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MATCHILD > Week 6 > Flashcards

Week 6 Flashcards

1
Q

What is the role of Surfactant?

A

Surface tension–reducing lipoprotein that prevents alveolar collapse

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2
Q

What is surfactant?

A

Type of phospholipid which maintains surface tension over the alveoli, which keeps them open.
Created by type II cells within the lungs
Present at 21 weeks gestation, increases at 24 weeks, is usually sufficient at gestational ages above 32 weeks and is optimal at 35 weeks

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3
Q

Delayed Cord Clamping

A

The SOGC recommends delaying cord clamping for 60 seconds for term and preterm infants not requiring resuscitation regardless of the mode of delivery.

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4
Q

Benefits of cord clamping

A

Increase placental transfusion, leading to an increase in neonatal blood volume at birth of approximately 30% (JOGC, 2012)

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5
Q

Hepatic System Function

A

Iron storage
Carbohydrate metabolism
Bilirubin conjugation

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6
Q

GI System Adaptations

A

Development of a mucosal barrier to prevent the penetration of harmful substances

Cardiac sphincter and nervous control of stomach are immature, leading to regurgitation and uncoordinated peristaltic activity

To gain weight the newborn requires an intake of 108 kcal/kg/day from birth to 6 months of age

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7
Q

Renal System Adaptations

A

Limited ability to concentrate urine until about 3 months of age (urine has a low specific gravity)
Six to eight voidings per day considered normal

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8
Q

Intake, Output, Weight Loss and Weight Gain

A

A maximum of 10% of weight loss should occur in the newborn
Weight should return to birth weight by 10-14 days

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9
Q

First 2 days of life (intake and output)

A

60 – 80 mL/kg/day (18-27 mL/lb/day) intake
8-12 feeds/day if breastfeeding
1 to 2 voids/day

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10
Q

After first 2 days of life (intake and output)

A

100 – 150 mL/kg/day (45-68 mL/lb/day) intake
8 – 12 feeds/day if breastfed
At least 6 voids/day by 4th day

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11
Q

What immunoglobulins does the newborn primarily depend on?

A

Newborn primarily dependent on three immunoglobulins:
IgG: protects the baby from many infections in the first months of life
IgA: it coats and seals your baby’s respiratory and intestinal tract to prevent germs from entering their body and ​bloodstream
IgM: Plays role in immune regulation

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12
Q

Neurologic System Adaptations

A

Development follows cephalocaudal and proximal–distal patterns
Acute senses of hearing, smell, and taste
Adaptations of respiratory, circulatory, thermoregulatory, and musculoskeletal systems
Reflexes: indication of neurologic development and function

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13
Q

First Period of Reactivity

A

Birth to 30 minutes to 2 hours after birth
Newborn is alert, moving, may appear hungry

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14
Q

Period of Decreased Responsiveness

A

30 to 120 minutes old
Period of sleep or decreased activity

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15
Q

Second Period of Reactivity

A

2 to 8 hours
Newborn awakens and shows an interest in stimuli

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16
Q

Orientation

A

response to stimuli

17
Q

Habituation

A

Ability to process and respond to auditory and visual stimuli
Ability to block out external stimuli after newborn has become used to activity

18
Q

Motor Maturity

A

ability to control movements

19
Q

Self Quieting Ability

A

consolability

20
Q

Social Behaviours

A

cuddling or snuggling

21
Q

Hearing Screening

A

Non-invasive testing
Initial screening - evoked otoacoustic emissions (EOAE) test
Follow-up for abnormal screen - auditory brainstem response (ABR) test

22
Q

Apgar Scoring System

A

Apgar score at 1 minute and 5 minutes, scoring from 0 (very poor) to 2 (excellent) in following areas: heart rate, respiratory rate, muscle tone, reflex irritability, skin colour

8 to 10: No intervention required except to support infant’s spontaneous efforts.
4 to 7: Gently stimulate; rub infant’s back; administer oxygen to infant.
0 to 3: Requires resuscitation.

23
Q

typical body measurements

A

Length: 45 to 55 cm (18-22 in)
Weight: 2500 to 4300 g (5.5-8.75 lb)
Head circumference: 33 to 35.5 cm (13.2-14 in)

24
Q

how is heat lost in newborns

A

conduction, evaporation, radiation and convection

25
Q

Cold Stress

A

Oxygen and vast amounts of energy are redirected to sustain thermogenesis.
This means that the brain and heart do not receive as much oxygen and energy.
Blood pH drops as a result of inadequate pulmonary perfusion.
Metabolism increases to maintain warmth, which results in glycolysis – glycolysis worsens jaundice

26
Q

Appropriate for Gestational Age

A

approximately 80% of newborns; normal height, weight, head circumference, body mass index

27
Q

Small for Gestational Age

A

weight <2,500 g (5 lb 8 oz) at term or below the 10th percentile

28
Q

Large for Gestational Age

A

weight >90th percentile on a growth chart; weight >4,000 g (8 lb 13 oz) at term

29
Q

Typical Characteristics of SGA

A

Head disproportionately large compared with rest of body
Wasted appearance of extremities; loose dry skin
Reduced subcutaneous fat stores
Decreased amount of breast tissue
Scaphoid abdomen (sunken appearance)
Wide skull sutures
Poor muscle tone over buttocks and cheeks
Thin umbilical cord

30
Q

Typical Characteristics of LGA

A

Large body, plump, full-faced
Proportional increase in body size
Poor motor skills
Difficulty regulating behavioural states

31
Q

full term

A

Born from the first day of the 38th week through 42 weeks

32
Q

preterm

A

Born before completion of 37 weeks

33
Q

late preterm (dumb)

A

Born beyond 42 completed weeks

34
Q

postterm

A

Born beyond 42 completed weeks

Inability of placenta to provide adequate oxygen and nutrients to fetus after 42 weeks

35
Q

Typical Characteristics of Postterm baby

A

Dry, cracked, peeling, wrinkled skin
Meconium-stained skin and nails; long nails
Long, thin extremities; creases over entire soles of feet
Wide-eyed, alert expression
Abundant hair on scalp
Thin umbilical cord
Limited vernix and lanugo

36
Q

Discharge planning; newborn must be able to

A

Thermoregulate
Control breathing (no apneic spells for 5-7 days)
Demonstrate respiratory stability (be free of a ventilator) and maintain SPO2 at 90-95%
Demonstrate ability to feed without ‘spells’, and gain weight
Parents must be emotionally ready to take on the task of having a premature newborn at home.
Family involvement is promoted, and parents can often stay with their newborns in hospital.

37
Q

Parental Eval prior to discharge

A

Confidence in caring for their newborn
Administer medications/medical care as needed
Demonstrate knowledge re: management of signs of symptoms of illness and when to return to hospital
Maintaining infection control at home
Maintaining a smoke-free environment

38
Q

What is Horner Syndrome?

A

damage to nerve which controls pupil dilation, eyelid control and perspiration

39
Q

Hyperbilirubinemia

A

Imbalance in rate of bilirubin production and elimination; total serum bilirubin level >5 mg/dL

MATCHILD (6 decks)

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