Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Simmons NURP 501 Exam 3 Weeks 12 and 13 > Week 13 Perinatal Disorder > Flashcards

Week 13 Perinatal Disorder Flashcards

1
Q

Toxoplasmosis: Description and Epidemiology

A

Cat feces
Undercooked meat
Ingestion of contaminated soil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Toxoplasmosis: Clinical findings

A 
Prematurity and low Apgar scores
Jaundice
Anemia
Hepatosplenomegaly
Chorioretinitis
Microcephaly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Toxoplasmosis: Diagnostic Studies

A

CT brain: Calcification or hydrocephalus
CSF: high protein, low glucose and evidence of T. Gondii
Serum Immunoglobulins: Antibodies against Toxoplasmosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Toxoplasmosis: Management, prognosis and prevention

A

Pyrimethamine, sulfadiazine with folic acid supplement

Infants with severe involvement at birth have impaired: vision, hearing, cognitive function

Prevention: gloves, and avoid contaminants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Congenital Rubella: Description and Epidemiology:

A

RNA virus. Contact transmission. Virus infects the placenta and is transmitted to the fetus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Congenital Rubella: Clinical Findings

A

Maternal infection before 16 weeks gestation, negative rubella titers in mother, 50% of infected women are asymptomatic

PE: Hearing loss, congenital heart disease, mental retardation, cataract or glaucoma, microcephaly and “blue berry muffin” skin lesion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Congenital Rubella: Diagnosis studies

A

nasopharyngeal secretions, conjunctiva, urine, stool, CSF

Measure serum immunoglobulins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Congenital Rubella: Managment and Prevention

A

Monitoring and intervention for developmental, hearing, vision and medical needs
Women of all child bearing age need to immunized

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

CMV: Description and Epidemiology

A

Member of the herpes virus. Transmitted with virus containing secretions and blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

CMV: Clinical findings

A

H & P: maternal infection, SGA/IUGR, hepatosplenomegaly, jaundice, petechial rash, chorioretinitis, cerebral calcifications, microcephaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

CMV: Diagnostic Studies

A

Viral cell cultures from urine, saliva, or other body fluids

Proof of congenital infection requires obtaining specimens within 3 weeks of birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

CMV: Management, prognosis, and prevention

A

Greatest risk are susceptible pregnant women exposed to urine and saliva from CMV infected children at daycares

Handwashing!

Ganivclovir to decrease progression of hearing impairment

Monitor urine for 18-24 months

The outcome of congenital CMV infection is poor (high morbidity rate): psychomotor retardation, microcephaly, hearing loss, seizures, chorioretinitis, optic atrophy, mental retardation, learning disabilities.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Group B Streptococcus: Description and epidemiology

A

Leading cause of sepsis in infants from birth to 3 months

Gram-positive diplococcus that forms colonies in maternal GU GI tract

GBS acquired by infants through vertical transmission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Group B Streptococcus: Clinical Findings

A

History: infants < 37 weeks gestation, ROM >18 hours, maternal fever during labor >100.4 F, previous delivery of a sibling with invasive GBS, maternal chorioamnionitis

PE: Poor feeding, temp instability, cyanosis, apnea, tachypnea, grunting, flaring, retractions, seizures, lethargy, bulging fontanelle, rapid onset deterioration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Group B Streptococcus: Diagnostic studies

A

blood culture,

CSF or both

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Group B Streptococcus: Management, prognosis, and prevention

A

PCN and aminoglycoside until GBS differentiated from E. coli or Listeria sepsis or meningitis

Screen all pregnant women at 35-37 week OB. GBS + women need IV PCN or ampicillin at onset of labor and every 4 hours until birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Listeriosis: Description and Epidemiology

A

Gram positive Rod
Soil, streams, sewage, certain foods, silage, dust and slaughterhouses

Mexican cheese, whole and 2% milk, uncooked hotdogs, undercooked meat, raw veggies, shellfish

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Listeriosis: Clinical Findings

A

H & P: brown-stained amniotic fluid, generalized sx of sepsis, whitish posterior pharyngeal and cutaneous granulomas, disseminated erythematous papules on skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Listeriosis: Diagnostic Studies:

A

Blood, CSF, meconium, and urine are cultures

CSF: high protein, decreased glucose, and high leukocyte account

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Listeriosis: Management and Prognosis

A

IV Ampicillin and aminoglycoside (gent) as initial therapy

Transplacentally acquired listeriosis usually results in SAB

Survivors on listeriosis: mental retardation, paralysis, and hydrocephalus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Congenital Varicella: Description and Epidemiology

A

Herpes Virus

22
Q

Congenital Varicella: Clinical Findings

A

H & P: Hx of maternal chickenpox infection, limb atrophy, scarring of the skin, eye manifestation

23
Q

Congenital Varicella: Diagnostic Studies

A

Immunofluorescent staining of vesicular scrapings

24
Q

Congenital Varicella: Management, Prognosis, Prevention

A

VZIG
Acyclovir
Vaccination of nonpregnant women

25
Q

Gonorrhea: Description and Epidemiology

A

Organism lives in exudate and secretions of infected mucous membranes

Gonococcal infection of the newborn are primarily acquired during delivery

26
Q

Gonorrhea: Clinical Findings

A

H & P: History of maternal gonococcal infections: Finding of conjunctivitis

27
Q

Gonorrhea: Diagnostic studies

A

a culture of eye exudate

28
Q

Gonorrhea: Management and prevention

A

Single dose of IM ceftriaxone 25-50 mg/kg not exceeding 125 mg) for prophylaxis of infants born to mothers with active infection

Gonorrheal conjunctivitis can lead to blindness

Eye ointment: 1% silver nitrate, 1 % tetracycline or erythromycin 0.5%

29
Q

Chlamydia: Description and Epidemiology

A

Infection occurs in 50% of infants born vaginally to infected mothers

30
Q

Chlamydia: Clinical Findings

A

H & P: History of maternal chlamydia infections, conjunctivitis within a few to several weeks after birth, infant commonly afebrile with normal activity level
Pneumonia 2-19 weeks after birth

31
Q

Chlamydia: Diagnostic Studies

A

Cell cultures

32
Q

Chlamydia: Management and Prevention

A

Oral erythromycin suspension 50 mg/kg/day divided by 4 doses for 10-14 days for conjunctivitis and pneumonia

Appropriately treat of the pregnant woman before delivery

33
Q

Syphilis: Description and Epidemiology

A

Routine maternal serological testing required in all states

34
Q

Syphilis: Clinical Findings

A

H & P: Maternal infection and positive serologic testing; majority of infants are asymptomatic at birth, hepatosplenomegaly; persistent rhinorrhea, maculopapular or bullous dermal lesions, FTT, restlessness, fever

35
Q

Syphilis: Diagnostic Studies

A

Vernereal Disease Research Lab VDRL

Rapid Plasma Repair RPR

36
Q

Syphilis: Management and Prevention

A

10 consecutive days of crystalline PCN 100-150,000 units/kg/day IV
Then Procain PCN G 50,000 units/ KG IM for 10 days
If more than 1 day missed entire course must be restarted
Untreated congenital syphilis can lead to multiorgan involvement

37
Q

Herpes Simplex Virus: Description and Epidemiology

A

3 Categories:
Disseminated disease: Present with sx suggestive of bacterial sepsis plus hepatitis, encephalitis, pneumonitis, DIC
CNS disease: Seizures and encephalitis
Local: Disease restricted to skin, eyes and mouth

HSV transmitted with direct contact during birth

38
Q

Herpes Simplex Virus: Clinical Findings

A

H&P: Mom has lesions and delivered vaginally. Vesicles in skin, eyes, and mouth are found.
S/S: Encephalitis, pneumonia or sepsis

39
Q

Herpes Simplex Virus: Diagnostic Studies

A

Tissue cultures from exudate 24-48 hours after birth

Rapis ID tests: PCR, DNA from CSF

40
Q

Herpes Simplex Virus: Management, Prognosis, Prevention

A

Antiviral therapy in final weeks of pregnancy for women with a hx of HSV
Acyclovir 20 mg/kg/dose IV every 8 hours for 14 days

Cesarean delivery before ROM in any woman with active infection

Acyclovir IV or ophthalmic drugs for the infected infant

41
Q

Cocaine: Infant Findings

A 
Low Birthweight, 
IUGR, 
prematurity, 
fetal distress
meconium staining
Anomalies of GU and GI
Feeding difficulties
liability of mood
42
Q

Cocaine: Management, complications and Prevention

A

Offer quiet environment with decreased stimuli
Mothers who use cocaine should not breastfeed
Prenatal cocaine exposure has been linked to:
changes in IQ
Neurobehavioral dysfunction
hyperactivity
aggression
short attention span

43
Q

Heroin and Methadone exposure:

A 
Tremors and hyperirritability
Limbs rigid and hyperreflexia
Skin abrasions secondary to hyperactivity
Tachypnea
Poor feeding
Diarrhea
Vomiting
High-pitched cry
Fist sucking
Low birth weight or SGA

Withdrawl begins 24-48 hours of life, withdrawal from methadone takes longer than with heroin

44
Q

Heroin and Methadone Management, complications and Prevention

A

Supportive Management: Swaddling, frequent feedings, protection from external stimuli

increased risk of SIDS

Meds: phenobarbital, tincture of opium and methadone can be used in severe SX

45
Q

Alcohol: Diagnostic Criteria

A

4 Digit Diagnostic Code

Growth Deficiency (Pre and postnatal despite adequate nutrition
Characteristic facial features: shortened palpebral fissures, thin upper lip, flattened philtrum and flat mid face
Evidence of brain dysfunction: microcephaly, structural abnormalities of the neurologic conditions such as seizures, behavioral and cognitive problems

Breast feeding should be avoided for 2-3 hours after consumption of alcohol

46
Q

Narcotics: Effects on Fetus and Newborn

A

Fetus: Increased rate of SAB and still births, IUGR

Newborn: High-pitched cry, tremulousness, sleeplessness, difficulty feeding, sweating, nasal stuffiness, sneezing, vomiting, cramping and diarrhea

Onset: 48 hours to 4 days after birth

Long-term effect: Increase risk for learning and behavioral problems

47
Q

Narcotics: Management and Therapy

A

Management: Neonatal Abstinence Scoring System

Abstinence Score <8: supportive measurements

Abstinence Score >8: and unresponsive to supportive measures: START phenobarbital

Other meds: tincture of opium, methadone, chlorpromazine. DO NOT paregoric

Breastfeeding ok while on methadone maintenance

48
Q

Marijuana: Effects on fetus and newborn

A

Fetus: No clear effect

Newborn: decreased visual responsiveness, increased tremors and startles

Long-term: increased incidence of learning deficits and behavior problems

49
Q

Marijuana: Managment

A

Supportive care: swaddling, swinging, frequent feeding and low lights

Breast feeding not contraindicated

50
Q

Tabacco: Effects on Fetus and newborn

A

Fetus: Growth restrictions, increased mortality: abruption, placenta previa, prematurity, respiratory distress, SAB

Newborn: Passes through breast milk, but no effects have been described

Long-term: increased risk of SIDS, aggressive type behavioral problems

Simmons NURP 501 Exam 3 Weeks 12 and 13 (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions