Toni - Week 7 - Exam 4 Flashcards
what is the definition of small for gestational age (SGA)?
birth weight < 10th percentile
what are characteristics of a SGA baby?
Loose, dry skin, little fat/muscle, scaphoid (sunken) abdomen, thin cord, wide skull sutures, weak cry
what are SGA babies at risk for?
Risk for hypoglycemia and developmental delay
what is the definition of large for gestational age (LGA)?
Birth weight > 90th percentile or full term > 4000 g
LGA could be related to what?
maternal diabetes, postdates, large parents
what are LGA babies at risk for?
Risk for hypoglycemia, respiratory distress, birth trauma
what are the two different gestational age variations?
postterm and preterm
what is the definition for postterm??
born > 42 weeks
T/F a postterm baby can be SGA, LGA, or AGA
TRUE
what are the characteristics of a postterm baby?
Wasted appearance, lack vernix, lanugo, & subcutaneous fat. Dry, cracked skin
what is a postterm baby at risk for?
Risk for asphyxia, hypoglycemia, meconium aspiration, birth trauma
what is the definition for preterm?
born < 37 weeks
preterm baby could could be related to what?
infection, ATOD, trauma, preeclampsia, malnutrition, diabetes, multiple pregnancy
what are the characteristics of a preterm baby?
Lack subcutaneous fat & surfactant. Weak lungs, suck, &
gag. Fragile capillaries (cerebral bleed)
what are the 4 characteristics of preterm infant care setting?
- Flexed in quiet, dark, warm nest
- Avoid overstimulation
- Facilitate self stimulation
- Prevent skin dryness/breakdown
what type of feedings are given in preterm infant care?
TPN, gavage, nipple supplemental nursing system, breastmilk fortifier
what are nurses assessing for in preterm infants?
Assess for cerebral bleed, necrotizing enterocolitis (NEC) - breakdown in bowel → infection → prevent by breastfeeding, hypothermia, hypoglycemia, retinopathy of prematurity, respiratory distress syndrome (RDS), cerebral palsy, developmental delay
what are risk factors for neonatal respiratory distress?
prematurity and maternal diabetes
what is the pathophysiology associated with neonatal respiratory distress?
Insufficient surfactant, inadequate/collapsed alveoli,
weak skeletal muscles
what should we be assessing for with neonatal respiratory distress?
• Signs/symptoms develop first 1-2 hours life
• Decreased O2 sat; duskiness, pallor, cyanosis; tachypnea, retractions,
nasal flaring, grunting, crackles, diminished breath sounds,
tachycardia
what are interventions for neonatal respiratory distress?
- Intra-tracheal surfactant replacement therapy
- Oxygen via bubble CPAP, oscillator, ventilator, hood, or NC
- Monitor O2 sats & arterial blood gases (ABGs)
- No oral feedings if respiratory rate > 60
what are the benefits of kangaroo care?
- Increased sleep time
– HR regularity
– Fewer apneic &bradycardic spells
– Decreased need O2
what are the outcomes of kangaroo care?
– Thermal synchrony – Effective breastfeeding – More rapid weight gain – Increased attachment – Shorter hospital stays
what implementations should be done during kangaroo care?
– Quiet warm environment – Infant upright on parent chest, ear over heart, skin to skin – Encourage to rock/stroke infant – Decrease activity if overstimulated
what causes hypoglycemia in an infant with a diabetic mother?
Fetal hyperinsulinism causes neonatal hypoglycemia
what should be assess for in an infant of a diabetic mother?
Assess for macrosomia, RDS, congenital anomalies (cardiac & spinal), birth trauma, polycythemia
what are interventions that should be implemented for an infant of a diabetic mother?
– Blood glucose check @ 30 min
& 1, 2, 4, 6, 9 12, & 24 hrs of
age
– Treat hypoglycemia
what is the definition of newborn hypoglycemia?
blood glucose < 40 mg/dL
what should we be assessing for hypoglycemia?
Assess for tremors, jitteriness, lethargy, poor feeding,
decreased muscle tone, apnea, cyanosis