preterm infants issues Flashcards
regarding preterm infant issues:
-define and state signs and symptoms of
hypoxic ischemic encephalopathy
syx/sx (5)
newborn baby brain damage
caused by oxygen deprivatoin and limited blood flow
syx/sx
-decreased alertness and actiivty
lack of typical reflexes
abonromal movements or seizure s
low or high muscle tone
breathing problems
resuscitation of newborn 5 steps
dry baby and maintain temperature
assess tone, resp rate and heart rate
if gasping/not breathing - give 5 inflation breaths (different from ventilation breaths- aim is to sustain pressure to open the lungs)
reassess (chest movements)
if heart rate not improving and <60
-start compressions and ventilation breaths at rate of 3:1
regarding preterm infant issues:
-define and state signs and symptoms of respiratory distress syndrome and pneumothorax
risk factors -4
syx/sx- 5
also known as surfactant deficinet lung disease
causes by insufficient surfacctant production and structular immaturity of the lungs- AND CAN CAUSE A PNEUMOTHORAX
-50% risk if born 26-28wks
-20% risk if born 30-31 wks
risk factors - male, mother diabetic, C-section, second born of premature twins
syx/sx
-tachypnoea
-intercostal recession
-expiratory grunting
-cyanosis
-CXR- ground glass appearance w indistinct heart border
regarding preterm infant issues:
-define and state signs and symptoms of meconium aspiration
syx/sx - 1
risk factors -6
respiratory distresss as a result of meconuim in the trachea
-occurs in immedite neontal period
-most common post term deliveires(44% risk in babies born after 42 weeeks)
- syx/sx
-respiratory distress
risk factors
-post term delvieries
materal HT
-preeclampsia
-chorioaminiotis
-smoking
-substance abuse
state some common brithing injureis
brachial palsy- nerves in arm are injured
brusing or forcep marks
caput or cephalhaematoma
caput succedaneum - significant swelling of soft tissues of babies scalp
brain damage- cerebral palsy
regarding preterm infant issues:
-define and state signs and symptoms of transient tachypneoa of the new born
syx/sx - 2
commenest cause of respiraotry distress in newborn period
-caused by delayed resoprtion of fluid in the lungs
-most common afer C-section ; possibly due to lung fluid not being squeezed out during passage through birth cnanal
syx/sx
-repsirtartory distress
-CXR shows hyperinflation of lungs and fluid in horizontal fissue
managment- observe- supportive ccare
-supplementary O2- usually settles within 1-2 days
regarding preterm infant issues:
-define and state signs and symptoms of persistent pulmonary hypertension of the newborn
syx/sx - 1
risk factors 3
failure of nromal circulatory transstion that occur after birht
-risk factor
-meconium aspiration
-infection
-congential abnormalties
- characterised by marked pulmonary hypertension -> secondary hypoxemia secondarty to right-to-left shunting of blood at the foramen ovale and ductus arteriossus
regarding preterm infant issues:
-define and state signs and symptoms of apnea and bradycardia
syx/sx -
common in preterm babies
-centres in brain that control breathing are immature and poorly coordinated
-watch baby- move them around
regarding preterm infant issues:
-define and state signs and symptoms of hypoglycaemia
risk factors -5
syx/sx - 12
management
-symptomatic
-asymptomatic
transient hypoglycamaeia common in first hours after birth even in term babies
-no clear cut off figure of <2.6mmol/l is used
persistent/severe hypoglycaemia cna be caused by:
-PRETERM BIRTH
-materal diabetes
-IUGR (intrauterine growth restriction)
-hypothermia
-sepsis
syx/sx
-can be asymptomamic
-autonomic chanes
–jitteriness
-irritable
-tachypenoa
-pallor
neuroglycopenic
-poor feeding/suckling
-weak cry-
-drowsy
-hypotonia
-seizures
other
-apnoea
-hypothermia
manamengt
-asymptomaitc- encourage feeding, monitor
symptomatic- or v low
-admit to neontal
IV 10% dextrose
regarding preterm infant issues:
-define and state signs and symptoms of persistent ductus arteriosus
syx/sx - 4
ductus arteriosus doesnt close after birth
-understandbly more common in preterm birth
syx/sx
-resipratory distress
-frequent respiratory infections
-mumur
-general failure to thrive syx
cuases of preterm brain injury (cerebral palsy)
antenatal- cerebral malformations and congential infections
intrapartum- birth asphyxia/trauma
postnatal- intraventricular haemorrhage, meningitis, head-trauma
cerebral palsy types 4
spastic
-subtypes include hemiplegia, diplegia or quadriplegia
dyskinetic
-damage to the basal ganglia and substania nigra
-athetoid movemnts (slow, involuntary, and writhing movements of the limbs, face, neck, tongue, and other muscle groups) and oro-motor problems
ataxic
-caused by damage to cerebellum w typical cerebellar signs
mixed
regarding preterm infant issues:
-define and state signs and symptoms of preterm brain injury (cerebral palsy)
syx/sx - 8
symtoms
- abnormal tone early infancy
-delayed motor milestones
-abnormal gait
-feeding difficulties
assocatied non-motor problems
-learning difficulties
-epilepsy
-squints
-hearing impairements
cerebral palsy types 4
spastic
-subtypes include hemiplegia, diplegia or quadriplegia
dyskinetic
-damage to the basal ganglia and substania nigra
-athetoid movemnts and oro-motor problems
ataxic
-caused by damage to cerebellum w typical cerebellar signs
mixed
cerebral palsy types 4
spastic
-subtypes include hemiplegia, diplegia or quadriplegia
dyskinetic
-damage to the basal ganglia and substania nigra
-athetoid movemnts and oro-motor problems
ataxic
-caused by damage to cerebellum w typical cerebellar signs
mixed
cerebral palsy types 4
spastic
-subtypes include hemiplegia, diplegia or quadriplegia
dyskinetic
-damage to the basal ganglia and substania nigra
-athetoid movemnts and oro-motor problems
ataxic
-caused by damage to cerebellum w typical cerebellar signs
mixed
regarding preterm infant issues:
-define and state signs and symptoms of retinopathy of prematuirty
syx/sx - 2
eye disease happen in preterm babies or weigh less than 3 pounds
caused by oxygen use in premature babies
disorganised growth of retinal blood vessels may result in scarring and retinal detachment
can be mild and resolve spontaneously or can be severe and leead to blindness
regarding preterm infant issues:
-define and state signs and symptoms of necrotising enterocolitis
syx/sx - 6
one of the leading cuases of deaths in premature infants
intial sympotms
-feeding intolerance
-abdomonial disteinsion
-bloody stools
can progress to:
-abdominal discoloruation
-perforation
-peritonitis
diagnosis of nectoritisn enterocolitis in a preterm infant
1 investiagtion and 6 signs
abdo xray
dilated bowel loops - often asymetircal distribution
bowel wall oedema
pneumatosis intestinalis (intramural gas)
portal venous gas
pneumoperitoneum from perforation
air both inside and outside bowel wall (RIGLERS SIGN)
chronic lung disease in preterm infants
most common is bronchopulmonary dysplasia
-resulting from poor lung growth and lung injury
