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exam2
neonatal pt2
Question | Answer |
---|---|
for what process of neonatal hospital stay do nurses assess if parents have realistic expectations of newborn's behavior, assess depth of their knowledge in caring for their newborn, parent education? | nursing management of discharge |
what includes parent teaching, demonstrate cultural competence, show respect for inherent dignity of patient whatever the age, gender or religion, accept the rights of individuals to choose their care provider, participate or refuse care, | discharge planning |
what includes acknowledgeing personal biases and preventing them from interfering w/ delivery of quality care, recognizing cultural issues be respectful, incorporate cultural preferences into plan of care, use educational materials appropriatly, assist | cultural competence |
when discharging name some teaching points to mention about infant care | head support, positioning, wrapping, breathing, bulb syringe, temp, thermometer, elimination, skin care, cord, diaper care, bathing, sponge baths, tub baths, behavior, sleep/wake phases, socialization |
what kind of infants are born before the 37th week, adequate prenatal care and teaching s&s of this labor can prevent this, very is less than 32 weeks, pre is 32-34 late primi is 34-37 wks primary reason for low birth weight | preterm infant |
what is classified by less than 2500 gms at birth? | low birth weight |
what is classified by less then 1500 gms at birth? | very low birth rate |
what is classified as less that 1000gms at birth rate? brain bleeds? | extremely low birth rate |
what can happen because of previous type of birth, multiple abortions, race/ethnic group, uterine cervical abnormality, multiple gestations, polyhydramnios, oligohydramnios, preg induced HTN, placenta previa after 22 weeks, short interval between pregs, | preterm infant nonmodifyable risks |
these may cause what? age less then 17 more then 35, unplanned preg, single, low ed level, poverty, domestic violence, life stress, # of implanted embryos in assisted reproduction, low pre preg w8, obesity, smoking, | preterm infant modifyable risk factors |
what manifests itself as infant appears frail and weak, underdeveloped muscles and tone, lack subcutaneous fat, skin appears red and translucent, blood vessle clearly visible, make sure their kneck is open? | preterm infant |
what manifest itself as niples and areolar barely visible, vernix caseosa and lanugo abundant, plantar creases absent if less then 32 weeks, pinna of ear soft and flat, lacks rolled over look of full terms? | preterm infant |
for what type of infant do you assess respiration (due to immature lungs), thermoregulation, fluid and electrolyte balance (abgs), skin, infection, pain | preterm infant |
for a preterm infant, what assessment consists of constant observation for apneic episodes for more then 20 seconds w dec in hr and droping o2 sat, effort of breathing e.g retractions, grunting is an early sign of RDS, tachypnea, nasal flaring, | preterm infant respiratory management |
for a preterm infant, what are some therepeutic management interventions of the respiratory sx? | o2 level monitoring, position for air passage drainage, suction PRN, maintain hydration, do not leave them on o2, assess for neuro trama @ birth |
because of thin skin w/ blood vessels near the surface, little subcutaneous fat, less brown fat, body surface area 5xs of an adult, extended extremeties, and immature temp control center, who is susceptible to cold stress? | preterm infants |
for a preterm infant, what can be some complications of heat loss? | hypoglycemia, metabolic acidosis, pulmonary vasoconstriction, impaired surfactant production, calories used for heat production |
what steps of therapeutic management for a preterm infant are durring assessment you keep a skin probe for continuous monitoring, radiant warmer or incubator> | thermoregulation |
in a newborn infant, these are all signs and symptoms of what? poor feeding, irritability, lethargy, weak cry or suck, dec muscle tone, cool skin temp, skin pale, motted, acrocyanosis, hypoglycemia, resp difficulty, poor w8 gain? | inadequate thermoregulation |
what are some interventions for the preterm infant interms of thermoregulation? | maintain heat |
what are preterm infants at risk for because they lose fluids easily (rapid rr and use of o2) large surface area, lack of flexion, radient warmers, phototherepy lights, immature kidney developmene? | fluid and electrolyte imbalance |
what is therepeutic management for fluid and electrolyte imbalance in a newbornm? | monitor i&os from all routes, including blood specimens, spec grav, w8 changes, signs of dehydration or overhydration |
these are s/s of what in the newborn? urine output <2ml/kg/hr, spec grav > 1.02, w8 loss greater than expected, dry skin and mucous membranes, sunken anterior fontanel, poor tissue turgor, blood elevated NA, Pro, Hct levels | dehydration |
these are s/s of what in the preterm infant, urine output >5ml/kg/hr, specific grav <1.001, edema, w8 gain, bulging fontanels, blood dec na, pro, hct levels, moist breath sounds, difficulty breathing? | overhydration |
what are some interventions for therepeutic management of fluid and electrolyte balance? | carefuly regulate iv fluids, dilate iv meds as little fluid as safe, assess iv site hourly, record changes freq |
for the preterm infant for what sx do you freq assess condition, record any changes, avoid using adhesives, gauze wraps instead of tape, do not use alcohol, do not use powders or oils? | skin |
what has a 3-10x greater than full-term to have 1+ episodes of sepsis during hospital stay? caused by maternal infection, lack of transfer immunoglobulin, immature immune response? | preterm infant- infection |
what infection is primary cause of neonatal meningitis and sepsis in the us, 10-30% of all women are asymptomatic carriers of this, found in urogenital lower GI tract, prophylactics treatment proir to delivery, antibiotics, dec transmition to newborn? | group b strep |