High Risk Newborn Flashcards by Hannah James

IUGR:
vasoconstriction in mom causes what in fetus

decreased growth in fetus

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high risk infants are classified according to what factors?

-birth weight (low)
-gestational age
-predominant pathophysiologic problems

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what is a plastic bag used for in neborns

prevent evaporative heat loss
(thermoregulation)

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preterm infants:
-organ systems are _________

immature

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low birth weight

<2500g

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very low birth weight

<1500g

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extremely low birth weight

<1000g

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signs of resp. distress

grunting
flaring
retracting

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apnea vs periodic breathing

apnea: >20 seconds and/or desat

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1 priority in preterm

breathing

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what happens during brown fat metabolism

norepi released –> vasoconstriction –> blood pumped to core–> brown fat metabolism triggered

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what is used in the body during brown fat metabolism

glucose and O2

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how can we prevent heat loss in hospital

by using an isolette

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if infant gets infection, what happens to temp

it goes down
(hypothermic)

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fragile capillaries in the brain can cause what

hypoxic episodes and unstable BP
–> lead to brain bleed

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nutrition: what do preterm babies struggle with

suck, swallow, breathe reflex

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How do you know an infant is ready to go home

-gain weight appropriately
-cry when hungry
-appropriate focus on parents
-good CNS

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milstones are corrected until what age

2 1/2 years

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respiratory system:
-surfactant

put fluid down endo trach tube to rapidly improve resp. function

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why give betamethasone prior to birth

mature lungs

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insensible water loss

losing fluids through skin and respirations

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nonnutritive suck

suck on pacifier while tube feeding

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vernix caseosa provides what

epidermal barrier

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why do we not want to wash baby a lot after birth

vernix caseosa:
-disrupts pH

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what can impact hearing in a fetus

-NICU (loud sounds) -ABX

when a baby gets hiccups or puts hand over face, what does it mean

STOP -they need a minute

how does asphyxia influence belly/GI

blood is shunted to more important organs -GI might not get perfused -infants won't tolerate feedings

best way to teach parents to touch newborn

hand on head and side

what touch can cause too much stimulation to newborn

stroking face

resp. distress syndrome (RDS)

poor air exchange -crackles

lack of surfactant lead to

atelectasis

who is at risk for RDS

-c/s without labor -2nd twin since they aren't squeezed as much -gest. diabetes -caucasian males

retinopathy of prematurity

mimic amount of O2 while ventilating -we want room air

patent ductus arteriosus (PDA)

-can stay open and cause circulatory issues

PDA treatment

-ibuprofen (rough on kidneys) -surgical ligation

Germinal matrix hemorrhage

-intraventricular hemorrhage -common

Germinal matrix hemorrhage: s/s

-bleed -full fontanelle -increased ICP -change in activity level

who is at high risk for germinal matrix hemorrhage

history of hypoxia birth asphyxia

Necrotizing Enterocolitis (NEC)

acute inflammatory disease of the GI mucosa -blood will go to heart and brain and not much O2 to gut

how to assess for NEC

abdominal girth-distention

NEC is rare in

breast fed babies

most frequent reason for readmission

hyperbili

pain needs to be _________ and _________. why?

anticipated and prevented prevent long term consequences

late preterm infant age

34-37 weeks

late preterm babies are at risk for

thermoregulation resp. distress nutrition (S,S,B) hypoglycemia hyperbili infection

postmature infants

>42 weeks

postmature infants are at risk for....

-meconium aspiration syndrom -persistant pulm. HTN

what causes mec to be released in utero

fetal distress leads to placental insufficiency, which lead to low O2 fetus senses acid-base imbalance, and increases breathing-> aspiration

persistant pulmonary HTN

green tinge on skin and umbilical cord -peeling skin: no more vernix

growth restricted infants are at risk for....

perinatal asphyxia hypoglycemia heat loss

LGA risks

injury shoulder dystocia cardiac defects

which one crosses the suture line

caput

which one doesn't cross suture line

cephalohematoma

subgaleal hemorrhage

vein of scalp -fetus looses blood volume -hypovolemic

what bone is most often fractured in birth

clavicle

IDM

infant of diabetic mother

CPD

cephalopelivic disproportion -head won't fit

vacuum: -3 pop offs means

STOP -increased risk to baby

brachial plexus injury

-one arm flexed and one flaccid -shoulder dystocia C5-T1

subdural hemorrhage

apnea unequal pupils tense fontanel seizure coma

subarachnoid hemorrhage

hypoxia

what happens to fetus when mother has gestational diabetes

-increased amounts of glucose cross placenta and stimulate fetal pancreas to release insulin

what risk is increased in mothers who have gestational diabetes

congenital anomalies -cardiac -renal -musculoskeletal -CNS

what is crucial for mothers with gestational diabetes

tight glycemic control!!

Macrosmia -insulin is a _______ _________

growth hormone

maternal hyperglycemia can affect the lungs how?

affect fetal lung maturity -deactivates surfactant

normal glucose does what after first 2 hours of life

drops -40-45 mg/dL

s/s of infection in neonates

-abd distention -irritable -lethargic -fever -apnea -decreased profusion -hypotensive

why are infants susceptible to infection

immature immune systems

sepsis early onset

-within first 7 days

cause of early onset sepsis

group beta strep and E. coli

risk factors for early onset sepsis

-prematurity -prolonged ROM -procedures during pregnancy or labor/birth -resuscitation -maternal fever -GBS

med of choice for GBS

ampicillin and gentamycin

s/s of GBS

-poor feeding -fever -hypothermia

risk factors for GBS

-ruptured membranes >18 hours -fever during labor -prev. birth with GBS -immature fetal monitor -IPC

Sepsis late onset

day 7-30

sepsis late onset: -causes

-health care acquired infections -maternally derived infection

tabacco can cause

low birth weight

alcohol can cause

-fetal alcohol syndrome -neruo developmental disorder

opioids: -babies are _________ not addicted

dependent

NAS

signs associated with withdrawal from opioids

NAS: -3 scores above 8

medical intervention (morphine)

cocaine risk factors

placental abruption IUGR LBW preterm birth

amphetamine risk factors

placental abruption preterm birth SGA

how do opioids affect sleep

obliterate REM sleep

benzo and barbiturate withdrawal

not seen until 7-21 days

why do we not give naracan

can cause seizures

High Risk Newborn Flashcards

(88 cards)