PP 2 of test 2

Question 1

physiologic jaundice

Answer 1

we expect to see some of this. but only AFTER 24 hrs of age. Levels of 5-7, starts in cephalocaudal distribution (head on down) see yellowing.

Question 2

Kernicterus

Answer 2

bilirubin encephalopathy ; bilirubin levels >20-25; neurologic symptoms, high pitched cry, seizures, fever. Deposited in brain stem and basel ganglia. Excreted through the bowels, want them to poop!! It can reabsorb if it sits in bowels too long.

Question 3

What can precipitate jaundice?

Answer 3

Rh incompatibility

Question 4

What is Rh incompatibility?

Answer 4

when baby’s blood mixes with mom’s blood and it’s different blood type. Mom will develop antibody’s for that blood type and it can attack the next pregnancy. Get rhogam shots after delivery!

Question 5

What is erythroblastosis fetalis?

Answer 5

hemolytic disease of the newborn usually caused by isoimmunization resulting from Rh incompatibility or ABO incompatibility

Question 6

What is hydrops fetalis?

Answer 6

Most severe expression of fetal hemolytic disorder with high mortality, a possible sequela to maternal Rh isoimmunization; infants exhibit edema (anasarca)

Question 7

Size for SGA

Answer 7

<10th%

Question 8

Size for LGA

Answer 8

> 90th%

Question 9

weight for LBW

Answer 9

<2500 grams

Question 10

weight for VLBW

Answer 10

<1500 grams

Question 11

Age for preterm babies

Answer 11

<37 weeks - between 34-37 late preterm

Question 12

Age for “full term” babies

Answer 12

38-42 weeks

Question 13

Age for “post term” babies

Answer 13

> 42 weeks; placenta begins to deteriorate and decalcify

Question 14

IUGR

Answer 14

Intro-Uterin Growth Retardation

Question 15

IUGR symmetric or asymmetric growth

Answer 15

symmetric - equally not to normal size

asymmetric- different limbs may be abnormal size

Question 16

preterm babies and impaired gas exchange

Answer 16

not enough surfactant (give betamethasone to mom if in preterm labor), smaller airway,

Question 17

signs of respiratory problems

Answer 17

tkypnea, grunting, retractions (seasaw), nasal flaring. Can give surfactant through ET tube if baby needs

Question 18

Therapy for oxygenation

Answer 18

O2, Cpap, oxyhood (bowl for o2 over head), Mechanical vent, INO (inhaled Nitric oxide), ECMO (heart/lung machine) Also, air should be warmed and humidified!!

Question 19

Risks & complications involved in using O2 Therapy

Answer 19

Bronchopulmonary dysplasia - chronic lung disease. going longer than 28 days
Growth and Development
Feeding - fortify breast milk to get more calories (24cal/ounce), make it a little easier for them to eat.
Overhydration
Apnea

Question 20

Assess for apnea

Answer 20

breathing, color and HR

Question 21

what are some Infections in preemies?

Answer 21

Neonatal sepsis,
Group A strep infection,
Necrotizing enterocolitis
Intraventricular Hemorrhage

Question 22

Group A strep infection

Answer 22

usually tested at 36 weeks so in preemies, you wouldn’t know. They are at a higher risk. Usually give prophylactic antibiotics

Question 23

Necrotizing Enterocolitis

Answer 23

“short gut” result of NE. When baby is hypoxic, it causes the gut to get less blood flow, causing eschemia and damaging mucosal cells, thus necrosis. Need to remove necrotic tissue, hence short gut. Mal absorption due to a smaller intestine.

Question 24

Assessing Necrotizing Enterocolitis

Answer 24

subtle signs (temperature), increase in abdomen girth, strange bowel habits, poor feeding, decreased bowel sounds.

Question 25

Treating Necrotizing Enterocolitis

Answer 25

stop feeding baby, antibiotics and removal of intestines

Question 26

Intraventricular hemorrhage

Answer 26

<30 wks. brain bleeding more risky w/in first 3 days of life. Increased ICP

Question 27

Assessment for Intraventricular hemorrhage

Answer 27

fontanels, apnea, hypotonia

Question 28

Treatment for Intraventricular hemorrhage

Answer 28

keep and eye on it, shunt may be possible. At risk for neuro issues.

Question 29

Retina in preemies

Answer 29

Not fully developed until about 3 wks after delivery. Need to be kept in dark rooms, eyes covered. Maintain VS

Question 30

Post term issues

Answer 30

Placenta deteriorates >42 wks. depletes baby of oxygen and nutrition.
Higher risk for meconium aspiration.
Pulmonary hypertension

Question 31

Pulmonary Hypertension in post term babies

Answer 31

term applied to the combined findings of pulmonary hypertension, right-to-left shunting & a structurally normal heart.

Question 32

Newborns of diabetic moms have issues as well. What are they?

Answer 32

• Glucose crosses the placenta but not insulin. This Causes the baby’s pancreas to have to work overtime to make it’s own insulin.
• Congenital anomalies (cardiac, muscular, nervous system)
• Macrosomia - big baby & round face. increased fat content, enlarged organs (spleen, liver & heart) lung maturity is decreased because of diabetes
• Birth Injury - shoulder dystocia
• Respiratory distress syndrome (RDS) - after birth, surfactant development delayed
• Hypoglycemia - after birth - all glucose from mom is now gone, levels drop!! (keep moms levels stable, it helps baby too)
• Cardiomyopathy - hypertrophic & nonhypertrophic
• Hyperbilirubinemia & polycythemic