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High Risk Newborn
Assessment of the High Risk Newborn
| Question | Answer |
|---|---|
| Why is it important to do a gestation age assessment when a baby is born? | Because the estimated delivery dat could have been wrong. |
| What does the gestational age assessment look at? | Neuromuscular and physical maturity. |
| What do the yellow boxes on a gestatinal age assessment relate to? | Neuromuscular maturity. |
| What is the big difference between a preterm and a term baby neuromuscularly. | The preterm baby lacks the ability to flex. |
| What is the difference in skin between a preterm and a term baby? | Preterm skin can sticky, gelatinous and transparent skin. Lanugo is sparce to absent. Lack of cartilage development. |
| When a nurse does a gestation age assessment, babies can be under in some characteristics and over in others, but the tool is reliable within: | 4 days |
| What kind of problems will a 32 week AGA baby encounter? | Bleeding, jaundice, hypoglycemia, apnea and RDS. |
| What kind of problems will a term LGA baby encounter? | Birth trauma, hypoglycemia, cesarean birth, diabetic mom. |
| Everything below the SGA curve of the gestinational age assessment, shows what kind of problems there? | Congenital anomalies |
| What are the two classes of preemies? | Premature Neonate (26-37 weeks) and Extremely Premature Neonate (<26 weeks). |
| In comparison to the term neonate,the premature newborns' head tends to be: | Larger |
| The earlier the gestation, the skin appears: | Less mature andn more transparent. |
| The goal during they physical exam is to: | Obtain or identify accurate information while the child is in a controlled calm state. |
| Signs of a calm preemie: | Constant state of regulated color and respiratory pattern. Maintenance of a flexed position. |
| The trachea in a premature neonate is: | Very soft and pliable. |
| In comparison to term babies, neonates chest walls are: | Very compliant and they may not be able to maintain adequate oxygenation and ventilation without positive pressure assistance. |
| If the HR of a premature neonate drops below 100 BPM, what should be evaluated immediately? | Ventilation and perfusion. |
| Even when the perfusion assessment is within acceptable limits, the preemie might be: | hypertensive |
| What can variations in BP cause in the preemie? | It could cause hemorrhage in these tiny babies. |
| Preemies do not have the ability to separately regulate their cerebral blood flow. Therefore it is essential to maintain a consistent: | systemic BP |
| Open parietal sutures on a preemie may indicate: | A cerebral bleed or hydrocephalus. |
| The eyelids of a preemie are fused shut prior to: | 24 weeks gestation |
| Unlike term babies, premature babies pinna is: | Very soft and compliant. |
| It is necessary to listen fo the presence of bowel sounds for at least 30-60 seconds because: | Their presence is a critical factor in determining readiness for feedings. |
| The scrotum of an extremely premature male is: | Flat and smooth |
| Female preemies genitalia is: | A prominant clitoris with flat labia when extremely premature. |
| When will the premature neonate pass meconium stools? | The premature neonate may not pass meconium stools for several days. |
| Subcutaneous fat stores in the extremely premature infant are: | Absent |
| The greatest enemy of the premature neonate is: | Immature physiologic systems. |
| The challenges involved in providing clinical support to the premature neonate include: | Oxygenation, thermoregulation, fluid and electrolyte balance,nutrition, skin care, developmental care and parental support. |
| Because preemies have ana immature respiratory center, their chemoreceptors are: | Not as senstive to hypoxemia and hypercapnia. |
| Common electrolyte imbalances seen in premature neonates are: | Hypernaturmia, hypergylcemia, and hyperkalemia. |
| In the extremely premature baby, hypernatremia usually reflects: | A deficiency of water relative to total body sodium content. |
| Why is hyperglycemia a common electrolyte imbalance seen in premature neonates? | Because preemies have a difficulty metabolizing glucose levels greater than 6mg/kg/minute. |
| Why is hyperkalemia a common electrolyte imbalance seen in premature neonates? | Tissues are easily damaged durin the birth process, and this results in the release fo potassium from the cells. Conditions such as intraventricular hemorrhage with a large blood loss or necrotizing enterocolitis can cause hyperkalemia as well. |
| What criteria are necessary before initiating enteral feedingisn with teh preemie? | Presence of bowel sounds, meconium passage, and soft, non-tender abdomen. |
| What is the most serious type of feeding intolerance in preemies? | Necrotizing enterocolitis |
| In comparison to the adults skin making up 3% of their body weight, the preterm newborns skin makes up: | Approximately 13% of their body weight. |
| Compared to normal weight infants, low birth weight babies are 40% more likely to: | Die during their first 28 days of life. |
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