Management of newborn complications
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| What is a preterm infant? | One who is born 20-37 weeks.
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| What is respiratory distress syndrome (RDS)? | decreased surfactant in alveoli regardless of birth weight.
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| What is bronchopulmonary dysplasia (BPD)? | stiff and noncompliant lungs leading to mechanical ventilation & O2.
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| What is retinopathy of prematurity? | abnormal growth of retinal blood vessels, usually linked with O2 administration in neonate.
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| What is patent ductus arteriosus (PDA)? | occurs when ductus arteriosus reopens after birth due to neonatal hypoxia.
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| What is necrotizing enterocolitis (NEC)? | inflammatory dz of GI mucosa d/t ischemia.
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| What are some s/s of preterm infant? | periodic breathing, lanugo, minimal creases on soles and palms, heels movable to ears, hypotonic muscles
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| The main priority in treating preterm newborns is supporting what systems? | cardiac and respiratory systems
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| What is surfactant? | a phospholipid that helps in alveoli expansion.
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| What are factors that can accelerate lung maturation in fetus while in utero? | increased GA, intrauterine stress, exogenous steroid use, ROM
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| What is a postterm infant? | one who is born after 42 weeks/
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| What is true? | postmature infant can be SGA or LGA.
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| What are some s/s of postterm infant? | thin loose dry cracked skin, meconium stained fingernails, hypoglycemia, macrosomia, s/s of cold stress
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| What is large gestational age (LGA)? | neonate...
- >90th % or
- >4000g (8lb.12oz.)
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| What are two leading factors of LGA? | postterm infants and maternal DM
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| What are nursing interventions for LGA neonate? | - early and frequent heel sticks
- early feedings to maintain glucose levels
- thermoregulation
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| What is neonate hypogylcemia? | - <40 mg/dL in term
- <25 mg/dL in preterm
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| Hypoglycemia can lead to what if left untreated? | mental retardation
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| What are s/s of neonate hypoglycemia? | poor feeding, jitterness, hypothermia, sweating, weak cry, lethargy
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| What is small for gestational age (SGA)? | neonate at or below 10th % of weight.
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| What are some s/s of SGA/IUGR? | drawn abdomen, sparse scalp hair, wide skull sutures, wide-eyed and alert
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| What is hyperbilirubinemia? | elevated serum bilirubin levels --> jaundice
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| What is physiologic jaundice? | normal, signs of jaundice after 24 hr of age.
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| What is pathologic jaundice? | appears before 24 hr of age, persistent after 7 days, bilirubin levels peak >13 mg/dL
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| What are two common factors for pathologic jaundice? | Rh or ABO incompatabiltiy and infection
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| What does the Direct Coombs' test reveal? | reveals the presence of antibody-coated Rh+ RBCs in newborn.
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| What is primary treatment of hyperbilirubinemia? | phototherapy
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| What is kernicterus? | bilirubin levels >24 mg/dL that affects the brain
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| What are side effects of phototherapy? | bronze discoloration, skin rash, pressure areas, dehydration, elevated temperature
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| What are nursing interventions for hyperbilirubinemia? | early and frequent feeding, eye mask, keep newborn undressed, no lotion or ointments, reposition q 2 hr, remove newborn from phototherapy q 4 hr and unmasking and checking for inflammation or injury.
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| What is tracheoespophageal atresia? | failure of espophagus to connect to stomach.
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| What are s/s of tracheoespophageal atresia? | excessive mucous secretions, drooling, periodic cyanotic episodes, immediate regurgitation after birth
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| What is phenylketonuria (PKU)? | inability to metabolize amino acid phenylalanine
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| What is galactosemia? | inability to metabolize galactose into glucoseq
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| What is hypothyroidism? | slow metabolism caused by maternal iodine deficiency during pregnancy.
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| What is spina bifida? | neural tube defect and may have protrusion of meninges and/or spinal cord.
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| What are nursing interventions for spina bifida? | - protect membrane with sterile covering
- observe for CSF
- position in prone or side lying
- assess for ICP
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| What is tetralogy of Fallot? | cyanotic heart defect characterized by VSD, overrriding aortic valve, pulmonary valve stenosis, rt ventricular hypertrophy.
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| What are nursing interventions for tetralogy of Fallot? | - conserve infant's energy
- give feedings with special nipple
- elevate head and shoulders
- place in knee-chest position during resp distress
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| What is patent ductus arteriosus? | noncyanotic heart defect in which ductus arteriosus fails to close after birth.
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| What are some s/s of birth injuries? | subarachnoid hemorrhage, facial paralysis, joint dislocations, soft tissue injuries
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| What three areas does neonatal abstinence scoring system assess? | 1. CNS
2. metabolic, vasomotor, and respiratory
3. GI
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| What are some nursing interventions for neonatal substance withdrawal? | - reducing external stimulation
- swaddling
- frequent small feedings
- have suction available
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| What is suspected if newborn has continuous high-pitched crying? | neonatal withdrawal syndrome
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| What is hydrocephalus? | excessive spinal fluid in brain --> bulging fontanels, sunsetting
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| What are nursing interventions for hydrocephalus? | - frequently reposition head to prevent sores
- measure head circumference daily
- assess for signs of ICP
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