arm to shirt

Brachial plexus injury: stimulate moro to test

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3
Q

Complications of infants w/ diabetic moms

A

Anomalies

Macrosomia

Birth trauma & asphyxia (bc so large)

RDS

Hypoglycemia (cause decrease surfactant = RDS)

Hyperbilirubinemia & polycythemia

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4
Q

Hypoglycemia

What number in the first how many hours of life

Risks

A

40 or less in 1st 72hrs of life

At risk:
-SGA
-LGA
-preterm
-infants of moms w/ diabetes
-Resp distress
-cold stress

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5
Q

Hypoglycemia manifestations

A

Jitteriness
Lethargy (not waking up for food)
Hypotonia
Hypothermia
Resp. Distress
Poor feeding

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6
Q

Hypoglycemia

Nursing management

A

Use facility protocol

-monitor blood sugar
-early and freq feedings
-administer glucose gel per protocol

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7
Q

Neonatal jaundice

Screen what 2 types
Screen how soon
Is transcutaneous level surpasses threshold then do what

A

TcB (transcutaneous)
TSB (serum)

Screened at minimum 24 hrs of life & prior to discharge
-unless showing signs of jaundice well do sooner

If transcutaneous levels surpass threshold for hours of life, serum bilirubin is collected

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8
Q

Types of jaundice

-physiological

After when
Increases what hours after birth
Levels decline by when and no greater than what

A

After 24 hours of age

Increases 72-120hrs after birth

Levels decline by 5-10 days, no greater than 10

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9
Q

Types of jaundice

Pathological

Before what hours

Persistent after what day

Rise how much per day

Gets to how much

A

Before 24 hrs of age

Persistent after day 14

Rise more than 5mg/dl per day

Rise to 15-20mg per day

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10
Q

Breast milk jaundice

Early vs late

What is happening

A

2-3 days of life (early)
5-7 days of life (late)

Enzyme in milk inhibits bilirubin conjugation

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11
Q

Breast milk jaundice tx

A

Continue breast feeding frequently

Supplement with formula until full supply is in and bilirubin levels drop

Phototherapy

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12
Q

Hemolytic disease of newborn

Destruction of what d/t what 2 things

Jaundice in 1st how many hours

2 lab findings

A

Destruction of RBCs from antigen-antibody reactions
1. RH incompatability
2. ABO:mom with O blood (anti A & B cross placenta)

Jaundice in 1st 24hrs

-hyperbilirubin
-anemia (rapid RBC destruction)

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13
Q

Hemolytic disease screenings

A

Direct coombs: positibe antibody coated RBCs
-from babies cord blood

Indirect coombs: presence of maternal antibodies
-from mom

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14
Q

ABO incompatibility

Fetal blood type
Moms blood type
Mom produces what

Cause what 2 things
Tx

A

Fetal A,B, AB
Mom O

Mom produces Anti A & B cross placenta

Causes:
-mild anemia
-hyperbilirubinemia

Tx: phototherapy

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15
Q

RH incompatibility

RH (?) mom produces what against babies RH(?) blood

Rhogam given what weeks and within how many hours of delivery

A

RH- mom produce antibodies against Rh + fetus

At 24-28 weeks within 72hours of delivery

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16
Q

If Rh- antibodies develop were worried about what 2 things

If left untreated can cause what

A

Can develop:
-erthroblastosis fetalis
-hydrops fetalis (anemia)

Untreated leads to :
Kernicterus=
High levels of bilirubin cross blood brain barrier and cause damage

17
Q

Hyperbilirubinemia tx

A

Freq feedings (2-3 BF & 3-4hr formula)

Monitor I/O

Phototherapy (bili blanket and lights)

Exchange (blood) transfusion: if serious

18
Q

Phtotherapy for jaundice

Nursing care

A

-expose all skin but genitalia (have diaper)

-eyes covered to protect retina

-monitor temp/I/O/hydration

-reposition Q2-3hrs

19
Q

Neonatal sepsis

Name

Early vs late

A

Sepsis neonatorum

Early: acquired beofr or during birth
-comp labor
-prolonged ROM
-prolonged labor
-chorioamnionitis

Late: develops after 1st week of life

20
Q

RF for infection

A

Prematurity

ROM >18hrs

Prolonged labor

Signs of infection in mom/GBS pos.

Invasive procedures

21
Q

Neonatal infections s/s

A

Temperature instability (low or fever)

Resp problems (apnea)

Tachycardia

Poor feeding

Lethargy

22
Q

Neonatal infection

Diagnostic testing

A

Cultures: blood, CSF (lumbar puncture), urine

CRP (inflammation if elevated)

CBC w/diff

23
Q

Neonatal infection tx

A

Broad-spectrum abx (IV) - until culture results

-early infection are ampicillin
& aminoglycoside (gentamicin)

-strict I/O
-Feeding
-Resp support

24
Q

Neonatal abstinence syndrome
-what is it
Test it how

A

Neonates w/ drug w/d from in utero drug exposure

Test:
Urine
Meconium
Cord blood (best option)

25
Q

What we do if mother is on opiates

When we see w/d from baby

A

During pregnancy Switch to methadon or buprenorphine (dont want total cessation)

24-72hrs after birth = w/d

26
Q

Neonatal abstinence syndrome scoring

What we want to do for tx

A

Scoring determine necessity of drug therapy to alleviate
w/d

-gradually taper off

27
Q

Signs of w/d in newborn

A

High pitch cry
Hypertonic (stiff as a board)
Sleep disturbance
Sneezing, yawning
Diaphoresis
Tachypnea
Vomiting/diarrhea

28
Q

Neonatal abstinence syndrome managment

A

Adminiter meds as ordered for tapering:
-morphine, clonidine, phenobarbital

Reduce stimulation

Monitor I/O

Pacifier for sucking

Monitor mother and infant interactions

29
Q

Other substances

Marijuana s/s (4)

A

Irritability
Preterm
IUGR
Deficits in attention/cognition

30
Q

Other substances

Tobacco s/s (6)

A

Irritability
Preterm
IUGR
Jitteriness
Increase risk of SIDs
Increased developmental delays

31
Q

Other substances

Alcohol s/s

A

Irritability
Jitteriness
Increase muscle tone
FAS (fetal alcohol syndrome)

32
Q

PKU (phenylketonuria) = tx

Galactosemia = tx

A

PKU:
-formula w/o phenylalanine

Galactosemia:
-no breastfeeding
-soy-based formula

N330 (17 decks)

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