PP 2 of test 2 Flashcards
physiologic jaundice
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.
Kernicterus
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.
What can precipitate jaundice?
Rh incompatibility
What is Rh incompatibility?
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!
What is erythroblastosis fetalis?
hemolytic disease of the newborn usually caused by isoimmunization resulting from Rh incompatibility or ABO incompatibility
What is hydrops fetalis?
Most severe expression of fetal hemolytic disorder with high mortality, a possible sequela to maternal Rh isoimmunization; infants exhibit edema (anasarca)
Size for SGA
<10th%
Size for LGA
> 90th%
weight for LBW
<2500 grams
weight for VLBW
<1500 grams
Age for preterm babies
<37 weeks - between 34-37 late preterm
Age for “full term” babies
38-42 weeks
Age for “post term” babies
> 42 weeks; placenta begins to deteriorate and decalcify
IUGR
Intro-Uterin Growth Retardation
IUGR symmetric or asymmetric growth
symmetric - equally not to normal size
asymmetric- different limbs may be abnormal size
preterm babies and impaired gas exchange
not enough surfactant (give betamethasone to mom if in preterm labor), smaller airway,
signs of respiratory problems
tkypnea, grunting, retractions (seasaw), nasal flaring. Can give surfactant through ET tube if baby needs
Therapy for oxygenation
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!!
Risks & complications involved in using O2 Therapy
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
Assess for apnea
breathing, color and HR
what are some Infections in preemies?
Neonatal sepsis,
Group A strep infection,
Necrotizing enterocolitis
Intraventricular Hemorrhage
Group A strep infection
usually tested at 36 weeks so in preemies, you wouldn’t know. They are at a higher risk. Usually give prophylactic antibiotics
Necrotizing Enterocolitis
“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.
Assessing Necrotizing Enterocolitis
subtle signs (temperature), increase in abdomen girth, strange bowel habits, poor feeding, decreased bowel sounds.
