OB Exam 4

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Megs2422
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210390
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OB Exam 4
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2013-03-30 22:50:34
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OB 2013
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Chanette's OB
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  1. neonatal transition
    first few hours of life, in which the newborn stabilizes respiratory and circulatory functions
  2. surfactant
    composed of surface-active phospholipids (lecithin and sphingomyelin) which are critical for alveolar stability
  3. alveolar surface tension
    the contracting force between the alveoli
  4. lung compliance
    the ease with which the lung is able to fill with air
  5. periodic breathing
    a breathing pattern characterized by pauses lasting 5-15 seconds
  6. in the first few days of life hematocrit may rise 1-2 g/dl above fetal level
    as a result of placental transfusion, low po intake, and dimished extracellular fluid volume
  7. physiologic anemia
    initial decline in hemoglobin
  8. Neonatal RBC's have a life span of _____
    80-100 days, approximately 2/3 the life span of an adults
  9. Neutral thermal environment (NTE)
    specific environmental temp range, where the rates of O2 consumption and internal body temp are maintained because of thermal balance
  10. convection
    loss of heat from the warm body surface to the cooler air currents
  11. radiation
    losses occur when heat transfers from the heated body surface to the cooler surfaces and objects not in direct contact with the body
  12. evaporation
    the loss of heat incurred when water is converted to vapor
  13. conduction
    the loss of heat into a cooler surface by direct skin contact
  14. nonshivering thermogenesis
    important mechanism of heat production unique to newborns, skin receptors percieve a drop in temp and thus stimulate the SNS
  15. BAT brown adipose tissue
    dark colored fat, enriched blood supply, dense cellular content, and abundant nerve endings
  16. total serum bilirubin
    the sum of direct (conjugated) and indirect (unconjugated) bilirubin
  17. total bilirubin at birth is usually ___________
    less than 3 mg/dl
  18. physiologic jaundice
    caused by accelerated destruction of fetal rbc's, impaired conjugation of bilirubin and increased bilirubin reabsorption from the intestinal tract
  19. serum levels of bilirubin are about ___________ before yellow coloration of the skin and sclera appear
    4-6 mg/dl
  20. peak bilirubin levels are reached between days __________ in the full term infant and between days ________in the pre term infant
    3-5 and 5-7
  21. breastfeeding jaundice
    appears in the first days of life, appears to be associated with poor feeding practices
  22. meconium
    formed in utero from amniotic fluid and its constuents, intestinal secretions, and shed mucosal cells, thick, tarry black or dark green
  23. active immunity
    the pregnant woman forms antibodies in response to illness or immunizations
  24. passive acquired immunity
    when IgG antibodies are transerred to the fetus in utero
  25. deep or quite sleep
    closed eyes with no movement, regular even breathing, jerky motions or startles at regular intervals
  26. light sleep
    active rapid eye movement, irregular resp, minimal activity, irregular sucking
  27. habituation
    the newborns ability to process and respond to complex stimulation ie bright light
  28. orientation
    newborns ability to be alert,, to follow and fixate on appealing and attractive complex visual stimuli
  29. gestational age assessment tools have 2 components:
    1. external physical characteristics 2. neurologic or neromuscular development
  30.  New Ballard Score
    a set of procedures developed to determine gestational age through neuromuscular and physical assessment of a newborn infant
  31. lanugo
    fine hair covering the baby, greatest amounts between 28-30 weeks
  32. acrocyanosis
    bluish discoloration of the hands and feet
  33. mottling
    lacy pattern of dilated blood vessels under the skin
  34. harlequin sign
      (clown) color change is occasionally notes: a deep red color develops over one side of the newborns body and the other side remains pale
  35. jaundice
     yellowish discoloration of skin and mucous membrane
  36. erythema toxicum
     an eruption of lesions in the area surrounding a hair follicle that are firm, vary in size from 1-3 mm and consists of a white or pale yellow pustule with an erythematous base
  37. milia
     exposed sebaceous glands, appear as raised white spots on the face especially across the nose; no tx necessary.
  38. skin turgor
    assess over the abdomen, forearm or thigh
  39.  vernix caseosa
     whitish, cheeselike substance, covers the fetus while in utero and lubricates the skin of the newborn
  40. telangiectatic nevi (stork bites)
     pale pink or red spots frequently found on the eyelids, nose, lower occipital bone, and nape of the neck. usually fade by 2nd bday.
  41. mongolian spots
    macular areas of bluish black or gray-blue pigmentation on the dorsal area of the buttocks. common in dark skin races. gradually fade. should be documented on newborns chart-as they can be confused as bruises
  42.  nevus flammeus (port-wine stain)
    capillary angioma directly below the epidermis. red-to-purple area of dense capillaries. does not grow in size, fade nor does it blanch.* if convulsions and other neurological problems accompany the mark it suggest Sturge-Weber Syndrom with invlovement of the 5th cranial nerve
  43.  nevus vasculosus (strawberry mark)
     capillary hemangioma. raised, clearly defines, dark red, rough surface, commonly found on head; grows rapidly starting 2nd - 3rd week of life reaches full size 1-3 months. they can later shrink and are best cosmetically when allowed to resolve spontaneously
  44. molding
    asymmetry caused by over-riding of the cranial bones during labor and birth
  45. craniosynostosis
     premature closure of the cranial sutures
  46. plagiocephaly
    asymmetry caused by pressure on the fetal head during gestation
  47. cephalohematoma
     a collection of blood resulting from ruptured blood vessels between the surface of a cranial bone and the periosteal membrane
  48. caput succedaneum
     localized and easily identifiable soft are of the scalp, usually from long difficult labor and use of vac. causes increase of tissue fluids, swelling and occasionally some bleeding
  49. chemical conjunctivitis
    may be caused by the instillation of silver nitrate drops into the newborns eyes
  50. subconjunctival hemorrhange
     appear in about 10% of newborns and are commonly found on the sclera, remain for a few weeks, no long-term effect
  51. epstein's pearls
    small glistening white specks on hard palate and gum margins (keratin-containing cysts) that feel hard to the touch, are often present. usually disappear and are of no significance.
  52. thrush
     white patches in infants mouth, usually from infected mother during birth, treated with nystatin
  53. pseudomenstration
    first week of life infant has vaginal discharge composed of thick whitish mucous, which can be tinged with blood. caused by withdrawal of maternal hormones
  54. smegma
     white cheeselike substance, often present between the labia -do not remove
  55. hypospadias
    occurswhen the urinary meatus is located on the ventral surface of the penis
  56. epispadias
     where the meatus is on the dorsal surface of the glans
  57.  phimosis
    condition in which the opening of the foreskin is small and the foreskin can not be pulled back
  58.  cryptorchidism
     failure of the testes to descend
  59. hydrocele
    a collection of fluid surrounding the testes in the scrotum
  60. polydactyly
    presenseof extra digits on either the hands or the feet
  61. syndactyly
     fusion or webbing of fingers or toes
  62. Erb-Duchenne paralysis
     damage to the upper arm (5th and 6th cranial nerves)
  63. tonic neck reflex
     when the newborn is supine and the head is turned to one side, in response, the extremities on the same side straighten, whereas on the opposite side they flex
  64. moro reflex
    when the newborn is startled by a loud noise or lifted slightly above the crib and then suddenly lowered. in response, the newborn straitens areas and hands outward while knees are flexed
  65.  trunk incurvation (galant reflex)
     seen when newborn is prone, stroking the spine causes the pelvis to turn to the stimulated side.
  66. curcumcision
    a surgical procedure in which the prepuce, an epithelial layer covering the penis is separated from the glans penis and excised
  67. prolactin
    released from the anterior pituitary in response to breast stimulation from suckling or the use of a breast pump-doubles each time an infant suckles, stimulating milk secreting cells
  68. foremilk
    the milk that flows from the breast at the start of feeding or pumping -watery milk high in protein and low in fat
  69. oxytocin
    acts on myoepithelial cells surrounding the alveoli in the breast tissue to contract, ejecting milk called the 'milk-ejection reflex'
  70. hindmilk
    rich in fat (can exceed 10%) and therefore high in calories
  71. colostrum
    initial milk that begins to be secreted during midpregnancy and is immediately available to the baby at birth. thick, creamy yellowish fluid with concentrated amounts of protein, fat-soluble vitamins and minerals and has lower amounts of fats and lactose compared to mature milk
  72. transitional milk
    qualities intermediate to colostrum and mature milk, still slight yellow.
  73. mature milk
    white or slightly blue-tinged in color. present by 2 weeks postpartum and continues thereafter. 13% solids (carbs, protein and fats) and 87% water
  74. 4 classic breastfeeding positions
    modified cradle, cradle, football or clutch and side-lying
  75. neonatal mortality risk
    the infant's chance of death within the newborn period (1st 28 days of life)
  76. small for gestational age (SGA)
    infants that are less that the 10th percentile for birth weight
  77. intrauterine growth restriction
    pregnancy circumstances of advanced gestation and limited fetal growth
  78. symmetric (proportional) IUGR
    long term maternal conditions (chronic hyptertension, substance abuse, etc.)
  79. asymmetric (disproportional) IUGR
    associated with acute compromise of uteroplacental blood flow
  80. postterm newborn
    any newborn born after 42 completed weeks of gestation
  81. postmaturity
    infant who is born after 42 completed weeks of gestation and also demonstrates characteristics of postmaturity sydrome (hypoglycemia, meconium aspiration, polycythemia
  82. preterm infant
    any infant born at 36 6/7 or less weeks gestation
  83. apnea of prematurity
    cessation of breathing for 20 seconds +, or for less than 20 seconds when associated with cyanosis, pallor, and bradycardia.  common problem in preterm infants between day 2 and 7.
  84. patent ductus arteriousus (PDA)
    the ductus arteriousus fails to close because of decreased pulmonary arteriole musculature and hypoxemia
  85. respiratory distress syndrome
    results from inadequate surfactant production
  86. intraventricular hemorrhage
    very common bleed in preterm infants of less than 34 weeks gestation and weighing less than 1500g
  87. fetal pH
    during labor pH 7.25 + is considered normal (nonacidemia) a pH of 7.20 - is considered an ominous sign of intrauterine asphyxia (acidemia) and a pH of less than 7 is considered pathogenic acidemia
  88. respiratory distress syndrome (rds)
    aka hyaline membrane disease is the result of a primary absence, deficiency or alteration in  the production of pulmonary surfactant
  89. cold stress
    excessive heat loss resulting in the use of compensatory mechanisms (such as increased respirations and nonshivering thermogenesis/use of brown fat stores) to maintain core body temperature
  90. hypoglycemia
    plasma glucose concentration of less than 40 mg/dl at any time in any newborn
  91. physiologic or neonatal jaundice
    normal process that occurs suring the transition from intrauterine to extrauterine life and appears after 24 hours of life
  92. erythroblastosis fetalis
    occurs when an Rh-negative mother is pregnant with an Rh-positive fetus and the maternal antibodies cross the placenta, thus destroying fetal rbc's
  93. hydrops fetalis
    most severe form of erythroblastosis fetalis, occurs when maternal antibodies attach to the Rh site on the fetal rbc's making them susceptable to destruction; severe anemia and multiorgan system failure result
  94. physiologic anemia of infancy
    a result of the normal gradual drop in hemoglobin for the first 6-12 weeks of life; at about 72 days of life the infants bone marrow begins producing rbc and anemia disappears
  95. polycythemia
    condition in which blood volume and hematocrit values are increased, more common in IUGR, fullterm or late preterm infants, transfusion from delayed cord clamping, cord stripping, twin-twin transfusions, mothers who smoke and intrauterine hypoxia
  96. sepsis neonatorum
    newborns up to 1 month are susceptible to this infection. caused by organisms that would not cause significant disease in older children

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