Prematurity, Risks
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| show | 1) Age, 2) size, 3) genetics, 4) maternal/environmental variables, 5) labor variables
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| show | 1) temp instability, 2) resp ineffectiveness, 3) cardiac instability, 4) glucose instability, 5) muscle tone variations, 6) ineffective feeding, 7) altered LOC, 8) ineffective interaction
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| A baby with nonreducible nuchal cord will show this pattern on fetal heart monitor | show 🗑
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| For majority of premature babies, they will have ______ throughout life | show 🗑
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| show | Prematurity
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| show | Teenage moms
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| show | 24-28 wks; intrauterine infection
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| show | PT/OT, sensory deficits, learning deficits
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| Our primary nursing role re: prematurity is ___ | show 🗑
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| ______ is paramount in a premature infant | show 🗑
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| What respiratory concerns do we expect with premature babies? | show 🗑
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| show | Reduce # of elective inductions, use of pit. Increase health status of mom, decrease fetal stress, identify high risk concerns, and respond quickly/appropriately
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| show | Bi-PAP, C-PAP
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| show | Caffeine
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| show | Surfactant; alveoli
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| show | Pale, flaring of nares
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| Moderate signs of respiratory distress | show 🗑
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| show | Intercostal/sternal/nuchal retractions, end expiratory grunting, stridor, hypotonia, poor response to pain, "asleep", cyanosis of peripheral (limbs) and/or central (mucous membranes/trunk)
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| True or false: acrocyanosis is a sign of respiratory distress | show 🗑
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| What is a pre/post-ductal test? | show 🗑
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| If saturation differences between pre/post is >= __% then there is a problem and cardiology consult needed | show 🗑
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| show | Umbilicus
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| When administering O2 via NC, we consider two things: | show 🗑
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| If a baby is not able to tolerate NC, we can use a _____ @ 2-5L/min which can be blended with room air | show 🗑
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| show | Continuous positive airway pressure
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| show | O2 sat, chest rise/fall, overall color, lung sounds, skin condition
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| show | Infection; blow out
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| show | Neopuff allows more control so you're less likely to blow lungs out
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| With intubation we can also cause ______ issues | show 🗑
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| How is O2 therapy and psych/social impairment related? | show 🗑
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| What is the rebound effect? How does it relate to eyes? | show 🗑
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| show | Retinopathy of prematurity
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| show | dose dependent
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| ____________ is one of the most common lung injuries as result of prematurity and extended O2 therapy | show 🗑
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| show | An injury to small airways, interfering with alveolar development, which reduces overall surface area for gas exchange
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| Bronchopulmonary dyplasia results in _____ hunger | show 🗑
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| How can we avoid bronchopulmonary dysplasia? | show 🗑
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| show | Give preemies surfactant, lower O2 levels, correct PDA, minimize tidal volumes
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| Long-term oxygen therapy should be weaned ______ and monitored ______ | show 🗑
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| show | Bleeding originates from brain w/extension from ventricular system
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| Intraventricular hemorrhage is a common problem, especially in infants born before _____ weeks | show 🗑
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| show | 72 hours
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| What can increase risk of hemorrhage? | show 🗑
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| show | Monitor unexplained Hct, drop, paleness/pallor, sx of respiratory distress or desat, seizures, lethargy, babies w/ weak suck and high pitched cry, hypotonia
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| show | Cluster care and be very gentle with baby
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| show | Congenital defects (shunting, conduction issues)
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| Suck-swallow-gag is not safe until at least ____ weeks | show 🗑
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| show | IV access
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| show | Want mothers to pump + store milk, fortify milk with calories, kangaroo care as much as possible, NG tube feed until suck/swallow good, may initially give all nutrition IV (TPN/lipids)
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| show | Ineffective themoregulation, intraventricular hemorrhage, seizures, disorganized feeding/attachment/cueing
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| Renal issues r/t prematurity include | show 🗑
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| NEC stands for | show 🗑
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| show | Thoughtfully use antibiotics, careful use of parenteral nutrition, SLOW feedings, corticosteroids, probiotics, breastmilk
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| What is NEC? | show 🗑
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| Assessment of NEC | show 🗑
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| show | Resp distress, temp instability, hypotension, lethargy, decreased UO
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| show | Increased/decreased WBC, thrombocytopenia, neutropenia, metabolic acidosis, CRP levels up
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| If we suspect NEC, our actions should be | show 🗑
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| 80% of preemies have _____ | show 🗑
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| Preemie skin issues include | show 🗑
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| Preemie issues with interaction | show 🗑
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| show | Cluster; constant
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| show | Progesterone given between 16-25 weeks to decrease risk of premature delivery
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| show | Prevents contractions by suppressing cytokines, prostaglandins and response to oxytocin
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| Near term/late preterm newborns may look _____ on the outside but they are ______ not normal | show 🗑
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| Late preterm NB will have these issues | show 🗑
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| Late preterm NBs will work very hard and then crash, often after _____ hours | show 🗑
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| Late preterm NBs are considered deliveries between ______ and ___ weeks | show 🗑
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| Late preterm NBs account for >70% of _____ | show 🗑
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| To prevent late preterm deliveries, we encourage mothers to ______ | show 🗑
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| Rates of late preterms have doubled d/t increased ______ and _______ | show 🗑
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| show | How does baby tolerate being in car seat? Late preterms may asphyxia in seat d/t poor tone
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| How can we keep women pregnant til 39 weeks? | show 🗑
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| Babies with bronchopulmonary dyplasia may have _______ delays | show 🗑
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| show | Steroids, Vit A, diuretics, bronchodilators
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| Bronchopulmonary dysplasia is associated with | show 🗑
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| Teach parents that complications such as ______, _______ and _______ r/t nutrition and hydration may arise for BD babies | show 🗑
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| show | True
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| show | Abruption, cord prolapse, LGA, IUGR, previa, worsening preeclampsia
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lapio-obgyn
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