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68wm6 p2 Pre Pos New
Preterm and Postterm Newborns
| Question | Answer |
|---|---|
| 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
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