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Newborn Care:

Management of newborn complications

QuestionAnswer
What is a preterm infant? One who is born 20-37 weeks.
What is respiratory distress syndrome (RDS)? decreased surfactant in alveoli regardless of birth weight.
What is bronchopulmonary dysplasia (BPD)? stiff and noncompliant lungs leading to mechanical ventilation & O2.
What is retinopathy of prematurity? abnormal growth of retinal blood vessels, usually linked with O2 administration in neonate.
What is patent ductus arteriosus (PDA)? occurs when ductus arteriosus reopens after birth due to neonatal hypoxia.
What is necrotizing enterocolitis (NEC)? inflammatory dz of GI mucosa d/t ischemia.
What are some s/s of preterm infant? periodic breathing, lanugo, minimal creases on soles and palms, heels movable to ears, hypotonic muscles
The main priority in treating preterm newborns is supporting what systems? cardiac and respiratory systems
What is surfactant? a phospholipid that helps in alveoli expansion.
What are factors that can accelerate lung maturation in fetus while in utero? increased GA, intrauterine stress, exogenous steroid use, ROM
What is a postterm infant? one who is born after 42 weeks/
What is true? postmature infant can be SGA or LGA.
What are some s/s of postterm infant? thin loose dry cracked skin, meconium stained fingernails, hypoglycemia, macrosomia, s/s of cold stress
What is large gestational age (LGA)? neonate... - >90th % or - >4000g (8lb.12oz.)
What are two leading factors of LGA? postterm infants and maternal DM
What are nursing interventions for LGA neonate? - early and frequent heel sticks - early feedings to maintain glucose levels - thermoregulation
What is neonate hypogylcemia? - <40 mg/dL in term - <25 mg/dL in preterm
Hypoglycemia can lead to what if left untreated? mental retardation
What are s/s of neonate hypoglycemia? poor feeding, jitterness, hypothermia, sweating, weak cry, lethargy
What is small for gestational age (SGA)? neonate at or below 10th % of weight.
What are some s/s of SGA/IUGR? drawn abdomen, sparse scalp hair, wide skull sutures, wide-eyed and alert
What is hyperbilirubinemia? elevated serum bilirubin levels --> jaundice
What is physiologic jaundice? normal, signs of jaundice after 24 hr of age.
What is pathologic jaundice? appears before 24 hr of age, persistent after 7 days, bilirubin levels peak >13 mg/dL
What are two common factors for pathologic jaundice? Rh or ABO incompatabiltiy and infection
What does the Direct Coombs' test reveal? reveals the presence of antibody-coated Rh+ RBCs in newborn.
What is primary treatment of hyperbilirubinemia? phototherapy
What is kernicterus? bilirubin levels >24 mg/dL that affects the brain
What are side effects of phototherapy? bronze discoloration, skin rash, pressure areas, dehydration, elevated temperature
What are nursing interventions for hyperbilirubinemia? early and frequent feeding, eye mask, keep newborn undressed, no lotion or ointments, reposition q 2 hr, remove newborn from phototherapy q 4 hr and unmasking and checking for inflammation or injury.
What is tracheoespophageal atresia? failure of espophagus to connect to stomach.
What are s/s of tracheoespophageal atresia? excessive mucous secretions, drooling, periodic cyanotic episodes, immediate regurgitation after birth
What is phenylketonuria (PKU)? inability to metabolize amino acid phenylalanine
What is galactosemia? inability to metabolize galactose into glucoseq
What is hypothyroidism? slow metabolism caused by maternal iodine deficiency during pregnancy.
What is spina bifida? neural tube defect and may have protrusion of meninges and/or spinal cord.
What are nursing interventions for spina bifida? - protect membrane with sterile covering - observe for CSF - position in prone or side lying - assess for ICP
What is tetralogy of Fallot? cyanotic heart defect characterized by VSD, overrriding aortic valve, pulmonary valve stenosis, rt ventricular hypertrophy.
What are nursing interventions for tetralogy of Fallot? - conserve infant's energy - give feedings with special nipple - elevate head and shoulders - place in knee-chest position during resp distress
What is patent ductus arteriosus? noncyanotic heart defect in which ductus arteriosus fails to close after birth.
What are some s/s of birth injuries? subarachnoid hemorrhage, facial paralysis, joint dislocations, soft tissue injuries
What three areas does neonatal abstinence scoring system assess? 1. CNS 2. metabolic, vasomotor, and respiratory 3. GI
What are some nursing interventions for neonatal substance withdrawal? - reducing external stimulation - swaddling - frequent small feedings - have suction available
What is suspected if newborn has continuous high-pitched crying? neonatal withdrawal syndrome
What is hydrocephalus? excessive spinal fluid in brain --> bulging fontanels, sunsetting
What are nursing interventions for hydrocephalus? - frequently reposition head to prevent sores - measure head circumference daily - assess for signs of ICP
Created by: odbal24