SGA, LGA, infant of diabetic mother, post dates Flashcards
1
Q
small for gestation age
A
SGA
2
Q
appropriate for gestation age
A
AGA
3
Q
large for gestation age
A
LGA
4
Q
• Preterm, full term, or post term infants that fall below 10th percentile • More likely to experience fetal distress and asphyxia • Low Apgar scores • Meconium aspiration • Polycythemia • Hypoglycemia - 40 BS is normal • Inadequate thermoregulation
A
SGA baby
5
Q
- Congenital malformations
- Chromosomal anomalies
- TORCH infections
- Pre-eclampsia
- Diabetes
- Poor placental function
- Smoking
- Drug abuse
- Alcohol abuse
- Maternal malnutrition
A
Risk factors for SGA
6
Q
- Long term condition r/t anomalies, early exposure in pregnancy
- Chronic prolonged restriction of growth
- Proportionate body
- Weight, length, head circumference all SGA
- May be small throughout life
A
SGA classifications: symmetric
7
Q
- Acute compromise cause by complications after 28 weeks gestation
- Weight is decreased but length and HC remain WNL
- Weight SGA, Length and head circumference AGA
- Long and skinny
- Generally will “catch up” in growth with adequate post delivery nutrition
A
SGA classifications: asymmetric
8
Q
- Prevention with good prenatal care!!
- Monitoring fundal height, US
- Preparation for early delivery if needed
- Measurements to determine classification
- Glucose monitoring
- Higher caloric need—frequent feedings
- Monitor thermoregulation
- Monitor respirations carefully >60 is a concern
A
Management of SGA infant
9
Q
- Infants above 90thpercentile
- Generally > 8#13 oz. (4000 gm)
- LGA preterm infant will resemble full term infant—may have preterm complications
- Macrosomia
A
LGA baby
10
Q
- Multiparas—size generally increases with each pregnancy
- Large parents
- Male infants
- Diabetic mother
A
causes of LGA baby
11
Q
- Prolonged labor
- Dystocia of labor
- Birth trauma
- Cesarean section—CPD
- Hypoglycemia—glucose may be normal to high initially then plummet
- Polycythemia
A
common problems with LGA baby
12
Q
- Identification and management with prenatal care
- Fundal height, glucose challenge test
- Delivery alterations
- Positioning, forceps/vacuum, epis
- Treatment of birth injuries
- Monitor glucose level
- Early and frequent feedings
- Monitor jaundice
A
management of LGA baby
13
Q
- May be SGA if severe or uncontrolled diabetes—uteroplacental insufficiency
- Typical IDM will be LGA
- Macrosomic
- Fat baby with ruddy complexion (due to extra RBC)
- Large cord and placenta also
- All organs except brain are larger
A
infant of diabetic mother (IDM)
14
Q
- Higher risk for congenital anomalies
- Neural tube, heart, kidney
- Asphyxia in utero
- RDS—less production of surfactant
- Hypoglycemia—maternal glucose ends but increased insulin by infant continues
- Hypocalcemia
- Polycythemia
- Birth trauma
A
Complications of IDM
15
Q
- Obese body
- Large, round, red face
- May be irritable
- Tremors—check blood sugar
- Poor muscle tone
A
characteristics of LGA IDM
16
Q
- Delivery alterations
- Identification of birth injury
- Identification of anomalies
- Identification of hypoglycemia and initiate feedings
- Monitor vitals for distress, heat loss
A
management of LGA or IDM
17
Q
- Over 294 days (42 weeks) beyond first day of LMP
- Complications arise from
- Uteroplacental insufficiency
- Fetal hypoxia
- Polycythemia
- Meconium aspiration
A
postdate infant
18
Q
- Underweight due to loss of subcutaneous fat
- Long and thin in girth
- Skin with patchy areas of desquamation Skin, long nails may be covered with meconium
- Wrinkled hands and feet on ventral surfaces
A
clinical signs of postdate infant
19
Q
- At delivery assess for injury
- Respiratory Distress
- Hypoglycemia
- Early and frequent feedings
- Temperature regulation
- Polycythemia - jaundice
A
nursing implications of postdate infant
