Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

NCMN 109A - Pedia Lecture > Physiologic Problems of the Newborn > Flashcards

Physiologic Problems of the Newborn Flashcards

1
Q

Excessive level of accumulated bilirubin in the blood

A

Hyperbilirubinemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

A yellowish discoloration of the skin and other organs

A

Jaundice or Icterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Hyperbilirubinemia is characterized by?

A

Jaundice or Icterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Cause of Hyperbilirubinemia?

A

Results from increased unconjugated or conjugated bilirubin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What type is commonly seen in newborns?

A

Unconjugated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Possible cause of Hyperbilirubinemia?

A

Physiologic Factors
Breastfeeding/Breastmilk
Excess productine of bilirubin
Disturbed capacity of liver
Ccombined overproduction and underexcretion
Genetic Predisposition
Some disease states (G6PD, hypothyroidism, galactosemia, GDM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Varying degrees of cns damage as a result of unconjugated bilirubin deposition in brain cells

A

Bilirubin Encephalopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

The yellow staining of the brain cells resulting to bilirubin encephalopathy

A

Kernicterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Factors That Enhance Bilirubin Encephalopathy

A

Respiratory Acidosis
Low Serum Albumin Levels
Intracranial Infections
Abrupt Fluctuations In Blood Pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Conditions That Increases Metabolic Demand for Oxygen or Glucose

A

Fetal Distress
Hypoxia
Hypothermia
Hypoglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Signs Of Bilirubin Encephalopathy

Prodromal Factors:

A

Decreased activity
Irritability
Lethargy
Loss of interest in feeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Signs Of Bilirubin Encephalopathy

Late Symptoms:

A

Rigid extensional of all extremities
Fever
Opisthotonus
Irritable Cry and Seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Mechanism of Physiologic Jaundice (Icterus Neonatorum)

A
  • sterile and less motile newborn bowel is initially less effective in excreting urobilinogen
  • in the newborn intestine, bglucoronidase converts conjugated bilirubin into unconjugated form
  • unconjugated form is reabsorbed by the intestinal mucosa and transported to the liver
  • enterohepatic circulation or enterohepatic shunting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Physiologic Jaundice
Feeding:

A
  • stimulates peristalsis and produces rapid passage of meconium thereby diminishing resorption of unconjugated bilirubin
  • introduces bacteria to aid in the reduction of bilirubin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Normal value of unconjugated bilirubin:

A

0.2-1.4 mg/dl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Direct bilirubin over

A

1.5-2 mg/dl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Physiologic Jaundice

Therapeutic Management

Primagry Goal:

A

prevent Bilirubin Encephalopathy & reverse Hemolytic Process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Physiologic Jaundice
Main Treatment:

A

Phototherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

used to reduce dangerously high bilirubin levels in hemolyic disease

A

Exchange Transfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Pharmacological Management of Physiologic Jaundice

A

Phenobarbital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

centered primarily on infant with hemolytic disease

A

Phenobarbital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Phenobarbital is most effective when

A

given to mother several days before delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what does Phenobarbital do?

A
  1. Promotes hepatic glucoronyl transferase synthesis
  2. Promotes protein synthesis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

exposure of infant’s skin to flourescent light

A

phototherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

light promotes bilirubin excretion by photoisomerization to transform it into

A

lumirubin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

NURSING CARE MANAGEMENT (PHYSIOLOGIC JAUNDICE)

ASSESSMENT

A
  • OBSERVE FOR EVIDENCE OF JAUNDICE AT REGULAR INTERVALS
  • BLOOD SAMPLES FOR MEASUREMENT OF BILIRUBIN
  • CAREFUL HISTORY TAKING
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

NURSING CARE MANAGEMENT (PHYSIOLOGIC JAUNDICE)

IMPLEMENTATION

A
  • EARLY INTRODUCTION OF FEEDINGS
  • FREQUENT NURSING WITHOUT WATER SUPPLEMENTATION
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

AN ABNORMALLY RAPID RATE OF RBC DESTRUCTION

A

HEMOLYTIC DISEASE OF THE NEWBORN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

ANEMIA CAUSED BY THIS DESTRUCTION STIMULATES THE PRODUCTION OF RBCS, WHICH IN TURN PROVIDES INCREASING NUMBERS OF CELLS FOR HEMOLYSIS

A

HEMOLYTIC DISEASE OF THE NEWBORN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Mechanism of Physiologic Jaundice (Icterus Neonatorum)

  • sterile and less motile newborn bowel is initially less effective in excreting ____________________
  • in the newborn intestine, __________________ converts conjugated bilirubin into unconjugated form
  • unconjugated form is reabsorbed by the _____________________ and transported to the ___________

This mechanism is called?
enterohepatic circulation or enterohepatic shuntin

A

urobilinogen; bglucoronidase; intestinal mucosa; liver

enterohepatic circulation or enterohepatic shunting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Physiologic Jaundice (Icterus Neonatorum)

Feeding
- stimulates __________ and produces rapid passage of ___________ thereby diminishing resorption of ___________________
- introduces _______________ to aid in the reduction of bilirubin

A

peristalsis; meconium; unconjugated bilirubin; bacteria

32
Q

when does jaundice become observable?

A

Levels > 5 mg/dl

33
Q

Timing of onset of Physiological Jaundice (Icterus Neonatorum)

A

AFTER 24 hours of birth

34
Q

persistent clinical jaundice over __ weeks in full term, formula fed infant

35
Q

Total Serum Bilirubin Thresholds:

Term infants (full-term):
Jaundice is concerning if total serum bilirubin exceeds

A

12.9 mg/dl

36
Q

Total Serum Bilirubin Thresholds:
Preterm infants:
Upper limit is __________ due to immature liver function.

37
Q

Total Serum Bilirubin Thresholds:
breast-fed infants: A level of ___________ is noted because breastfeeding can increase bilirubin levels slightly due to certain compounds in breast milk.

38
Q

major causes of HDN are?

A

isoimmunization and ABO incompability

39
Q

primary aim of isoimmunization:

A

prevention

40
Q

postnatal therapy for hemolytic disease of the newborn:

A

phototherapy
exchange
transfusion
pericardial and pleural fluid aspiration
mechanical ventilatory support
inotrope therapy

41
Q

Prevention of Isoimmunizaton:

A

administration of RHIg to all unsensitized RH negative mothers

42
Q

administration of RHIg must be within _____ after first delivery, miscarriage, abortion and repeated after subsequent pregnancies

43
Q

administration of RHIg at __________________ further reduces risk

A

26-28 weeks aog

44
Q

treatment for infants whose mothers are already sensitized

A

intrauterine transfusion

45
Q

consists of infusing blood into the umbilical vein of the fetus

A

intrauterine transfusion

46
Q

in exchange transfusion, infant’s blood is removed in small amounts (_____________at a time) and it is then replaced with _________________

A

5-10 ml; compatible blood

47
Q

what does exchange transfusion do/its purposes?

A

removes the sensitized erythrocytes
lowers serum bilirubin level
corrects anemia
prevents cardiac failure

48
Q

in exchange transfusion, a catheter is inserted into the _______________ and threaded into the _______________

A

umbilical vein; inferior vena cava

49
Q

a catheter is inserted into the umbilical vein and threaded into the inferior vena cava

A

exchange transfusion

50
Q

in exchange transfusion, depending on the infant’s weight, _____________ of blood is withdrawn within _____________and the same volume of donor blood is infused until targeted volume is reached

A

5-10 ml ; 15-20 seconds

51
Q

in exchange transfusion, __________________ may be given after infusion for citrated donor blood

A

calcium gluconate

52
Q

for ABO incompability, treatment is

A

early detection and implementation of phototherapy

53
Q

____________________________ are used in combination with phototherapy

A

intravenous immunoglobulin transfusions

54
Q

exchange transfusion is required only when

A

phototherapy fails to decrease bilirubin concentration

55
Q

present when nb’s blood glucose concentration is lower than the body’s requirement for cellular energy and metabolism

A

hypoglycemia

56
Q

in a newborn, hypoglycemia is defined as a serum glucose level of ______________________________

A

less than 45 mg/dl

57
Q

TYPES OF NEONATAL HYPOGLYCEMIA

A

EARLY TRANSITIONAL NEONATAL
CLASSIC TRANSIENT NEONATAL
SECONDARY ASSOCIATED
RECURRENT, SEVERE

58
Q

LGA or normal size infants who suffer from transient hyperinsulinism

A

Early Transitional Neonatal

59
Q

infants who suffered intrauterine malnutrition that depleted glycogen and fat stores (sga, preterm, polycythemic infants)

A

Classic Transient Neonatal

60
Q

response to perinatal stress that increase the infant’s metabolic needs relative to glycogen stores

A

Secondary Associated

61
Q

caused by enzymatic or metabolic endocrine defect such as congenital hyperinsulinism, hypopituitarism, hypothyroidism

A

Recurrent, Severe

62
Q

Clinical Manifestations for Hypoglycemia
Cerebral Signs

A

jitteriness, tremors, twitching, weak or hig-pitched cry, lethargy, hypotonia, limpness, seizures and coma

63
Q

Clinical Manifestations for Hypoglycemia
Other Clinical Manifestations

A

cynosis, apnea, rapid and irregular respirations, sweating, eye rolling, refusal to feed

64
Q

hyperglycemia is blood glucose concentration greater than ________________ (full term infant) or greater than ____________ (preterm infant)

A

125 mg/dl; 150 mg/dl

65
Q

hyperglycemia is treated by?

A

reducing the infant’s glucose intake

66
Q

untreated hyperglycemia may reduce in?

A

osmotic diuresis with subsequent fluid volume loss and dehydration

67
Q

VITAMIN K DEFICIENCY BLEEDING

A

HEMORRHAGIC DISEASE OF THE NEWBORN

68
Q

HEMORRHAGIC DISEASE OF THE NEWBORN IS CLASSIFIED ACCORDING TO APPEARANCE

A

EARLY
CLASSIC
LATE ONSET

69
Q

newborn’s vitamin k stores are absent and prothrombin activity is moderately deficient

A

HEMORRHAGIC DISEASE OF THE NEWBORN

70
Q

vitamin k dependent coagulation factors (ii, vii, ix,x)are significantly reduced

A

HEMORRHAGIC DISEASE OF THE NEWBORN

71
Q

newborn’s sterile intestinal tract is unable to synthesize the vitamin until feeding is initiated

A

HEMORRHAGIC DISEASE OF THE NEWBORN

72
Q

signs and symptoms of hemorrhagic disease of the newborn

A

blood oozing from umbilicus or circumcision site
bloody or black stools
hematuria
ecchymoses on skin & scalp
epistaxis
bleeding from punctures

73
Q

classic hemorrhagic disease usually occurs _________ after birth

74
Q

late onset hemorrhagic disease usually occurs

A

2-12 weeks of age

NCMN 109A - Pedia Lecture (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions