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68wm6 p2 Pre Pos New

Preterm and Postterm Newborns

What is a preterm baby? Gestational age less than 38 weeks
What is a postterm baby? Gestational age beyond 42 weeks
What is a term baby? Gestational age of 38-42 weeks
What is used to evaluate gestational age? Ballard Scoring System
What does the ballard scoring system focus on? physical and neuromuscular characteristics
What does the ballard scoring system determine? how well the infant has grown for the amount of time spent in utero
What is Small for Gestaional Age (SGA)? size is below the 10th percentile
What is Appropriate size for Gestational Age (AGA)? infant whose size is AGA falls between the 10th and 90th percentiles
What is Large for Gestational Age (LGA)? size is above the 90th percentile
What is Extremely Low Birth Weight (ELBW)? weight is 1000g (2 lb 3 oz) or less at birth.
What is Very low birth weight (VLBW)? weight is 1500g (3lb, 5 oz) or less at birth
What is Low birth weight (LBW)? weight is 2500 g (5 lb 8 oz) or less at birth and of any gestational age (not to be confused with preterm)
What are examples of inadequate respiratory function in preterm newborns? *Poorly developed cough reflex and narrow respiratory passages *Apneic spells *Retractions *Grunting *Insufficient production of surfactant *Respiratory Distress Syndrome
Incidence of infection is how much greater in preterm newborns? 3 to 10 times greater
What is retinopathy? a general term that refers to some form of non-inflammatory damage to the retina of the eye
In newborns, who is retinopathy most likely in? Infants of less than 28 weeks gestation, 1500 g or less
What is Necrotizing Enterocolitis (NEC)? death of intestinal tissue
When are incidence of Necrotizing Enterocolitis (NEC) much higher in preterm newborns? after infants have been fed
List four S/Sx of Necrotizing Enterocolitis (NEC): *Abdominal distention *Increased gastric residuals *Decreased or absent bowel sounds *Vomiting *Bile-stained emesis or residuals *Bloody stools *Abdominal tenderness *Signs of infection
What is the Tx of Necrotizing Enterocolitis (NEC)? *Antibiotics *Parenteral nutrition to rest the bowel *NPO *Continuous or intermittent gastric suction *May need to surgically remove necrotic bowel and place an ostomy
What can be done to minimize the effects of pressure on the diphragm from distended intestines in the preterm newborn? Position infant on the side to minimize effects
What is Bronchopulmonary Dysplasia (BPD)? A chronic lung condition that affects newborn babies who were either put on a breathing machine after birth or were born very early (prematurely)
What preterm infants does Bronchopulmonary Dysplasia (BPD) occur most often in? infants weighing less than 1500 g at birth
What causes Bronchopulmonary Dysplasia (BPD)? High levels of oxygen, oxygen-free radicals, and high positive-pressure ventilation that damage bronchial epithelium and interfere with alveolar development
List five S/Sx of Bronchopulmonary Dysplasia (BPD): *Tachycardia *Tachypnea *Retractions *Rales *Wheezing *Respiratory acidosis *Increased secretions *Bronchospasm *Characteristic changes in the lungs on chest X-ray
How can Bronchopulmonary Dysplasia (BPD) be prevented? *Use of maternal steroids to reduce prematurity and RDS *Minimizing exposure to oxygen *Avoidance of fluid overload *Increased nutrition
What is the Tx of Bronchopulmonary Dysplasia (BPD)? *Gradual decreases in oxygen, bronchodilators, and antibiotics *Diuretics given and fluids restricted *Increased calories and protein are important!! *Infant may go home on long-term oxygen therapy
Why are diuretics given and fluids restricted during the treatment of Bronchopulmonary Dysplasia (BPD) in a preterm nerwborn? Infants are prone to fluid overload
List five handicaps of the preterm newborn: *Inadequate respiratory function *Sepsis *Poor temperature control *Hypoglycemia *Hypocalcemia *Increased tendency to bleed *Retinopathy of Prematurity (ROP) *Necrotizing Enterocolitis (NEC) *Immature kidneys *Jaundice
Why may a preterm newborn need to be placed on parenteral nutrition? *GI tract does not absorb nutrients well *Lack reservoirs of calcium, iron and other nutrients *Insufficient bile acids and pancreatic lipase *Small stomach capacity
What are indicators that a preterm infant is ready for oral feeding? *Intact gag reflex *Coordination of sucking, swallowing, and breathing
At what gestational age do infants have the ability to suck and swallow? 34 weeks
List four signs of inadequate thermoregulation (cold stress): *Decreased skin temperature *Signs of respiratory difficulty *Signs of hypoglycemia *Mottled skin *Lethargy *Decreased muscle tone
What are the physical characteristics of postterm newborns? *Thin with loose skin *Unusually alert and wide-eyed *Little vernix and lanugo *Skin wrinkles *Nails long
What are problems associated with postterm infants? *Asphyxia *Meconium aspiration *Poor nutrition status *Higher perinatal mortality rate *Risk for low temperature *Polycythemia
Created by: Shanejqb