Peds - Newborns

Question 1

anterior fontanelles close

Answer 1

between 6 and 18 months

Question 2

posterior fontanelles close

Answer 2

by 2 months

Question 3

meconium aspiration

Answer 3

meconium is first stool of newborn, if passed before delivery fetus is at risk for meconium aspiration, can occur in utero or just after delivery, causes infant to become ill very quickly

Question 4

Meconium aspiration S&S

Answer 4

accessory muscle use, increased WOB, grunting, nasal flaring, adventitious breath sounds

Question 5

assessment to determine if meconium has passed in utero

Answer 5

visible meconium in fluid/on infant, discolored or foul smelling amniotic fluid, discoloration of the cord, discoloration of the nails/tongue on the infant

Question 6

meconium aspiration tx and interventions

Answer 6

quick action is essential to good outcome, suction immediately after birth, intubation if indicated, IV abx, IV fluids

Question 7

Jaundice

Answer 7

elevate bilirubin level resulting in yellowing of sclera, skin, and mucous membranes

Question 8

unconjugated bilirubin (indirect)

Answer 8

heme that is released from hemoglobin in process of red blood cell breakdown is converted to unconjugated bilirubin and transported to liver

Question 9

conjugated bilirubin (direct)

Answer 9

unconjugated bilirubin is converted to conjugated bilirubin in the liver and then excreted in stool

Question 10

Physiological Jaundice

Answer 10

appears on day 2-3 of life, is expected and not considered pathologic unless other issues arise, is due to the normal transition from the placenta removing bilirubin to the infant’s liver now doing the work, will be followed up outpatient with pediatrician

Question 11

Pathological Jaundice

Answer 11

occurs in first 24 hours of life, indicates some problem or disease process that needs addressed, could be a liver issue or an ABO incompatibility

Question 12

kernicterus

Answer 12

type of brain damage that can result from high levels of bilirubin in the blood; can lead to cerebral palsy, hearing loss, problems with vision, problems with teeth, intellectual disabilities

Question 13

kernicterus tx

Answer 13

phototherapy; helps break down bilirubin so it can be excreted in the feces, must ensure eyes and genitals are covered; to ensure they are excreting it encourage feedings