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6336 Mgnt of childbearing family > Test 1 > Flashcards

Test 1 Flashcards

1
Q

When the infant has an increased HR and temp think…

A

sepsis or CHF, SVT

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2
Q

What is the purpose of the R atrial blood being shunted across the PFO to the Left atrium?

A

to provide the highest oxygenated blood to coronary, carotid and subclavian arteries

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3
Q

The APGAR score is

A

an initial assessment of the infant’s transition to extrauterine life

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4
Q

which of the following facilitates transition to extrauterine life?

A

decreased plumonary and increased systemix vascular resistance

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5
Q

at birth, an infant has a HR of 140, loud cry, some flexion of the arms and legs, withdrawal of the feet when stimulated, and a pink body with blue extremities. This infant’s APGAR score is.

A

8

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6
Q

When is Breastfeeding contraindicated in the US

A

maternal HIV

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7
Q

What milk has the highest concentration of immunoglobulins?

A

Colostrum

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8
Q

When is it acceptable for full terms infants to regain their birth weight?

A

2 weeks

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9
Q

What type of care helps the mother’s breast milk supply increase?

A

Skin to skin contact

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10
Q

What vitamin is very low in human milk and is recommended to provide supplements

A

Vit D

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11
Q

What formula is required for infants if they have galactosemia?

A

Soy based - Prosobee

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12
Q

What are the four main reasons elective cesarean births are rising?

A
  1. VBAC rates have fallen by 55% since 1996
  2. C/S rates have increased 33% from 1996-2004
  3. half of all c/s are repeats
  4. 50% of all late preterm infants are born by c/s
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13
Q

What is the main effort to reduce iatrogenic prematurity?

A

Wait for the onset of spontaneous labor

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14
Q

Infant tend to start sucking at different ages. What makes a difference on suck maturation?

A

Every week

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15
Q

In periventricular leukomalacia, the infants are at risk for ___ and the incidence of PVL is not known.

A

increased vulnerability to injury

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16
Q

After 32 weeks, what is when the cell increase in size (plumping up)

A

Hypertrophic

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17
Q

When the height and age growth patterns are mismateched?

A

IUGR

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18
Q

There is a proportional decrease in weight related to the # of _____ per day by the mom

A

cigarettes smoked

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19
Q

With a SGA infant, the temp should be taken Q ____ until stable and then Q 4 hours

A

Q 30 mins

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20
Q

With an IDM mother the infant can be expected to have

A

Hypocalcemia (hormonal response) and MAJOR anomalies including Heart

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21
Q

What vitals would you see in the first 30 minutes after birth?

A

HR 160-180
RR 60-80
alerts, startles, tremors, crying

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22
Q

What happens to a cold stressed infant?

A

tachypnea and metabolic acidosis

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23
Q

What is the difference between colostrum and transitional milk?

A

Colostrum has high concentrations of IgG

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24
Q

When breastfeeding the infant will become____ and must feed more frequently than Q5 hours!

A

sleepy

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25
Q

The protein hydrolysate formula is used for infants with shourt gut or intractable diarrhea because of

A

of malabsorption

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26
Q

To calculate intake, you add all the volumes and see if it is enough

A

add up divide my 24 hrs and divide by weight

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27
Q

When should the infant regain BW by

A

2 weeks

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28
Q

What organ produces the greatest amount of glucose?

A

The liver - 4-6mg/kg/min

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29
Q

Why is the infant of an IDM mother quickly get hypoglycemia after birth?

A

Because the infant is in hyperinsulinemia

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30
Q

When a mother is receiving MgSo4, the infant will be…

A

hyponia and decrease variability while in utero

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31
Q

What are two major complications from PROM?

A
  1. cord prolapse

2. chorioamnionitis

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32
Q

Chronic HTN can be diagnosed in a mother if symptoms occurred before ____weeks

A

20weeks

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33
Q

When is the Glucose tolerance test completed?

A

At 27-28 weeks

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34
Q

What are three cardiac disease an infant can develop being from an IDM mom?

A
  1. pulmonary HTN
  2. Coarctation of aorta w. valve involvement
  3. Marfan’s syndrome w. aortic involvement
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35
Q

What is the most significant effect in an infant r/t PKU disease?

A

Brain growth

36
Q

When a mother has a CMV infection, the infant may be born with? (2)

A

Hepatomegaly and microcephaly

37
Q

When polyhydramnios is diagnosed, you should think…

A

esophageal atresia

38
Q

When monitoring the fetal well being, what are the 5 things the MD test for?

A
  1. fetal breathing
  2. Gross body movements
  3. Fetal tone
  4. Non-stress test
  5. Amniotic fluid index
39
Q

What test observes the accelerations in FHR following a stimulus such as fetal activity?

A

Non-stress test

40
Q

During a contraction stress test, a negative result (no decelerations during a contraction predicts…

A

fetal well being for at least 7 more days

41
Q

What results when the amniotic sacs and the placentas do not split? the infants are at risk for cord entanglment and TTTS

A

Monoamnioyic and Monochorionic.

42
Q

When twins are discordant, what are the three measurements used to determine when the smaller one says its time to deliver?

A

Abd, head (BPD), and weight

43
Q

In the second trimester, what serum is screened?
if the level is high = ____
if the level is low = ____

A

Alpha-fetoprotein
high = NTD
low = chromosomal effects

44
Q

At what weeks does the AF peak?

A

32 weeks (900-1000ml)

45
Q

What are two indications for an amniocentesis?

A
  1. abnormal maternal serium

2. fetal structural abnormality

46
Q

How many weeks is it safe and considered routine to do an amniocentesis? and it is def not to determine gender!!

A

16 weeks

47
Q

What test is used to assess FHR and reactivity in response to fetal movement?

A

Non-stress test

48
Q

When there is reverse end diastolic flow _____

A

delivery baby!

49
Q

What is considered fetal tachycardia?

A

> 160 HR

50
Q

The fetus will exhibit early decelerations during a contraction when ______

A

there is pressure on the fetal head

51
Q

The fetus will exhibit variable decelerations during a contraction when ______

A

compression on the umbilical cord

52
Q

The fetus will exhibit late decelerations when there is _____

A

uteroplacental insufficiency

53
Q

What is a good biophysical profile score?

A

8/10 + normal AF = well fetus

54
Q

When a mother is diagnosed with polyhydramnios, what si most likely to happen d/t a distended uterus.

A

premature delivery and increase rate of c/s

55
Q

How is the anterior fontanel described in an SGA infant?

A

increased in size with decreased membransous bone formation

56
Q

What are three important short term morbidities in an SGA infant?

A

Impaired thermoregulation, hypoglycemia, and NEC

57
Q

What does an LGA infant from an IDM mother have hypocalcemia?

A

the maternal diabetes causes immaturity of parathyroid function in the infant

58
Q

In cervical length measurements, what together has the highest risk of preterm labor?

A

Short cervix and funneling cervix

59
Q

What protein, if present in the secretions (found between the amnion and chorion) predicts preterm labor?

A

glycoprotein

60
Q

Dichorionic and diamniotic is what percent of all twin deliveries?

A

88%

61
Q

Normal twin growth parallels singletons until?

A

30weeks

62
Q

What is when the AFI is < 5cm (pockets) and the infant will most likely have respiratory problems?

A

Oligohygramnios (<500mls of AF)

63
Q

What is when the AFI is >25cm and you should think Esophageal TEF. >2000mls of AF

A

Polyhydramnios

64
Q

What is defined by “late preterm”

A

34-36 6/7 weeks

65
Q

What is the primary substrate for brain development?

A

glucose

66
Q

When does bilirubin peak?

A

5-7 DOL

67
Q

In the first 16weeks, there is a rapid increase in cell number (not size). This is? Insult at this stage calls for IUGR (symmetric)

A

Hyperplastic growth

68
Q

From 16-32 weeks, there is an increase in size and number of cells. this is? Insult at this stage calls for Asymmetric or symmetric growth

A

Hyperplastic and hypertrophic cell growth

69
Q

What does the Ponderal Index measure?

A

Weight and length (femur length)

70
Q

In an LGA infant, he will have Cardiomegaly which is..

A

Enlargement of walls of the heart but not the size of the chambers

71
Q

What occurs when IV glucose is administered straight into pancreatic circulation?

A

increase in insulin production, which causes a decease in serum glucose

72
Q

Infant is most likely to have type 2 diabetes later in life if (mom or Dad) has diabetes?

A

Dad

73
Q

When should you begin IV glucose immediately?

A

If infant is symptomatic with a serum <40mg/dL

74
Q

What are the common growth patterns for infants?
1st week:
6 months:
1 year:

A

1st week: regain BW
6 months: 2x BW
1 year: 3x BW

75
Q

Closure of the foramen ovale during transition

from fetal to neonatal life occurs due to

A

increase in left atrial pressure

76
Q

All of the following are indicative of
perinatal asphyxia EXCEPT:
a. Apgar scores of 0/1 minute, 1/5 minutes
and 3/10 minutes
b. Hypotonia
c. Initial pH of 7.18 on an umbilical artery
sample
d. Oliguria with hematuria at 12 hours of
life

A

c. Initial pH of 7.18 on an umbilical artery
sample

Must be below 7.00pH

77
Q

An SGA infant is at risk for… when compared to LGA or AGA

A

multiple congential anomalies

78
Q

How many calories should a term infant have each day?

A

110

79
Q

An SGA/LGA/ AGA infant will have

A

decreased vernix and immature labia

80
Q

The breakdown of amino acids and fats for glucose is called

A

gluconegensis

81
Q

How many ml/kg should a term infant have?

A

110-120

82
Q

After the initial screen for BG is low, what is the next step?

A

send off to lab

83
Q

What drug causes an infant to have a increase in neonatal glucose?

A

cortisol

84
Q

What is a normal vs after 30 minutes of life?

A

no bowel sounds

85
Q

When does the bilirubin peak in a term baby?

A

At 100hrs old

6336 Mgnt of childbearing family (3 decks)

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