The High-Risk Infant Flashcards
The highest risk of neonatal mortality occurs in infants whose weight ___ at birth and whose AOG ___
Less than 1000g, less than 28 weeks
Lowest risk of neonatal mortality occurs in infants whose birthweight ___ and AOG ___
3000-4000g, 38-42 weeks
Criteria for fetal transfusion syndrome
1) Difference of 5 g/dl hgb 2) Difference of 20% body weight
Criteria for monovular twins
1) Same sex 2) Features obviously alike 3) Same hair color, texture, curliness 4) Same color and shade of eyes 5) Same skin texture and color 6) Same conformation and size of hands and feet 7) Close anthropometric agreement
Symmetric vs asymmetric IUGR: Earlier onset
Symmetric
Symmetric vs asymmetric IUGR: Associated with diseases that seriously affect fetal cell number
Symmetric
Symmetric vs asymmetric IUGR: Associated with poor maternal nutrition
Asymmetric
Symmetric vs asymmetric IUGR: Associated with exacerbation of maternal vascular disease such as preeclampsia and chronic htn
Asymmetric
T/F: Survival rate of LBW and sick infants is higher when they are cared for at or near their neutral thermal environment
T
Optimal environmental temp for minimal heat loss and O2 consumption for an unclothed infant is one that maintains the infant’s core temp at ___
36.5-37C
Very premature infants (less than 1000g) may lose as much as ___ml/kg/hr
2-3
A larger premature infant (2000-2500g) may have an insensible water loss of approximately ___ml/kg/hr
0.6-0.7
Fluid intake in term infants is usually begun at ___ on day 1
60-70ml/kg
Smaller more premature infants may need to start with ___ fluid intake on day 1
70-80
For TPN, infusate should contain ___ synthetic amino acids and usually ___ glucose
2.5-3.5g/dL, 10-15g/dL
The process of oral alimentation requires a synchronized process that is usually absent before ___
34 weeks of gestation
___ is the practice of feeding very small amounts of enteral nourishment to VLBW preterm infants to stimulate development of the immature GIT
Trophic feeding
Benefits of trophic feeding
1) Enhanced gut motility 2) Improved growth 3) Decreased need for parenteral nutrition 4) Fewer episodes of sepsis 5) Shortened hospital stay
For infant less than 1000g, initial trophic feeding can be given at ___ then increased to ___
10-20ml/kg/24h for 5-10 days, 20-30 ml/kg/24hr
While ongoing trophic feeding in infants , IV fluids are needed until feedings provide ___
120ml/kg/24h
For infants >1500g, feeding is initiated at a volume of ___ with increments of ___
20-30ml/kg/24h, 20-30ml/kg/24h
Vitamin ___ supplementation reduces BPD in ELBW infants
A
Iron stores, even in a VLBW neonate, are usually adequate until ___
An infant’s BW has doubled
Iron supplementation in VLBW neonates should be started when BW has doubled at a dose of
2ml/kg/24h
Factors that increase the chance of survival among premature infants
1) Antenatal steroids 2) Female sex 3) Singleton pregnancy
Prior to discharge of a premature infant, growth should be occurring at steady increments of ___
30g/day
