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
