Question | Answer |
What (5) factors present at birth that can place an infant at risk | 1. Maternal low socioeconomic level
2. Exposure to environment dangers
3. Pre existing maternal conditions
4. Maternal Age and parity
5. Pregnancy complications |
Maternal low socioeconomic level | decreased access to health care |
Exposure to environment dangers | Toxic chemicals
Illict drugs |
Pre existing maternal conditions | Heart disease
diabetes
hypertension
Renal disease |
Pregnancy complications | Abruptio placentae
Placenta previa
Pre-eclampsia |
What same factors (5) contribute to the common complications of the SGA (small for gest. age) newborn and the Pr AGA (preterm appropriate for gest. age) Newborn | 1. Maternal factors
2. Maternal disease
3. Environmental factors
4. Placental factors
5. Fetal factors |
Maternal factors contributing to common comp. of SGA and Pr AGA | Grand multiparity
Multiple gestation pregnancy
Low socio economic status
Poor maternal nutrition |
Maternal disease contributing to common comp. of SGA and Pr AGA | Heart disease
Hypertension
Pre-eclampsia |
Environmental factors contributing to common comp. of SGA and Pr AGA | Maternal use of drugs
Exposure to toxins
High altitude |
Placental factors contributing to common comp. of SGA and Pr AGA | Small placenta
Placenta previa
Abnormal cord insertions |
Fetal factors contributing to common comp. of SGA and Pr AGA | Congenital infections
Chromosomal syndromes |
Postmaturity | Applies to any newborn born after 42 weeks gestation
Most are of normal size and health |
Post maturity syndrome | Fetus is exposed to poor placental function, impairs nutrition and oxygenation, |
Post maturity syndrome characteristics | 1.Hypoglycemia
2.Meconium aspiration
3.Polycythemia
4.Congenital anomalies
5.seizure activity
6.Cold stress |
Pre term newborn Respiratory difficulties | 1. Lack of surfactant causes the alveoli to collapse, and the infant becomes hypoxic.
2. Incomplete development of the muscular coat of the pulm. blood vessels, leads to left- to- right shunting of blood through the ductus arteriosus back into lungs. |
Pre term newborn Temperature control difficulties | 1. Less able to produce heat b/c of the higher ratio of body surface to body weight.
2. Lack of brown fat
3. Thin skin, causes greater insensible water loss
4. Lack of flexion increases heat loss |
Pre term newborn Gastrointestinal difficulties | 1. Poor suck effort
2. High caloric needs & limited ability to take in nutrition
3. Increased basal met. rate & O2 needs related to increased
effort at sucking
4. Increased chance of aspiration |
Pre term newborn Gastrointestinal difficulties continued | 5. Decreased ability to convert amino acids
6.Decreased ability to handle formula protein
7. Diminished blood flow to the intestines, resulting in necrotizing enterocolitis |
Nursing assessment and initial interventions for newborn w/ selected congenital anomalies focus on | 1. Respiratory
2. Nutritional
3. Neurologic
4. Parental involvement |
Respiratory focus for newborn with selected congenital anomalies | 1. Ability of infant to breathe
2. Maintain Respiratory function |
Nutritional focus for newborns with selected congenital anomalies | 1. Is infant able to suck and swallow
2. Does feeding cause Respiratory distress?
3.Intervention: Provide calories by breast, nipple, gastro tube, or IV |
Neurologic focus for newborns with selected congenital anomalies | 1. Is infant able to move all extremities?
2. Is head circumference normal size, and maintain normal size?
3. Intervention: Keep HOB elevated if head circumference is larger than normal |
Parental involvement for newborns with selected congenital anomalies | 1. Assess parents knowledge of infants anomaly
2. Keep parents informed about infants condition
3. Teach parents appropriate home care of infant |
Special care of the infant who was exposed to drugs or alcohol focuses on | 1. Assessment of the mothers last drug intake and dosage
2. Assessment for congenital anomalies and complications
3. Assess feeding difficulties
4. Provide low stimulus environment to minimized withdrawal complications |