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Reproductive > Test 4 part 2 > Flashcards

Test 4 part 2 Flashcards

1
Q

Hyperbilirubinemia neurologic toxicity – high levels of bilirubin will cross blood brain barrier and cause bilirubin-induced neurologic dysfunction (BIND) by damaging brain tissue

A

kernicterus

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2
Q

a graph chart used for prediction of hyperbilirubinemia risk levels in newborns according to hours of life and bilirubin levels

A

Nomogram

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3
Q

mother’s antibodies attack newborns RBC. It is common for mothers with O+ type blood to have naturally occurring anti-A or anti-B antibodies (IgG class) that can cross the placenta and attack fetal RBC with blood types A, B, or AB

A

ABO incompatibility

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4
Q

differs from ABO and is more severe. Pregnancies at risk of Hemolytic disease of the newborn (HDN) are those in which an Rh D negative mother becomes pregnant with an RhD positive child (the child having inherited the D antigen from the father). The mother’s immune response to the fetal D antigen is to form antibodies against it (anti-D). These antibodies are usually of the IgG type, the type that is transported across the placenta and hence delivered to the fetal circulation

A

Rh incompatibility

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5
Q

occurs when the immune system encounters an antigen for the first time and mounts an immune response

A

Isoimmunization or sensitization

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6
Q

a condition that is the consequence of a previous disease or injury

A

Sequelae

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7
Q

Birth trauma due to cephalopelivic disproportion

A

Shoulder dystocia
Brachial plexus injuries
Cephalohematoma
Other hematomas and bruising

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8
Q

treatment for polycythemia

A

Normal saline
Plasmanate
5% albumin
Fresh frozen Plasma

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9
Q

Polycythemia exchange can be done via

A

UVC that is not in the liver
Low UAC
PIV

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10
Q

LGA secondary to

A

Fetal hyperinsulinemia and polycythemia

Maternal pre and gestational diabetes

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11
Q

SGA secondary to

A

Maternal renovascular disease

Vascular damage of placenta

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12
Q

Blood glucose monitoring is required for

A

IDM
LGA
SGA

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13
Q

Most common congenital anomalies with infants of diabetic mothers are

A

Cardiac
CNS
Skeletal

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14
Q

Congenital anomalies with infants of diabetic mothers is caused by

A

high maternal glucose early in pregnancy

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15
Q

Why do you observe for tetnay (hypocalcemia) in infants with diabetic mothers

A

possible delay in parathyroid hormone synthesis after birth

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16
Q

SGA fetal factors

A 
Congenital infections-TORCH
Discordant twins
2 vessel cord
Trisomies
Metabolic disease
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17
Q

Types of IUGR

A

symmetrical and asymmetrical

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18
Q

IUGR where there is a lack of blood flow through whole pregnancy

A

symmetrical

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19
Q

IUGR where lack of blood flow in 3rd trimester

A

asymmetrical

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20
Q

Risks for the SGA neonate

A 
Asphyxia
Aspiration syndrome
Hypothermia
Hypoglycemia 
Polycythemia
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21
Q

Post term infant risks

A 
Increased size
CPD
Shoulder dystocia 
Cold stress
Hypoglycemia
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22
Q

neonate born after 42 weeks

A

psotmature syndrome

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23
Q

Caused by withdrawal from narcotics

A

Neonatal abstinence syndrome (NAS)

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24
Q

how much meconium is needed for testing NAS

A

5 gms

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25
Q

Test urine and meconium for NAS if mother

A

Has positive urine tox screen in hospital
Has history of use or positive tox screen in pregnancy
Any mother admitted intoxicated

26
Q

major sign of neonatal sepsis

A

unstable temperature regulation

27
Q

work up for neonatal sepsis includes

A 
Blood culture from 2 different peripheral sites 
Spinal tap
Urine culture
CBC w/ differential
WBCs
CXR
28
Q

treatment for bacterial neonatal sepsis

A

Penicillin
Ampicillin
Used with Gentamicin

29
Q

treatment for fungal neonatal sepsis

A

amphotericin B

30
Q

How long is treatment for neonatal sepsis

A

7-14 days if bacterial longer if fungal

31
Q

when does jaundice first appear

A

bilirubin level 5 mg

32
Q

Severe hyperbilirubinemia related to

A 
Hemolytic disease
Primary liver disease
Sepsis
Viral exposure (CMV, rubella)
Maternal use of oxytocin, sulfa drugs
Large cephalohematoma
33
Q

Measures serum antibodies
Used for antibody titer in prenatal labs (antibody screen)
Rhogram screen
What we are measuring in mom

A

Indirect coombs

34
Q

measures antibodies on the surface of the RBCs

What we are measuring in baby

A

Direct coombs

35
Q

Rh-mom that is isoimmunized or sensitized and has formed antibodies to Rh negative antigens to Rh + fetus

A

erythroblastis fetalis

36
Q

racial/ ethnic/ environmental risk factors for hyperbilirubinemia

A

East asian
Native american
Greeks born in Greece
Higher altitudes

37
Q

how far should the phototherapy light be

A

no further than 20’’ away

38
Q

with blue phototherapy light what needs to be monitored

A

apnea and or pulse oximetry

39
Q

Procedure involves the withdrawal and replacement of newborn blood with donor blood
Gives non-susceptible cells, removes bilirubin in serum, adds albumin (binds bilirubin)

A

exchange transfusion

40
Q

when is APGAR done

A

after 1 minute and repeated at 5 min

41
Q

if respiratory system is compromised then what will follow

A

cardiac compromise

42
Q

preterm babies are at high risk for respiratory distress within the first

A

6 hours of birth

43
Q

signs of respiratory distress in preterm babies

A

grunting
flaring
retractions

44
Q

the basic problem in a preterm baby with RDS is

A

surfactant deficiency

45
Q

Treatment for RDS before birth

A

Corticosteroids give between 24-34 weeks

46
Q

Related to delayed clearance of amniotic fluids in lungs, so gas exchange is impaired leads to

A

acidosis

47
Q

what needs to be rules out if TTN continues

A

sepsis

48
Q

Failure of the intestines to return into the abdominal cavity from the umbilical cord during development
Normally occurs at 10-12 weeks
Usually has membranous covering
Bowel appears normal unless sac ruptured

A

oomphalocele

49
Q

Bowel herniates through an abdominal wall defect
Usually to right of umbilical cord
Defect has no membranous covering
Bowel appears edematous matted
Term or near term gestation infants, but IUGR common

A

gastroschisis

50
Q

airway problems with gastroschisis must be taken care with

A

immediate intubation and ventilator

51
Q

what to do for infection prevention for gastroschisis

A

Kerlix soaked in warm saline covered with plastic warp

52
Q

a group of anomalies involving the brain and spinal cord
Failure of the cranial end of the neural tube to close causes anencephaly
Failure of the caudal end of the neural tube to close causes spina bifida

A

neural tube defects NTD

53
Q

Cephalic (head) anterior neural tube closure fails/arrests
Usually occurs between the 23rd and 26th days
Results in the absence of a major portion of the brain, skull, and scalp
Not compatible with life

A

Anencephaly

54
Q

Bones of the skull do not close completely – common location is occipital lobe and often includes areas of disturbance in posterior fossa, cerebellum, and superior mesencephalon
Meninges, cerebral spinal fluid (CSF), & possibly brain tissue protrude into a sac-like formation.

A

Encephalocele

55
Q

Protrusion of the meninges with CSF fluid in sac (no nerves)

Most of these infants require ventricular shunts

A

Meningocele

56
Q

protrusion of meninges, CFS, and nerves
Poorer prognosis
Lower/limb weakness/paralysis and bladder control issues are common
Will also require ventricular shunt

A

Myelomeningocele

57
Q

When embryonic structures of the upper lip, nose, and hard and soft palate fail to close
Results after failure to fuse by the end of 7 to 8 wks gestation

A

cleft lip and palate

58
Q

The most commonly occuring birth defect
Either occur as change the direction of blood flow or Change the normal structure and function of the heart chambers or great vessels

A

Congenital heart defects CHD

59
Q

critical congenital heart defects cause what in newborns

A

low levels of O2

60
Q

when should screening for CCHD be done

A

24 hours

Reproductive (19 decks)

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