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OB > Test-3 > Flashcards

Test-3 Flashcards

1
Q

Neonatal period

A

Birth to 28 days

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2
Q

Nursing care for neonate

A 
Body heat
Respiratory function
Infection
Nutrition, hydration 
Assist parents
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3
Q

Transitional phase

A

First 6-12 hrs of life

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4
Q

4th stage

A

Birth-4hrs

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5
Q

Respiratory mechanical changes

A

30 mL forced out of lungs into lymphatic system

PULMONARY arteries dilate and receive blood

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6
Q

Respiratory chemical

A

Mild hypoxia and acidosis produced by labor-stimulate breathing center in medulla
-sensory stimulation

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7
Q

Ability to establish functional residual capacity

A

Depends on surfactant in alveoli

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8
Q

Normal respiration in newborn

A

Irregular, shallow, diaphragmatic, moist

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9
Q

Periods of apnea in newborn

A

> 15 seconds should be noted
<30 seconds- side effect of drugs
60 seconds- respiratory distress

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10
Q

Signs of respiratory distress

A 
Cyanosis
Apnea, tachypnea
Retractions of chest wall
Grunting
Flaring nostrils
Hypotonia
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11
Q

Assess newborn

A

Every 30 minutes for first hour
Every hour up to 4 hours
Once per shift> 4 hours old

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12
Q

Respiratory distress cause

A 
Lack of surfactant 
Pneumothorax 
Bronchopulmonary hypertension 
Hypoglycemia 
Patent ductus arteriosus 
Transient tachypnea ( common in c/s, delay lung clearance)
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13
Q

Pathophysiology of respiratory distress- preterm

A

Surfactant starting at 24-28 weeks

Phospholipid (70-80%)

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14
Q

PG test

Phosphatidylglyerol

A

Represents advanced fetal PULMONARY maturity

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15
Q

LS ratio

Lecithin/sphingomyelin

A

Are the lungs mature?

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16
Q

Atelectasis

A

May be caused by hypoxemia, hypercarbia, right to left shunt, metabolic acidosis

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17
Q

Complications of respiratory distress

A

Necrotizing enterocolitis

Bronchopulmonary dysplasia- chronic lung problem from treatment of ventilation

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18
Q

Respiratory distress nursing actions

A 
Patent airway- assess e.g. tube
O2, CPAP, ventilation 
Maintain neutral thermal environment 
VS, O2 sats, suction, blood gases
Claiming measures
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19
Q

Circulatory system

A

Transition occurs within seconds of clamping cord

Influenced by respiratory system

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20
Q

Three physiologic shunts during fetal life

A

Foreman ovale
Ductus arteriosus
Ductus venosus

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21
Q

Foramen ovale

A

Opening between right and left atrium- hole allows reddest blood go from right atrium to left atrium, then left ventricle and out aorta. Blood with most O2 goes to brain

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22
Q

Ductus arteriosus

A 
Connects PULMONARY artery and aorta 
Closes within 15 hours after birth
PULMONARY resistance less than vascular resistance 
Left to right shunt
Closes ductus arteriosus
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23
Q

Ductus venosus

A

Connects umbilical vein to inferior vena cava
Closes by day 3 of life, becomes a ligament
Blood flow stops when cord is clamped

24
Q

Circulatory system nursing actions

A 
Birth to 1st hour 
Cyanosis/hr every 30 mins
1-4 hours old
Cyanosis/ Hr every hour 
4-24 hours old
HR once/ shift
25
Q

Factors that negatively affect thermoregulation

A

Little subcutaneous fat
Little brown fat
Loss of heat
Large body surface

26
Q

Neutral thermal environment

A

Environment that maintains body temperature with minimal metabolic changes or changes in oxygen consumption

27
Q

Brown adipose tissue

A

Dense adipose tissue
No shivering thermogenesis
Neck, thorax, axillary, kidney

28
Q

Brown adipose tissue promotes

A 
Increase metabolism 
Heat production
Heat transfer to peripheral system
Reserves rapidly depleted during cold stress 
Preterm have limited amount
29
Q

Evaporation

A

Water on skin converted to vapors - bathing, birth

30
Q

Conduction

A

Heat to cooler surfaces

Cold hands/bed

31
Q

Convection

A

Air currents

Oxygen masks

32
Q

Radiation

A

Heat to cooler near by objects

Walls

33
Q

Cold stress

A 
Decrease temp
Increase respirations, HR
Increase O2 demand
Depletion of glucose 
Decrease surfactant
Respiratory distress
34
Q

Cold stress risk factors

A 
Prematurity 
Small for gestational age 
Hypoglycemia 
Prolonged resuscitation efforts 
Sepsis
35
Q

Signs and symptoms of cold stress

A 
TEMP <36.5 or 97.7
Pallor 
Mottling
Lethargy
Apnea
36
Q

Cold stress actions

A

Skin to skin
Dry baby

Preheat warmer
Monitor TEMP
Glucose check

37
Q

Critical lab value

Glucose

A

Less than 40

38
Q

Risk factors for hypoglycemia

A 
Small or large for gestational age
<37 weeks 
Diabetic mom
Delayed feeding
Stressed or ill baby
Medication
39
Q

Signs and symptoms of hypoglycemia

A 
Apnea
Lethargy
Decreased tone
TEMP instability 
Poor feeding
40
Q

Nursing actions hypoglycemia

A

Prevention
Assess s&is
Check glucose
Decrease cold risk stress

41
Q

Conjugation of bilirubin

A

Increased RBC volume +
Shorter RBC life span=
Increased bilirubin

42
Q

Indirect bilirubin

A

From breakdown of RBCs converted by liver enzymes to direct bilirubin

43
Q

Direct bilirubin

A

Excreted through urine/ stool

44
Q

Normal bilirubin levels and critical level

A

Normal: 5-6
Critical: >13

45
Q

Preterm and bilirubin

A

Worry about kernicterus: abnormal accumulation of unconjugated bilirubin in brain cells

46
Q

Pathological jaundice

Red flag

A 
Occurs <24 hrs old
>12.9 term neonate
>15 preterm 
Increased more than 5 per day
Lasts more than a week
47
Q

Risk factors for pathological jaundice

A

ABO and Rh incompatibility
Sepsis
Hypoxemia
Metabolic factors

48
Q

Nursing actions

Jaundice

A

Assessment
Tests: blood draw
Coombs test

49
Q

Jaundice treatment

A

Phototherapy
Fluids
Exchange transfusion

50
Q

Gastric capacity for newborns

A

5-10 mL then increases to 60 mL by 7th day

51
Q

Types of stool

A

Meconium
Transitional (3rd day)
Breastfeed- yellow mustard seed, not smelly
Formula- less often, tan, yellow, green, stronger odor

52
Q

Necrotizing enterocolitis- preterm

A

Inflammation of bowel

53
Q

Necrotizing enterocolitis risks

A

Prematurity
Impaired GI host defense
Bacterial colonization from feeding tubes
Umbilical Cathe placement

54
Q

Necrotizing enterocolitis

Causes

A

Hypoxia
Cold stress
Hypocolemia
Patent ductus arteriosus

55
Q

Necrotizing enterocolitis

Findings

A 
Apnea
Respiratory failure
Hypoxemia
Unstable TEMP 
Abdominal distension 
Bloody stools
Lethargy
56
Q

Necrotizing enterocolitis

Nursing

A

Distension
With hold feeding
Orogastric tube for decompression

57
Q

Bronchopulmonary dysplasia

A

Chronic lung problem that effects neonates who have been treated with mechanical ventilation

OB (6 decks)

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