Unit 2 (Newborns): 5

Question 1

Pathologic jaundice

When does it happen?
Associated with?
Causes?

Answer 1

Before 24 hours of age
Associated with bilirubin encephalopathy or kernicterus

Causes:
* ABO incompatibilities
* Maternal infections
* Maternal ingestion of sulfonamides, diazepam or salicylates near term

Question 2

Physiologic Jaundice

When does it happen?
More common in who?
What happens?

Answer 2

Most common
After 24 hours of age

More common in LPI (late preterm) and preterm infants

• Rapid breakdown of RBC
• Immature liver
• Dehydration

Question 3

Transient Tachypnea of the
Newborn (TTN)

TERM!!!!!

what is it?
More likely to happen?
Resp rate?
Signs/symptoms? 4

Answer 3

Delayed clearance of fetal lung fluid from lungs.

More likely to happen in C section w/o labor

Respiratory rate > 60 breaths/min.

Signs/Symptoms:
* Grunting, retracting, nasal flaring, cyanosis

Question 4

Hypoglycemia

BG levels lower than?

Symptoms?
JPLAR THAS

Treatment?

Answer 4

Blood glucose level lower than 40 in the first 72 hours

Jitteriness
Poor feeding
Lethargy
Abnormal cry
Respiratory distress

Temperature Instability
Hypotonia
Apnea
Seizures

Treatment
* Early and frequent feeds.
* Monitor blood sugar levels in at risk infants

Question 5

Respiratory Distress Syndrome
(RDS)

PRETERM!!!!

What is it? lack of?

Symptoms present?

What are the symptoms?
RRGN TD FGS

Treatment?

Answer 5

Breathing disorder caused by premature lungs
Lack of surfactant

S&S present 4-24 hours of life

Signs/Symptoms:
* Rapid shallow breathing
* Retractions
* Grunting
* Nasal flaring
* Tachypnea then apnea
* Decreased breath sounds
* Fine rales
* Generalized cyanosis
* Shortness of breath

Treatment:
* Warm moist oxygen
* Exogenous surfactant
* Mechanical support prn (CPAP, ventilator)

Question 6

Compare TTN and RDS

TTN is unique to? Generally?

RDS affects? Requires? Can lead to?

Answer 6

TTN
* Unique to the term infant
* Generally time-limited with little respiratory support needed

RDS
* Affects preterm infants
* Requires aggressive support
* Can lead to complications such as BPD

Question 7

Explain nursing care during newborn transition:

4 methods of heat loss

Answer 7

i. Convection – air movement – heat lost to cooler air
ii. Radiation – heat loss to cooler surface not in direct contact
iii. Evaporation – moisture vaporization from the skin, thin skin
iv. Conduction – heat lost to cooler surface directly in contact with newborn

Question 8

Explain infant indicators of effective breastfeeding.

1. Most breastfed infants should have?
2. Stool should no longer?
3. Infant seems?
4. Infant?
5. Urine is?

Answer 8

Most breastfed infants should have 3-4 stool diapers by 4th day of life!!!

Stool should no longer be meconium-like, but yellow in color.

Infant seems content between feeds

Infant gains weight

Urine is pale yellow and not concentrated

Question 9

LATCH acronym?

Answer 9

Latch: grasps nipple, tongue down, rhythmic sucking

Audible swallowing

Type of nipple, inverted, flat, out

Comfort of nipple: cracked is bad, should be soft/non tender

Hold (positioning): no assistance needed by nurse