Special Needs Flashcards
Perinatal asphyxia
Deprivation of o2 during birth process
Perinatal asphyxia risks
Bad FHR
Bad 02
Fetal distress
Premature
IUGR/SGA
Tobacco use
Pre-eclampsia/eclampsia
Initial steps/normal steps for neonatal resuscitation
-Provide warmth using radiant
-dry baby (stimulate breathing)
-position head to open airway
-bulb suction
Neonatal resuscitation if severe
<100bpm = (PPV) positive pressure ventilation via bag mask
<60bpm = chest compressions after ventilations
Administer epinephrine, volume expanders (Isotonic IVF)
Premature infants
Prior to what week
Breathing
Thermoregulation
Feeding
Prior to 37 weeks
Breathing: immature lungs/ decreased surfactant
Thermoregulation: lack of brown fat, poor muscle tone
Feeding: immature GI system, sucking reflex around 32 weeks(cant PO feed).
Premature assessment
Looks/muscle/fat
Skin
Soles
Male genitalia
Female genitalia
Scrawny/poor muscle tone/minimal fat
Thin skin/abundant languo and vernix
Poorly formed ears/fused eyelids
Absent creases
Undescended testes/minimal scrotum rugae
Prominent labia and clitoris
Preterm infant respiratory distress
-why they have resp issues
-interventions
Immature lungs (less alveoli/deficient surfactant)
Interventions:
-surfactant thru ETT
-oxygen (warmed and humidified)
-CPAP
-mechanical ventilation (will try not to)
Premturity:
-thermoregulation (why they are colder)
-interventions
Thermoregulation:
-thin skin, less fat
-less borwn fat
-extended extremities
Interventions:
-neutral thermal environment
-skin to skin
-warmers
-incubators/isolettes (the box)
Prematurity
-kidneys
-GI tracts
Kidneys: immature
-pee alot
-get I&O
GI tract:
-gavage feeding (NG tube)
-assess for intolerance
(vomiting entire feed, abdominal distention, residual)
Preterm nursing care
Cluster care
Reduce stimulation
Position (change @ care times)
Skin to skin
Non-nutritive sucking (@ 32 weeks they can suck)
Postmature infants
-age
-what we see
> 42 weeks
-long thin body
-meconium-stained fingernails/skin/cord
-peeling/cracked/dry skin (vernix is gone)
Postmature infants
Complications
Increased mortality
Aging placenta: risk of hypoxia
Passing meconium: risk of aspiration
Hypoglycemia
Polycythemia (high H&H, RBC)
Hyperbilirubinemia (have to break down excess RBCs)
SGA (small for gestational age)
Percentile and wt
Contributing factors(4)
Below 10%
<2500g
Contributing factor:
-HTN/pre-eclampsia
-smoking/substance abuse
-infections
-multiple fetal gestation (multiple babies)
SGA
Potential complications
Perinatal asphyxia
Resp. Distress syndrome
Hypoglycemia
Heat loss issues
SGA nursing management
Resp support
Prevent cold stress
Intiate early/frequent feedings
Prevent infection
Monitor for jaundice
