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NCMN 109A - Pedia Lecture > PDA, Retinopathy of Prematurity, Macrosomia, Addicted Mothers and FSA > Flashcards

PDA, Retinopathy of Prematurity, Macrosomia, Addicted Mothers and FSA Flashcards

1
Q

A congenital heart defect in which the ductus arteriosus, a blood vessel that allows blood to bypass the lungs in fetal circulation, fails to close after birth.

A

Patent Ductus Arteriosus

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2
Q

The ductus arteriosus usually closes ____________ of life.

A

24 to 48 hours

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3
Q

The ductus arteriosus usually closes 24 to 48 hours of life. If it remains open , it leads to

A

abnormal blood flow between the aorta and pulmonary artery

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4
Q

Common complication of severe respiratory disease in preterm infants

A

Patent Ductus Arteriosus

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5
Q

Occurs in the majority of preterm infants under 1200 g (2.6lb)

A

Patent Ductus Arteriosus

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6
Q

Patent Ductus Arteriosus occurs in the majority of preterm infants under __________

A

1200 g

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7
Q

PDA incidence diminishes in direct relationship to

A

increasing birth weight

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8
Q

Clinical Consequences of PDA

A

Increased Pulmonary Blood Flow
Left Heart Strain
Risk of Endocarditis

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9
Q

Increased Pulmonary Blood Flow results in

A

respiratory symptoms such as tachypnea, grunting, or cyanosis

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10
Q

Left Heart Strain can lead to

A

left ventricular hypertrophy or failure

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11
Q

Clinical Manifestations of PDA in infants

A

Tachypnea
Heart Murmur (often a continuous “machinery” murmur)
Poor feeding and growth
Sweating during feedings
Cyanosis (especially if there is a large PDA)

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12
Q

Clinical Manifestations of PDA in other children

A

Shortness of breath
Fatigue
Palpitations
Difficulty exercising

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13
Q

Assessment for PDA

A

Assess for systolic murmur at the second intercostal space, left upper sternal border, or out the clavicular area.

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14
Q

Large defect can cause

A

rales, congestion, increased work breathing, difficulty in feeding or failure to thrive.

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15
Q

Diagnostic Findings for PDA

A

Physical Exam
Echocardiogram
Chest X-ray
Electrocardiogram
Pulse Oximetry

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16
Q

Confirms the diagnosis by visualizing the patent ductus and assessing the amount of shunting.

A

Echocardiogram

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17
Q

May show enlarged heart or increased pulmonary vascular markings.

A

Chest X-ray

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18
Q

May show signs of Left ventricular hypertrophy or strain

A

Electrocardiogram

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19
Q

May show low oxygen levels if significant shunting occurs.

A

Pulse Oximetry

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20
Q

Nursing Interventions for PDA

A

Vital signs
Oxygenation
I&O
Feeding support
Medications
Preoperative care (if surgical closure is needed)

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21
Q

Medications used for PDA

A
  • Prostaglandin Inhibitors (e.g., Indomethacin or Ibuprofen)
  • Diuretics
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22
Q

help DA close in premature infants

A

Prostaglandin Inhibitors (e.g., Indomethacin or Ibuprofen)

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23
Q

to manage fluid retention and pulmonary congestion in more severe cases.

A

Diuretics

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24
Q

Nursing Diagnosis for PDA

A

Impared Gas Exchanges
Imbalanced Nutrition: Less than body requirements
Risk for infection

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25
Q

Potentially blinding eye disorder that primarily affects premature infants.

A

Retinopathy of Prematurity

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26
Q

involves abnormal growth of retinal blood vessels, often leading to scarring and retinal detachment

A

Retinopathy of Prematurity

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27
Q

Retinopathy of Prematurity involves abnormal growth of retinal blood vessels, often leading to

A

scarring and retinal detachment

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28
Q

is one of the most common causes of vision impairment in children worldwide, particularly in very low birth weight preterm infants.

A

Retinopathy of Prematurity

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29
Q

ROP is one of the most common causes of vision
impairment in children worldwide, particularly in

A

very low birth weight preterm infants

30
Q

Risk Factors for ROP

A
  • Prematurity (<32 weeks gestation)
  • Low birth weight (<1500g)
  • Oxygen therapy (excessive oxygen levels can lead to abnormal vessel growth)
  • Sepsis, blood transfusions, and long stays in NICU also contribute.
31
Q

Mild, where blood vessels are slightly abnormal but without scarring

32
Q

Moderate, with more significant abnormal vessel development

33
Q

Severe, where abnormal blood vessels grow and cause scarring and retinal detachment

34
Q

Retinal Detachment, partial or total

35
Q

Total Retinal Detachment, resulting in blindness

36
Q

Clinical Manifestations for ROP

A

abnormal eye movements, strabismus(crossed eyes), or
visual disturbances

37
Q

Diagnostic Test for ROP

A

Fundus Examination
Staging and Classification

38
Q

ROP is staged based on the

A

severity of the abnormal blood vessel growth

39
Q

Treatment for ROP

A

Laser therapy
Cryotherapy
Anti-VEGF (Vascular Endothelial Growth Factor) Injections
Vitrectomy

40
Q

by destroying the peripheral retina, preventing further abnormal growth of blood vessels and retinal detachment

A

Laser therapy

41
Q

medications that block signals causing abnormal vessel growth

A

Anti-VEGF (Vascular Endothelial Growth Factor) Injections

42
Q

removal of the vitreous gel

A

Vitrectomy

43
Q

Nursing Interventions for ROP

A
  • Monitor for signs of ROP
  • Routine ROP screening
  • Oxygent regulation
  • Support for Family and Education
  • Post-Treatment Care
  • Promote optimal neonatal care
44
Q

signs of ROP

A

abnormal eye movements or difficulty in tracking objects in older infants

45
Q

Nursing Diagnosis for ROP

A

Risk for Impaired Vision
Risk for infection
Anxiety

46
Q

Risk Factors for Infant with Diabetic (Macrosomia)
Maternal Factors

A

poorly controlled diabetes, maternal obesity, or longstanding diabetes (pre-pregnancy)

47
Q

Risk Factors for for Infant with Diabetic Mothers (Macrosomia)
Genetics

A

Fetal genetic makeup can influence the degree of macrosomia

48
Q

Complications for Infant with Diabetic Mothers (Macrosomia)

A

Birth Trauma
Hypoglycemia
Respiratory distress syndrome (RDS)
Jaundice
Obesity and metabolic syndrome in later life

49
Q

Clinical Manifestations for Infant with Diabetic Mothers (Macrosomia)

A
  • Large for Gestational Age (LGA)
  • Excessive subcutaneous fat
  • Round face and ruddy complexion
  • Birth injuries
  • Hypoglycemia
  • Respiratory Distress
  • Jaundice
50
Q

how many grams is LGA

A

4000 grams

51
Q

Nursing Interventions for Infant with Diabetic Mothers (Macrosomia)

A
  1. Monitoring blood glucose levels
  2. Early feeding and glucose management
  3. Monitor for birth injuries
  4. Respiratory support
  5. Jaundice management
  6. Education for parents
52
Q

Nursing Diagnosis for Infant with Diabetic Mothers (Macrosomia)

A
  • Risk for Imbalanced Nutrition: Less than body requirements
  • Risk for Injury
  • Risk Impaired gas exchange
53
Q

Infants born to addicted mothers are at high risk for

A

withdrawal symptoms, developmental delays, and other health complications due to prenatal exposure to substances.

54
Q

Maternal substance use during pregnancy affects fetal development, leading to

A

neonatal abstinence syndrome (NAS) and other complications.

55
Q

Common Substance

A

Opioids (Heroin, Methadone)
Cocaine
Alcohol
Marijuana
Methamphetamines
Nicotine

56
Q

Fetal Growth Effects of Maternal Drug Use on the
Fetus & Newborn

A
  • Intrauterine Growth Restriction (IUGR).
  • Low birth weight and preterm birth.
  • Increased risk of stillbirth.
57
Q

Clinical Manifestations of infants born to Addicted Mothers

A

Irritability
Tremors
Poor feeding
High-pitched crying
Seizures
Respiratory distress

58
Q

This is a severe form of Fetal Alcohol Spectrum Disorders caused by alcohol exposure during pregnancy

A

Fetal Alcohol Syndrome

59
Q

is a substance that causes developmental abnormalities in a fetus

A

teratogen (alcohol)

60
Q

Clinical Manifestations for FAS
Physical fetaures

A

Smooth philtrum
Thin upper lip
Small palpebral fissures
Short stature and low birth weight
Microcephaly (small head circumference)

61
Q

Clinical Manifestations for FAS
Cognitive and Behavioral Effects

A

Learning disabilities
Poor memory and attention span
Hyperactivity
Difficulty with problem-solving
Poor impulse control

62
Q

Clinical Manifestations for FAS
Medical Conditions

A

Congenital heart defects (e.g., atrial septal defects.
Hearing loss
Kidney abnormalities
Speech and language delays

63
Q

Nursing Diagnosis for FAS

A
  • Delayed growth and development
  • Risk for impaired Nutrition
  • Risk for impaired parenting
64
Q

Before birth, the ductus arteriosus connects the __________________ to the ______, diverting the blood from the lungs (which aren’t in use yet) into _________________

After birth, the lungs become ______________, and the ductus arteriosus should close to allow _____________________.

The failure of the ductus to close results in a __________________________________________________________________________________________________

A

pulmonary artery; aorta; systemic circulation; functional; normal circulation; persistent connection between the aorta and pulmonary artery

65
Q

In PDA
Blood flows from the ___________________ into the___________________________

This extra blood flow can lead to ______________________________________________________________________________________________________

A

higher-pressure aorta; lowest-pressure pulmonary artery; pulmonary hypertension, increased workload on the left side of the heart, and potentially heart failure

66
Q

Confirms the diagnosis by visualizing the patent ductus and assessing the amount of shunting

A

Echocardiogram

67
Q

May show enlarged heart or increased pulmonary vascular markings.

A

Chest X-ray

68
Q

May show signs of Left ventricular hypertrophy or strain

A

Electrocardiogram

69
Q

May show low oxygen levels if significant shunting occurs.

A

Pulse Oximetry

70
Q

excessive oxygen levels can lead to

A

abnormal vessel growth

71
Q

In full-term infants, retinal blood vessel growth is
completed by ______________ of gestation

NCMN 109A - Pedia Lecture (8 decks)

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