Pediatrics- Complications of Infants Flashcards
What is phenylketonuria
PKU is an inherited metabolic disorder in which the newborn likes the enzyme phenylalanine hydroxylase
This enzyme converts phenylanine and essential amino acid into Trysonie
The lack of this enzyme leads to the accumulation of phenylaline in the newborns, bloodstream and tissues, which causes cognitive impairment
What is the key prevention of PKU in newborns?
Identification of clients in the reproductive years, who have disorder mess it here, to strict dietary guidelines from three months before conception throughout pregnancy
How often do patients with KPK you have to get there phenylalanine levels monitored
1 to 2 times per week throughout pregnancy
Who gets screen for PKU?
All newborns buy bullets brought protein usually within the first two days of birth
Expected findings in a newborn with PKU
Growth failure
Frequent vomiting
Irritability
Musty odor in urine
Blue eyes very fair skin light blonde hair
When is the blood spot analysis performed to check for PKU?
After the newborn has ingested, a source of protein, usually within two days of birth
What is nursing care of PKU?
Focuses on dietary intake
Dietary restrictions, as soon as PKU was diagnosed, or within 7 to 10 days of birth
Please patient on formula low in phenylalanine
Breast feed contains enzyme so I might not be possible
What should be the intake for a newborn with PKU?
20 to 30 mg phenylalanine per kilogram of body weight per day
Call is level between two and eight
What are complications of PKU?
Cognitive impairment
Hyper activity with erratic behavior
Bizarre behavior
Headbanging
Arm biting
Spasticity
What is meningocele/ myelomenigiocele
Spina bifida,
Neural tube defects that are present at birth in affect the CNS and spine
Occur when neural tube fails to close during the third and fourth week of embryonic development
What is meningiocele
Protrusion of saclike says that contains meninges in spinal fluid
What is myelomenigiocele
Upper Tution of saclike says that contains meninges, spinal fluid, and a portion of the spinal cord and nerves
What allergy do you have to assess for in spina bifida
Latex
What are manifestations of increased intracranial pressure
Hi bitch cry
Lethargic
Vomiting
Bothering fontanelles
Widen, cranial, suture lines
Increase head circumference
What is necrotizing enterocolitis?
An inflammatory disease of the G.I. Makossa caused by a Soumia or hypoxia. She may result in death of mucosal sell, leading to necrotic patches that interfere with digestion.
Respecters for necrotizing enterocolitis
Prematurity
Respiratory distress
Intrauterine growth restriction
Receiving internal feeds
G.I. vascular compromise
Physical assessment of a patient with necrotizing enterocolitis
Abdominal distention
Bloody stools
Periods of apnea
Hypotension
Poor feeding
What is a diagnostic procedure for necrotizing enterocolitis?
Abdominal x-rays
Look for sausage shaped dilation of intestine
Characterize soapsuds appearance of intestinal wall due to air infiltration
Free air and abdominal cavity, if perforation has occurred
Nursing care for a patient with necrotizing enterocolitis
Prevention with hold feedings for 24 to 48 hours
Discontinue all feedings
Insert NG tube
Measure abdominal girth
Scereal abdominal x-rays
Removal of necrotize portion of bowel
Temporary colostomy
What is respiratory distress syndrome?
Results of surfactant deficiency in the lungs, characterized by pour gas exchange, and ventiltory failure
What does surfactant
Phospholipid that assist in Alviola expansion keeps alveoli from collapsing and allows Gas exchange to occur
What is atelectasis?
Collapsing a portion of the lungs
Risk factors for respiratory distress syndrome
Premature
Meconium staining
Cord prolapse
Nuchal cord
Maternal diabetes mellitus
Premature rupture of membranes
Cold stress
Expected findings in respiratory distress syndrome
Tachypnea
Nasal flaring
Gruntin
Retractions
Fine crackles
Nursing care for respiratory distress syndrome
Suction the newborn smell trachea nose
Maintain thermoregulation
Provide mouth and skin care
What is beeactant piracy at Alfa and calfactant
Long surfactant
What is congenital hypothyroidism?
Occurs due to an absent or non-functioning thyroid gland
When will findings occur in congenital hypothyroidism
Three months in a formula, fed infant
Six months in a breast-fed infants
Risk factors for congenital hypothyroidism
Females
Low birthweight
Maternal low iodine levels
Physical assessment for congenital hypothyroidism
Sleeping excessively
Enlarged tongue
Poor, sucking
Cool dry skin on extremities
Subnormal temperature
Short, thick neck
Nursing care for a patient with congenital hypothyroidism
Assess feeding difficulties
Treatment is administration of synthetic thyroid hormone
Medication must be taken in definitely
Supplemental vitamin D to support rapid bone growth
What is substance exposed infants?
Maternal substance use during pregnancy consist of any use of alcohol or drugs, intrauterine drug exposure can cause withdrawal in the neonate
What is hyperbilirubinemia
Elevation of blood bilirubin levels resulting in jaundice
What is psychological jaundice?
Considered benign from normal newborn physiology of increase Billy Rubin production, due to shorten lifespan, in breakdown of fetal RBCs and liver immaturity
When does does physiologic jaundice occur
After 24 hours of age
What does hemolytic disease or pathological jaundice
Result of an underlying disease
When does pathologic jaundice occur?
Before 24 hours of age 
What is kernicterus
Bilirubin encephalopathy
Increase permeability of the blood brain barrier to on conjunctive bilirubin
Potential for irreversible brain damage
Caused by bilirubin, depositing in brain
Expected findings of hyper bilirubinemia
Yellowish tint to skin
When release of pressure observe the skin for a yellowish tint, a skin is blanched
Expected findings of kernicterus
Yellow skin
Poor feeding
Decreased activity
High-pitched cry
Temperature instability
Laboratory test for hyperbilirubinemia
Our specific blood bilirubin levels to predict newborns at risk for hyperbilirubinemia
Nursing care for hyper bilirubinemia
Set up phototherapy
Encourage parents to hold and interact with newborn when lights are off
Auxiliary temp every four hours
Feed, newborn, early and frequent every 3 to 4 hours to promote bilirubin excretion in stools
What is nursing care during phototherapy?
Maintain an eye mask over the newborns eyes
Avoid applying lotions
Remove newborn from phototherapy every four hours
Reposition newborn every two hours
What is newborn sepsis?
Infection, contracted by the newborn before during or after delivery newborns are more susceptible due to their limited immunity in ability to localized infection infection can spread rapidly into the bloodstream
How to reduce the risk of infection in newborns
Prophylactic anabiotic treatment of the eyes of all newborns, inappropriate umbilical cord care
Expected findings in newborn sepsis
Temperature instability hypothermi
Suspicious drainage (eyes, umbilical cord)
Poor weight gain
Abdominal distention
Respiratory distress
Color changes
Low blood pressure
Poor muscle tone
What does plagiocephaly
Acquired condition that occurs from cranial molding in infancy
What happens in plagiocephaly?
Infants head becomes a symmetric or oblique in shape due to flattening of the occiput
What is a risk factor for plagiocephaly?
Supine sleep position
What are key prevention of plagiocephaly?
Lying prone position for 30 to 60 minutes per day while awake
Alternate the infants, head position each night to avoid persistent pressure on the occiput
Wearing customize helmet to reshape the skull
How long does a customized helmet for plagiocephaly need to be worn?
23 hours a day usually for three months
 What is considered a late preterm infant
Between 34 and 37 weeks
What is considered an early preterm baby?
Between 24 and 34 weeks
What is an expected findings for premature infant?
Head large
Thin skin
Abundant Laguna
Soft, ear cartilage
Poor suck, swallow reflux
Testicles undescended
What are symptoms of down syndrome?
Broad flat nose
Protruding tongue
Short neck
Low set ears
Fifth finger curved N-word
Cardiac anomalies
What can an infant go through if their mother was using drugs or alcohol while pregnant?
Withdrawal
What are long-term complications of fetal alcohol syndrome?
Central nervous system dysfunction
Behavioral difficulties
Language abnormalities
Delayed growth
Poor, maternal bother
