OB Exam 1 ch24 HR Newborn
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OB Exam 1 ch24 HR Newborn
an infant whose birth weight is less than 2500 g (regardless of gestational age)
an infant whose birth weight is less than 1500 g
an infant whose birth weight is less than 1000 g
an infant born between 34 and 36/37 weeks of gestation, regardless of birth weight; 70% of preterm babies are in this stage
late preterm (near term) infant
an infant whose birth weight falls above the 90th percentile of intrauterine growth charts; weighing 4000 g or more at birth
large-for-gestational-age (LGA) infant
an infant whose birth weight is below the 10th percentile
small-for-gestational-age (SGA) infant
found in infants whose intrauterine growth is restricted (sometimes used as a more descriptive term for the SGA infant)
intrauterine growth restriction (IUGR)
an infant born before the completion of 37 weeks, regardless of birth weight
premature (preterm) infant
an infant born between the beginning of 38 weeks and the completion of 42 weeks of gestation, regardless of birth weight
an infant born after 42 weeks of gestational age, regardless of birth weight
postmature (postterm) infant
What are some reasons respiratory problems occur?
-decreased # of alveoli
- smaller lumen in resp system
-bony thorax not calcified
-immature/fragile lung capillaries
-weak skeletal muscles
S/S of respiratory distress
nasal flaring, grunting, poor color, retractions, tacypnea, paradoxical breathing
when should you see the infant starting to show respiratory distress/problems?
appears during the 1st 24-48 hrs after birth but it PEAKS at 72 hours
what is the L:S ratio? what does it mean? what should the ratio be? how many weeks should this occur at?
the L stands for lecithin and S stands for sphingomyelin, the measure of these 2 things are used to determine fetal lung maturity (how developed the infant's lungs are)
the ratio should be 2:1 (lungs are considered mature)
occurs approx. at 35 wks of gestation
what are late-preterm infants at a high risk for?
thermoregulation, hypoglycemia, hyperbilirubinemia, spesis and respiratory function
what are the 6 factors that increase occurrence of Respiratory Distress Syndrome (RDS)?
maternal diabetes, c-section w/o labor, hypovolemia, 3rd trimester bleeding, male, caucasian
what are the 7 factors that decrease occurrence in Respiratory Distress Syndrome (RDS)?
mom received sternoid prenatally, prenatal stressors (HTN), IUGR, prolonged rupture of membranes, perinatal infection, female, african american
if meconium is not removed from the airway at birth, it can migrate down to the terminal airways, causing mechanical obstruction and leading to
meconium aspiration syndrome
when is Meconium Aspiration Syndrom at it's high risk? in which type of infants?
what are 3 treatments for meconium aspiration syndrome?
suctioning (below chords), surfactant, and ECMO (in severe cases)
this is a term applied to the combined findings of pulmonary hypertension, right-to-left shunting, and a structurally normal heart
persistent pulmonary hypertension of the newborn (PPHN)
there is another name for Persistent Pulmonary HTN of the Newborn (PPHN), what is it?
Persistent Fetal Circulation
in PPHN, if the pressure in lungs does not decrease, the persistent fetal circulation continues. why is PPHN also called persistent fetal circulation?
b/c the syndrome includes revision to fetal pathways for blood. revisions like Ductus Arteriousus and Formen Ovale open (they were closed at birth)
what type of infant typically is seen with PPHN and what do they typically show?
-infant born at term or postterm
- they exhibit tachycardia and cyanosis
this is the goal for thermoregulation; is the enviornmental temperature at which O2 consumption and metabolic rate are minimal but adequate to maintain the body temperature
neutral thermal enviornment (NTE)
what are 3 ways to reduce heat loss?
warming O2 and fluids