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159 Cards in this Set
- Front
- Back
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Demographic factors that may negatively effect pregnancy include age less than ____ and age greater than ___. Multiparity greater than ___ and nonwhite race have increased incidence of ____ labor and other complications.
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16
35 4 preterm |
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What are some reasons that a pregnant woman under age 16 is at greater risk?
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cervical incompetency- cervix weaker, less developed. Can cause preterm labor or miscarriage.
Nutritional Factors Developmental Factors High Risk Behaviors |
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Why do women over 35 have a higher risk of problems in pregnancy?
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less availability of fully functional eggs
Increased likelihood of chromosomal anomalies like Downs Syndrome |
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Social-personal factors include low prepregnancy weight or the opposite: ______, height less than ____cm or _____ft, smoking, use of alcohol or _____.
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obesity
152 cm or 5 feet drugs |
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CPD, or ________ _______ is when the pelvic bone structure is too narrow or small.
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cephalopelvic disproportion
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Some obstetric factors that can make a pregnancy "high risk" include a birth of a previous infant greater than _____ g, RH _______, and previous _______ or _______ death
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4000
sensitivity fetal or neonatal |
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Some existing medical conditions that can lead to complications in pregnancy include Diabetes Mellitus, ____ disorders, ______ and _____ disease, concurrent _________, ________ ______ surgery within one year of conceiving.
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thyroid
renal & cardiac infection (such as UTI, Group B Strep) Gastric Bypass |
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After Gastric Bypass surgery, a woman should wait at least one year to get pregnant. She may be deficient in B vitamins, which are important for the development and function of _____, _____, ____ in the fetus.
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blood
immune system neurologic system |
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Define large for gestational age (LGA)
What can be some causes? |
at or above the 90th percentile for gestational age
causes: genetic, obesity, gestational diabetes |
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If a baby is LGA, what is a risk?
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hypoglycemia
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For a LGA baby, blood sugar should be at least _____, if ill, high risk and receiving TPN, D5/10W, IV fluids, or regular feedings, should be at least ____.
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40
50 |
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What does AGA mean?
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Appropriate for gestational age
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Birth injuries such as shoulder distocia and clavicle fracture (often from forceps, vacuum use) are most common in ____ babies.
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LGA
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SGA stands for ____ ____ ____. How is it defined?
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small for gestational age
at or below 10th percentile for gestational age |
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What can cause SGA babies? (5) What are these babies at risk for?
(3) |
maternal smoking
chronic HTN/PIH multipara undernutrition race At risk for: hypoglycemia feeding/nippling problems inadequate thermoregulation |
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____ ______ _______ is often used when gestational age is unknown or there is no prenatal care. It is usually done in 1st ____ weeks by Dr.
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New Ballard Scoring
24 |
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LBW stands for _____ _____ ____ and is considered a weight of _____g or less at birth
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low birth weight
2500 g |
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VLBW stands for ____ _____ ____ _____. It is defined as a weight of _____g or less at birth.
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very low birth weight
1500 g |
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ELBW stands for _____ ____ ____ ___ and is defined as _____ g or less at birth.
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extremely low birth weight
1000 |
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When talking about LBW, VLBW, and ELBW, it needs to be correlated with _______ ____. In general, when we use these terms we are talking about full term babies.
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gestational age
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Babies with gestational age between 27-33 weeks, they look very similar and the age is difficult to identify, especially with _____ and ____.
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IUGR
SGA |
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____ height and ________ can estimate size, but gestational age is often difficult to predict when LMP is unknown.
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fundal
ultrasound |
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Some causes of low birth weight include _______ insufficiency, a blood pressure disorder known as ____, smoking, and inadequate ______.
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placental
PIH nutrition |
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Define a preterm/premature infant.
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Born before the beginning of the 38th week regardless of birth weight
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_____ is the failure of the fetus to grow normally as expected for gestational age.
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IUGR
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35-38 weeks is considered ____ term.
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near
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What are some signs of a preterm infant?
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frail, floppy
decreased muscle tone thin/translucent skin more lanugo vernix |
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In a preterm infant, it is important to do VS q ____ h, especially _______. Watch for s/s of____ and ______. Blood sugars need to be done regularly.
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4
temperature RDS and hypoglycemia |
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IUGR is usually caused by what?
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placental insufficiency
or small placenta |
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Differentiate between chronic IUGR and acute IUGR.
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chronic- baby was small from beginning, more symmetrical growth (head and body are both small)
acute- more common in later stages, head is larger, not symmetrical with body. |
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Maternal factors that are related to premature labor include preeclampsia, eclampsia, uterine _____, infections such as vaginal infections, _____, and ____. Also, _____ incompetence, diabetes, ____ and _____ diseases/disorders, abdominal surgeries, poor _____ care, and drug use.
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Maternal factors that are related to premature labor include preeclampsia, eclampsia, uterine tumors, infections such as vaginal infections, UTI, and sepsis. Also, cervical incompetence, diabetes, cardiac and renal diseases/disorders, abdominal surgeries, poor prenatal care, and drug use.
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What is the screening done for preterm labor? When is it best done? Describe this test.
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fetal fibronectin culture
most accurate at 22-34 weeks If positive for fibronectin, there's a good chance this mom will go into labor within 2 weeks. Fibronectin is found in the shedding from amniotic sac. |
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What is normal amount of amniotic fluid?
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800-1200 ml
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Fetal factors that can lead to preterm labor include _____ infection, t_________, s_______, premature ______ of _______, and not enough or too much _______ fluid, known as _____ or _______.
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Fetal factors that can lead to preterm labor include rubella infection, toxoplasmosis, syphilis, premature rupture of membranes, and not enough or too much amniotic fluid, known as polyhydramnios or oligohydramnios.
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Oligohydramnios is defined as less than ____ml of amniotic fluid and is linked with ____ or ____ problems.
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500
GI or kidney |
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Placenta factors such as _____ ______ and _____ ______ are risk factors related to premature labor.
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placenta previa
abruptio placentae |
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Factors that can affect fetal growth include maternal prepregnancy weight, amount of weight gained in pregnancy, ____ disorders, and congenital defects such as a ________ uterus.
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eating
bicornuate uterus |
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Rubella infection, toxoplasmosis, syphilis, premature rupture of membranes, polyhydramnios, oligohydramnios can all lead to ...
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preterm labor
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What are two things that cause the placenta to not function properly?
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smoking
high BP |
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Rubella infection is linked to what 3 things?
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SGA
premature labor fetal death |
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If a woman is at risk for preterm labor, we need to educate her about some signs of labor such as....
What should we encourage her to do? |
bloody show, backache, real labor contractions (not braxton-hicks), cervical pain
Encourage her to see her HCP if any signs of labor are evident and to not lift too much, take it easy. |
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A preterm infant is any infant born before the ____ week of gestation.
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38th
However in this section we are usually referring to before the 35-36 week where lung immaturity is delayed. |
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Preeclampsia, eclampsia, uterine tumors, infections such as vaginal infections, UTI, and sepsis. Also, cervical incompetence, diabetes, cardiac and renal diseases/disorders, abdominal surgeries, poor prenatal care, and drug use are maternal factors that can lead to....
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preterm labor
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The minimum age requirement for a scheduled C section is usually ____ weeks.
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38.3 or 39
If less than 38.3 weeks there's a higher risk. |
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Amelia Sonya Taylor was the youngest surviving baby. She was less than _____ weeks.
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22
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_____ g is usually the cutoff for viability
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>750 g
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An acute, serious GI disease that can occur in preterm infants is known as _____ _______. Symptoms include feeding intolerance, increased gastric residuals, abdominal distension and bloody stools.
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Necrolizing Entercolitis (NEC)
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The cause of Necrolizing Entercolitis (NEC) is unknown. What are some risk factors? (7)
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Asphyxia
RDS Umbilical artery catheter exchange transfusion PDA Polycythemia GI infection Shock |
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In premature babies the process by which the duct closes off sometimes does not function effectively. The bypass can remain open after birth which means that some of the blood will continue to flow through the duct. What is the name of this condition? What is the main symptom?
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PDA- It is referred to as a ‘patent’ (meaning open) ductus arteriosus
Respiratory difficulty |
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What is the most common cause of death of infants less than one month old?
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RDS- Respiratory Distress Syndrome
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What is the most common cause of RDS? What are some other causes?
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inadequate surfactant production
(immature lung problem) sepsis pneumothorax CNS depression |
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CNS depression can be caused by drugs such as ////
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magnesium sulfate
opiates such as morphine general anesthesia in c- section (try to deliver quickly because anesthesia knocks out drive to breathe) |
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Pneumothorax is the collection of air or gas in the space inside the chest around the lungs, which leads to a lung collapse. It occurs when the alveoli in a baby's lung burst, leaking air into the space between the lung and chest wall (pleural space). The most common cause is ________ and the use of a ______ _________. Other causes include meconium aspiration
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RDS
mechanical ventilator. If the baby is put on a ventilator, there is extra pressure on the baby's lungs, which can sometimes burst the air sacs. Less commonly, an otherwise healthy baby can develop an air leak when he or she takes the first few breaths after birth. This occurs because of the pressure needed to expand the lungs for the first time. |
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What are some signs of a pneumothorax?
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Bluish skin color (cyanosis)
Fast breathing Flaring of the nostrils Grunting with breathing Irritability Restlessness Retractions Another sign: difficulty auscultating breath sounds. The heart or lung sounds may seem as if they are coming from a different part of the chest than normal. |
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Tests for pneumothorax include:
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Chest x-ray
Light probe placed against the babys chest, also known as "transillumination" (pockets of air will show up as lighter areas) |
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In any ____-____ delivery, the ICN/NICU resuscitation team is ready.
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high-risk
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Apnea of prematurity is apnea with or without an identifiable cause and may require ...
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gentle stimulation or BVM
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Central apnea occurs when the ____ is immature and the infant "forgets" to breathe. Apnea is defined as a period without breathing greater than ____ seconds. O2 sats will decrease, and HR can slow to around ____.
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CNS
20 60 |
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O2 cannot perfuse to vital organs if heart rate is less than ____.
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80
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______ lubricates alveoli, helps decrease surface tension, and allow alveoli to expand with ease.
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surfactant
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What is the term for lung collapse? What is the team for collapse of alveoli?
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pneumothorax
atelectasis |
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Describe the pathophysiology of RDS
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insufficient production of surfactant
alveoli collapse with exhaling lungs become noncompliant "stiff" results in severe retractions--> atelectasis & hypoxia --> pulmonary vasoconstriction & decreased blood flow to lungs --> decreased oxygen to vital organs |
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Before ____ weeks, surfactant production is inadequate. The peak of surfactant production is at ___ weeks.
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34
36 |
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True or False: Chronic fetal stress causes lungs to mature more quickly.
Examples? |
True.
Examples: Preeclampsia PIH prolonged ROM maternal drug use |
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_____ and ____ are synthetic forms of surfactant given to infants to improve lung function. They are administered via
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survanta and curosurf
ET Tube (endotracheal tube) (intubation) |
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If a fetus is expected to be born before ___ weeks or if there is a low ____ ratio, a corticosteroid can be given to the ___. What are 2 types of this enodegenous steroid and how are they given?
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34
L/S mother betamethasone, dexamethsone Rescue dose - 2 doses 12 h apart 1 more dose 7 days later PRN (only need 2 doses if preterm birth is imminent |
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When the L/S ratio is low, the mother can be given corticosteroids through __ weeks gestation.
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37
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Clinical manifestations of RDS appear hours after birth. They involve increased work of breathing which includes _____ing, ______ing, and _____ing. In assessing color, you may see _____ or _____. When auscultating, you will hear decreased breath _____ or rales. Blood gases will change in that there is an increase/decrease in CO2 and an increase/decrease in O2.
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Clinical manifestations of RDS appear hours after birth. They involve increased work of breathing which includes grunting, flaring, retracting. In assessing color, you may see cyanosis or pallor. When auscultating, you will hear decreased breath sounds or rales. Blood gases will change in that there is an increase in CO2 and decrease in O2.
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hypoxemia leads to respiratory ______.
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acidosis
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In _______ _______ disease, you will see whited out areas on the chest x-ray and won't be able to visualize the heart. There are hyaline deposits in the alveoli. The name of this disease is basically just another word for _______.
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hyaline membrane
RDS |
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In managing RDS, ____ is given to the infant via ET tube immediately after delivery or when signs of RDS are present.
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surfactant (exogenous synthetic)
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To keep the infant with RDS stable, we monitor STABLE, which stands for...
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sugar
temperature airway breathing labs emotions |
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The preterm infant with RDS may need IV feedings. This is usually done through the _____ ______ and requires frequent monitoring of _____.
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umbilical cord
ABGs |
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In administering O2 for the preterm infant with RDS, use the highest/lowest concentration possible. It is dangerous if O2 Sat is higher than ___. Be sure to monitor ___ saturation and _____.
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lowest
93 O2 , ABGs |
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Oxygen is warmed and humidified which can be in the form of a hood or cannula. Which is better? What can happen if too much O2 is given?
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cannula is more common, more accurate
Too much O2 can cause vision problems, and later diseases such as leukemia. |
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BPD is a chronic lung disease of infancy. What does it stand for?
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Bronchopulmonary Dysplasia
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BPD is a form of COPD and an extension of RDS. It is the result of ____ _____ _____.
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acute lung injury
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What are 5 causes of BPD?
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acute lung injury
Increased amounts of O2 Positive Pressure Ventilation Diseased, injured, or immature lungs Surfactant deficiency |
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S/S of BPD are similar to RDS. This disease is more manageable. They include increased ____ of breathing, tachy_____ and tachy____ , retractions, nasal _____, decreased air _____, lung sounds such as ______ and ______, and the infant may ____ easily. There may be ______ around the mouth.
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S/S of BPD are similar to RDS. This disease is more manageable. They include increased work of breathing, tachycardia and tachypnea, retractions, nasal flaring, decreased air movement, lung sounds such as crackles and wheezes, and the infant may tire easily. There may be cyanotic around the mouth.
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With BPD, there is a higher risk of lung infections, colds, and _____. It is often difficult to ween the infant off of _____.
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asthma
oxygen |
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Treatment for BPD includes low flow oxygen therapy, nutritional support (weak ability to nipple) steroids, breathing treatments, and sometimes fluid restriction because...
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the heart has enlarged, increased workload/demand on heart ( a form of CHF)
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Respiratory therapy is often needed for BPD to loosen secretions, suction and provide breathing treatments. There is a high susceptibility to respiratory infection and many die from _____ or _____ failure.
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cardiac
respiratory |
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Premature and LBW babies are prone to inadequate thermoregulation. They have inadequate amounts of ____ ___. S/S of
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brown fat
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Axillary temperature of an infant with RDS should stay within ____ and ___ C or ____ and ____. Greater than ___ is damaging to the infant.
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36.5 and 37 C
97.5 to 98.6 F 37.2 |
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Signs of inadequate thermoregulation (10)
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abdominal skin temp <36 or >36.9
change in feeding behavior lethargy irritability sometimes jittery decreased muscle tone cool skin temperature mottled skin signs of hypoglycemia signs of respiratory difficulty |
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Fluid and electrolytes may be imbalanced in babies with RDS. Signs of dehydration include urine output is less than ___ ml/kg/hour. Urine specific gravity is greater than ___. Weight loss is _____ than expected. The skin and mucous membranes are ____. Anterior fontanel appears _____, there is poor skin ______, and the blood will show increased/decreased sodium, protein, and hematocrit levels due to dilution.
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imbalanced in babies with RDS. Signs of dehydration include urine output is less than 2 ml/kg/hour. Urine specific gravity is greater than 1.020 Weight loss is greater than expected. The skin and mucous membranes are dry. Anterior fontanel appears sunken, there is poor skin turgor, and the blood will show increased sodium, protein, and hematocrit levels due to dilution.
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Signs of overhydration include urine output __ ml/kg/hour, urine specific gravity is _______. Edema may be present, weight gain is _____ than expected, and fontanels will be ____. In the blood, sodium, protein, and hematocrit will be increased/decreased. Breath sounds will be _____ and there may be difficulty breathing.
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Signs of overhydration include urine output >5 ml/kg/hour, urine specific gravity is <1.001. Edema may be present, weight gain is greater than expected, and fontanels will be bulging. In the blood, sodium, protein, and hematocrit will be decreased. Breath sounds will be moist and there may be difficulty breathing.
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In care for the fragile skin of the premature infant with RDS, use tape minimally if at all. Don't use ___ if possible. If you must use povidone iodine, wash it off with sterile water. Change ______ frequently to decrease risk of skin breakdown and infection.
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alcohol
positions |
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What are some s/s that a premature infant is in pain? (too many to memorize, just try to list some and look it over a few times!)
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high-pitched, intense cry
"cry face" eyes squeezed shut mouth open grimacing tense, rigid muscles or flaccid muscle tone?? ok... rigitity or flailing of extremities color changes: red, dusky, pale increased or decreased HR increased respirations or apnea increased BP decreased O2 sat due to bradycardia (this one doesn't make much sense, I guess the baby can go from one extreme to the other such as in increased respirations or apnea) |
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In a term baby, BP is usually <70-80 over <60. In a ____ baby, it can be as low as 40/6.
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preterm
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All meds given to preterm infants need to be _______, including TPN and multivitamins.
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cosigned
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Normally, breastmilk or formula has 20 calories per ounce. If an infant is premature they may need 22-24 cal/oz or if very severe growth problem ____ cal per oz. ____ is added to increase fat content.
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30
Oil |
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What are some signs an infant is not ready for nipple feeding? (4)
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RR > 60
No rooting or sucking absence of gag reflex excessive gastric residuals |
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What are some adverse signs you may observe doing nipple feedings? (9)
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tachycardia
bradycardia increased RR decreased O2 sat apnea cyanosis coughing, gagging, choking falling asleep early in feedings feeding time > 25 to 30 min |
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Feeding should be time limited, no more than ____ minutes.
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25-30
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Necrolizing endocarditis can be caused by not enough _____ to he gut.
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oxygen
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Retinopathy of Prematurity (ROP) is acquired and the exact cause is unknown. It is associated with prematurity and the use of ____. It damages the blood vessels in the eyes and can cause ____ detachment or ____ness. It can be treated later in life with laser surgery, cryosurgery, lazer coagulation and needs follow up with opthamologist.
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oxygen
retinal blindness |
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Periventricular-Intraventricular Hemorrhage is the rupture of blood vessels in germinal matrix located around ventricles of the ______. Why are babies susceptible to this?
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brain
High blood pressure in babies can lead to high pressures in the brain from forceps/vacuum delivery or other trauma during birth. |
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The symptoms of Periventricular-Intraventricular Hemorrhage may be few and subtle. What are some symptoms? (7)
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lethargy
poor muscle tone deterioration of resp. status drop in HCT bulging fontanels seizures decreased reflexes |
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Try to keep O2 level below ____.%
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40
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How is for Periventricular-Intraventricular Hemorrhage (brain bleed) diagnosed?
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US
Also in assessment, look for signs of ICP |
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What is the treatment for Periventricular-Intraventricular Hemorrhage (brain bleed) ? If hydrocephalus develops, what is done?
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maintain resp. function
Don't overstimulate (increases BP & HR) Daily measure of head circum. hydrocephalus- lumbar tap or ventricular peritoneal shunt |
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What O2 concentration to we administer to preterm babies?
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Try to keep below 40% if possible (too much can cause retinopathy)
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A head US is done on all babies born before ____ weeks.
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34
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Necrolizing entercolitic (NEC) is an acute inflammatory disease of the GI mucosa that commonly occurs with prematurity. What are some risk factors? (8)
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asphyxia
RDS umbilical-artery-catheter-exchange-transfusion PDA- patent ductus arteriosis polycythemia- high # of RBCs GI infection shock (hypoxia, hypovolemia) feeding too early/too high of concentration formula |
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The direct cause of NEC is unknown. It is linked with poor perfusion to the bowel due to ______ entering the bowel and forming necrotic ____ pockets
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bacteria
gas |
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_________ is associated with low birth weight, stress, and premature rupture of membranes, RDS, anemia, and maternal sepsis.
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NEC
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What is the tx for NEC?
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NPO- let bowel rest
IV fluids, antibiotics, TPN NG tube to decompress surgical resection of bowel (if perforated or deterioration occurs) colostomy if severe |
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What are some general s/s of NEC?
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decreased activity
hypotonia pallor apnea bradycardia low levels of O2 oliguria hypotension temperature instability |
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What are some GI s/s of NEC?
(7) |
abdominal distention/ tenderness
bile stained residual aspirates vomiting: bile or blood bloody stools diarrhea No BM redness of abdominal wall |
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What are babies with NEC at risk for? (3)
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gangrene
hypovolemia DIC |
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How is NEC diagnosed?
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x-ray
(you will see bowel loop distention, pnueumo-peritoneum, or portal air or a combination of these findings) |
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What are some nursing implications for the care of a baby with NEC?
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monitor closely
measure abdomen daily hematest stools post op care if after surgery If abd distended, don't tape diaper No rectal temps. teach parents about care |
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What is a severe complication that can be caused by NEC?
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perforation --> sepsis
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Who is considered a postterm infant?
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baby born after 42 weeks
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At about 40 weeks, if mom not yet in labor, Dr will do an NST. Why?
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Check on placenta
(starts to deteriorate can cause asphyxia) |
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What are some complications of postmaturity, known as postmaturity syndrome? (6)
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decreased placental function
oligohydramnios (<500ml) hypoxia malnourishment hypoglycemia (used up fat stores) birth trauma (big baby) cord compression |
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What are some signs that a baby is post term?
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wide eyed
Little or no lanugo/vernix long fingernails wrinkled, cracked, peeling skin meconium staining |
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SGA is sometimes used interchangeably with _____. What can it be caused by?
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IUGR
placental insufficiency which is possibly due to maternal smoking, drug use, alcohol, or maternal infection. |
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What are some complications for an SGA baby?
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blood sugar & feeding complications
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What culture tends to have tiny babies (SGA)?
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Asian
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True or False: LGA babies are usually children of diabetic mothers and they will show immature aspects of development.
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true
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A baby that weighs greater than _____ g is considered LGA.
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4000
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What are some complications of LGA babies?
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hypoglycemia
polycythemia--> jaundice birth traumas |
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Asphyxia can occur in utero because of a nuccal cord, knot in cord. Apgars will likely be low. Bloodwork will be done to check what?
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Checking for organ damage
kidney function liver enzymes |
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TTN stands for what? Describe this condition. It can be confused with _____
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Transient Tachypnea of the Newborn
retained amniotic fluid which causes tachypnea & grunting usually resolves in 72 h. Chest x-ray shows wet lung or young lung. can be confused with RDS |
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What will you see on the x-ray for a "wet lung" and a "young lung" for a preterm baby?
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wet lung- web like
young lung- ground glass |
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Meconium Aspiration Syndrome (MAS) can lead to
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pneumothorax, pulmonary HTN, edematous lungs
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What are some causes of pathological jaundice (abnormal/nonphysiological) ?
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birth trauma such as hematoma
hemorrhage hemalytic disease (due to Rh incompatibility) ABO incompatibiliy asphyxia high HCT maternal diabetes -any condition that causes destruction of RBCs or impairment of liver |
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Complications of pathological jaundice include...
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necrosis of neurons associated w/
neurological damage cerebral palsy hearing loss mental retardation ADD |
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Pathologic jaundice is nonphysiological jaundice. When does this occur and at what level is it usually at?
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first 24 hours of life
higher than 12 mg/dl |
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If untreated, jaundice can lead to a chronic and permanent result known as ...
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kernicterus / bilirubin encephalopathy
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What is the treatment for pathologic jaundice?
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phototherapy (light oxidizes the bilirubin in skin and it becomes water soluble, then excreted in urine/stool)
Can also use billi blanket (expose as much as skin as possible, but cover private areas ) Feedings that can be tolerated Frequent feedings IV therapy |
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Polycythemia is elevated # of RBCs. What will this baby look like? What will the bloodwork show?
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Red face, ruddy, red body
High HCT |
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What is the risk of polycythemia?
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fluid overload can lead to CHF
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What is the treatment for polycythemia?
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IV fluids, partial exchange transfusion (take out some blood, replace with plasma)
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In ABO incompatibility, what is the mother's blood type? What this cause?
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O
She has anti A and anti B antibodies in her blood, and those can get passed to baby which will cause breakdown of fetal RBCs leading to erythroblastocis fetalis. This causes hemalytic disease of the neonate associated with pathological jaundice. |
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What are some risk factors for sepsis?
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prematurity
SGA (immature immune system) prolonged ROM greater than 18 h maternal fever @ time of delivery meconium aspiration |
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What are the methods of infection for neonatal sepsis?
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itrauterine
birth canal iatrogenic (nosocomial) environmental exposure |
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What is the difference between early and late onset neonatal sepsis?
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early - 1st 7 days (acquired during birth, usually expressed in first 48 h)
late- after 1st 7 days |
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What are some s/s of neonatal sepsis?
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Infants usually have subtle signs of infection..
respiratory distress tachpnea (poor perfusion) mottled skin grey color hypoglycemia poor feeding Meningitis & PNA are common in early onset. |
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What is a cause of late onset neonatal sepsis?
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usually a more localized infection, such as meningitis
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If not treated, sepsis can lead to ___ ____.
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septic shock.
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True or False: If a mother might have GBS but we aren't sure, the infant is monitored for 24 hours for any signs of infection.
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False. 48 h
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When are mom's screened for GBS?
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36 weeks
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What are some s/s that may indicate an advanced infection?
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jaundice (early onset)
evidence of hemorrhage (petechiae, purpura, pulmonary bleeding) anemia enlarged liver and spleen respiratory failure shock seizures also: irritability, high pitched cry, poor feeding, grey color |
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What is the treatment of infection in the newborn?
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If mom is GBS, she gets Penicillin G
Baby gets broad spectrum antibiotics until culture results are in. Start with ampicillin, then gentimycin if ampicillin doesn't work. |
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What's the problem with giving an infant gentamycin?
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Can be toxic
need to do peak and trough |
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Why does a diabetic mother usually have a LGA baby?
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Mom is hyperglycemic--> baby's pancreas works fine, but extra glucose crosses the placenta, is utilized by baby and causes the baby to grow large.
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Why is a baby of a diabetic mother at risk for hypoglycemia?
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Baby can become hypoglycemic because the baby is accustomed to having lots of extra sugar, so the pancreas secretes excess insulin.
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Why would a baby of a diabetic mom be susceptible to RDS
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Diabetic mom doesn't make phospholipids, which are necessary for surfactant production. Also occurs because high levels of insulin block the effect of cortisol on lung maturation.
Can end up in NICU, enlarged heart- big murmur |
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What are some signs an infant's mom is a diabetic?
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Macrosomia is common
• Round face- • Plethoric • Poor muscle tone • Irritable |
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Hypocalcemia is rare. Early onset occurs in the first ___ hours of age. Late onset occurs at about what age? What are some s/s?
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72 h
1 week old may be asymptomatic signs are similar to hypoglycemia also include muscle twitches |
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What is the treatment for hypocalcemia?
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calcium gluconate
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What are some signs you will see in the infant when the mother was abusing drugs? S/S are usually shown within ____ h and it may take _____ to ween off the drugs. (11)
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high pitched cry
difficult to console GI- poor feeding, regurgitation, diarrhea, excessive suck stuffy nose tachypnea sneezing yawning tremors 24-72 weeks |
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What is NAS? When do s/s begin? Explain the scoring and treatment.
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Neonatal Abstinence Syndrome- a test for possible neonate withdraw
A score higher than 8 indicates drug withdraw and interventions are needed. Opiate derived drugs are given such as phenobarbital and morphine. Other tx includes gavage or IV feeding, don't overstimulate, incorporate soothing measures. |
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Fetal alcohol effects are now termed what?
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alcohol related neurodevelopmental disorder
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What are some complications of fetal alcohol defects?
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ADHD
fine motor impairment mild delays in speech |
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What is PKU?
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phenylketonuria
an autosomal recessive disorder It can lead to CNS damage such as mental retardation from toxic levels of the amino acid phenylamine. |
