High risk newborn

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High risk newborn
2013-02-06 14:13:04
High risk newborn

High risk newborn
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  1. The two umbilical arteries tell you what's happening with _____
    Baby because they are taking waste away from baby. 
  2. The one umilical vein tells you what's happening with ____
    MOM-the umbilical vein delivers O2 and nutrients to baby.
  3. Preterm is considered under ____ weeks.
    37 weeks
    • LBW=<2500g
    • VLBW=<1500g
    • ELBW=<1000g
  5. Late preterm is from ___ to ____ weeks.
    34 to 36 6/7 weeks
  6. Respiratory issues with preterm infant
    • *decreased # of functional alveoli
    • *deficient surfactant levels
  7. Early signs of resp distress in perterm infant
    • tachypnea
    • nasal flaring
    • expiratory grunting (PEEP)
    • retractions (subcostal, intercostal, or suprasternal)
    • Paradoxic breathing- 5-10 sec pause followed by 10-15 sec rapid breathing
    • apnea- cessation of resp for >20 sec
  8. Cyanosis, what is normal and not normal in newborn?
    Acrocyanosis (hands and feet) is normal, yet central cyanosis indicated poor oxygenation.
  9. MAP should equal _____ to properly perfuse vital organs.
    weeks of gestation
  10. Signs of hypovolemia in newborn
    prolonged capillary refill >3sec, pale color, poor muscle tone, lethargy, tachycardia then bradycardia
  11. Why are preterm infants often times given gravage feeding?
    Because they burn a tremendous amount of calories trying to eat.  Gravage feeding is passive allowing them to conserve energy. 
  12. S&S of overheating in premature infant
    • apnea, flushed color
    • they are unable to sweat and being overheated is just as dangerous as being cold.
  13. S&S of seizure in premature infant
    Usually subtle-may be twitching of hand or half smile.
  14. CNS, what to monitor?
    • 1. seizure activity
    • 2. hyperirritability
    • 3. CNS depression
    • 4. elevated intracranial pressure
    • 5. abnormal movements such as decorticate posturing
  15. Why do premature infants have an increased tendency to bleed (prolonged PT, PTT)?
    They don't have vitamin K to help in clotting
  16. All premature infants are treated for _____
    Infection, because they don't give S&S making it hard to know if they have an infection.
  17. O2 sate of premature infant
    • 1min 60-65%
    • 2min 65-70%
    • 3min 70-75%
    • 4min 75-80%
    • 5min 80-85%
    • 10min 85-90%
  18. Coordination of suck and swallow occurs at ___to___weeks.
    32-34 weeks & not fully synchronized until 36-37 weeks gestation
  19. Why are premature newborns at an increased risk for necrotizing enterocolitis?
    • NEC is an acuteinflammator disease of the GI mucose commonly complicated by perforation. 
    • 3 factors:  intestinal ischemia, colonization by bacteria, and substrate(formula) in the intestinal lumen. 
    • Treatment:  rest gut, TPN, treat infection, WASH HANDS!!!
  20. Abd distention could indicate _____ in preterm infants.
    necrotizing enterocolitis
  21. Noise levels of ___ to ____ can cause hearing loss in premature infant.
    • 90-110db
    • incubator produces 60-80db
  22. Premature infants need a period of undisturbed sleep for _____.
    50 minutes for a full sleep cycle
  23. ____ is shown to reduce stress of premature newborn.
    skin to skin contact with parents
  24. Monitor for pneumothorax because it often preceeds _____
    intracranial hemorrhage
  25. Giving a preterm infant high amounts of arterial oxygen can cause ____
    retinal detachment
  26. Post term infant is considered beyond ____
    42 weeks gestation
  27. What are risk factors for postterm infants?
    • meconium aspiration
    • Persistent pulmonary HTN of the newborn
  28. If a postterm infant has meconium aspiration what is the immediate action of birth?
    endotracheal suctioning before first breath to prevent chemical pneumonitis from meconium aspiration.
  29. What is PPHN?
    • Persistent pulmonary HTN of the newborn
    • consists of:  pulmonary HTN, right-to-left shunting, and a structurally normal heart.
    • *they can revert to fetal circulation
    • Treatment:  INO & ECMO
  30. Want moms with gestational diabetes to have an A1C of ____
  31. Erb palsy
    • damage to the upper plexus from stretching or pulling away of the shoulder from head as in shoulder dystocia.
    • arm paralyzed but grasp present
  32. Klumpke palsy
    • severe stretching of upper extremity.
    • hand paralysis
  33. Brachial palsy
    • entire arm paralyzed
    • tx:  prevent contractures and maintain correct placement, passive ROM
    • recovery takes 3-6 months
  34. facial palsy
    • pressure on cranial nerve VII during delivery
    • results in loss of movement on the affected side, facial drooping
    • resolves within hours to days of birth
  35. phrenic palsy
    • diaphragmatic paralysis with parazixic chest movement and elevated diaphram
    • usually unilateral causing respiratory distress
    • place on affected side to allow expansion of unaffcted lung
    • extended recovery time
  36. Measure head q____
    30 minutes to see changes