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Chapter 13 and 14
Preterm and Postterm Newborns/The Newborn with a Perinatal Injury or Congenital
| Question | Answer |
|---|---|
| How well developed the infant is at birth and the ability of the organs to function outside the uterus | Level of Maturation |
| A serious neurological complication that can cause brain damage, due to jaundice | Kernicterus |
| A deficient synthesis or release of this can result in Respiratory Distress Syndrome | Surfactant |
| Interventions for preterm infant receiving gavage feeds | Aspirate stomach contents prior to administration, observe and record bowel sounds and passage of meconium |
| Can be given to increase production of surfactant | Corticosteriods |
| Interventions for apneic preterm infant | Gentle rubbing of the infant's feet, ankles, and back, suctioning of the nose and mouth, raising the infant's head to semi-fowlers, ambu-bag |
| Treatment for hypocalcemia | Calcium gluconate |
| Nursing interventions to prevent ROP | Monitoring of O2 sats, maintain sufficient level of vitamin E, avoid high levels of O2 |
| Signs and symptoms of RDS | Tachypnea, grunt-like sounds, nasal flaring, cyanosis, intercostal and sternal |
| Nursing interventions for preterm infants at risk for NEC | Observing vital signs, maintaining infection control techniques, carefully resuming oral fluids, measure abdomen, listen to bowel sounds |
| Signs and symptoms of NEC | Abdominal distention, bloody stools, diarrhea, bilious vomitus |
| Signs and symptoms of hypoglycemia | Tremors, weak cry, lethargy, convulsions, plasma glucose level lower than 40mg/dl (term) or 30mg/dl (preterm) |
| Normal urine output for preterm infant | 1-3 ml/kg/hr |
| Physical characteristics of preterm infant | Skin is loose and transparent, lack of subcutaneous fat, fine hair (lanugo) covers forehead, shoulders, arms, vernix caseosa is abdundant, extremities appear short, soles of feet have few creases, abdomen protrudes, nails are short, genitalia are small |
| Developmental age for a 4-month old infant who was born at 36 weeks gestation | 3 months |
| Signs and symptoms of cold stress | Decreased skin temp, increased respiratory rate with period of apnea, bradycardia, mottling of skin, lethargy |
| Physical characteristics of postterm infant | Skin is loose, little lanugo, little vernix caseosa, dry skin, that cracks and peels, nails are long may be stained with meconium, thick head of hair |
| The actual time, from conception to birth, that the fetus remains in the uterus | Gestational age |
| Increase CSF within the ventricles of the brain due to obstruction or inadequately reabsorption | Hydrocephalus |
| Nursing actions for infants with hydrocephalus | Frequent position change, support the head, may use lamb's wool or sponge under head, decrease stimulation, unhurried manner when feeding, side-lying position after feeding, observe for signs of ICP |
| For infants with a VP shunt, what positioning should be used | If bulging fontanelles, semi-Fowlers to promote drainage of the ventricles, if sunken fontanelles, flat because too rapid a reduction of fluid may led to seizures or a bleed |
| More serious protrusion of the membranes and spinal cord through an opening | Meningomyelocele |
| Nursing interventions for infants with Meningomyelocele | Assess the sac, observe for deformities, measure head circumference, place in prone position, moist sterile dressing to sac, observe for lack of anal sphincter and dribbling of urine, good skin care |
| Nursing interventions for infants with VP shunt | Assess kin, head and chest circumference, measure abdomen, observe for signs and symptoms of ICP, infection control measures |
| Technique to feed infant after cheiloplasty | The infant receives feeding by dropper until wound is healed (1-2) weeks |
| Signs and symptoms of developmental hip dysplasia | Limitation of abduction, asymmetry of skin folds, shortening of femur |
| When should infants be screened for PKU | 48-72 hours of life, preferably after ingestion of proteins |
| Commonly used formulas for PKU | Lofenalac, phenex 1, phenyl free, phenex 2 |
| When is RhoGAM given | Given to RH negative mother after delivery of an RH positive fetus |
| When is a cheiloplasty completed | No later than 3 months of age |
| What finding would you expect from a macrosomic newborn | Large for gestational size, prone to injuries, low blood glucose levels, cushingoid appearance, may suffer from RDS or congenital anomlies |
| Signs and symptoms of down syndrome infant | Close-set eyes, upward-slanting eyes, small head, round face, flat nose, protruding tongue, deep straight line across the palm, short and thick hands, little finger that is curved, congenital heart defects |
| Metabolic defects | Cystic fibrosis, PKU, Tay-Sachs, hypercholesterolemia |
| Signs and symptoms of ICP | High pitches cry, unequal pupil size or response to light, bulging fontanelles, irritability or lethargy, poor feeding, abnormal vitals |
| Nursing interventions for infants with intracranial hemorrhage | Handle infant gently, elevate head, decrease stimulation, carefully feed, observe for signs and symptoms of ICP |
| How many weeks gestation is surfactant adequate for infant to breathe | 34 weeks |
| Preterm infants have a tendency to bleed due to | Deficiency in prothrombin |
| Tool used to estimate gestational age based on external characteristics and neurological development | Ballard Scoring System |
Created by:
wallacem
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