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High Risk Newborn
Review CH 27
Question | Answer |
---|---|
What (5) factors present at birth that can place an infant at risk | 1. Maternal low socioeconomic level 2. Exposure to environment dangers 3. Pre existing maternal conditions 4. Maternal Age and parity 5. Pregnancy complications |
Maternal low socioeconomic level | decreased access to health care |
Exposure to environment dangers | Toxic chemicals Illict drugs |
Pre existing maternal conditions | Heart disease diabetes hypertension Renal disease |
Pregnancy complications | Abruptio placentae Placenta previa Pre-eclampsia |
What same factors (5) contribute to the common complications of the SGA (small for gest. age) newborn and the Pr AGA (preterm appropriate for gest. age) Newborn | 1. Maternal factors 2. Maternal disease 3. Environmental factors 4. Placental factors 5. Fetal factors |
Maternal factors contributing to common comp. of SGA and Pr AGA | Grand multiparity Multiple gestation pregnancy Low socio economic status Poor maternal nutrition |
Maternal disease contributing to common comp. of SGA and Pr AGA | Heart disease Hypertension Pre-eclampsia |
Environmental factors contributing to common comp. of SGA and Pr AGA | Maternal use of drugs Exposure to toxins High altitude |
Placental factors contributing to common comp. of SGA and Pr AGA | Small placenta Placenta previa Abnormal cord insertions |
Fetal factors contributing to common comp. of SGA and Pr AGA | Congenital infections Chromosomal syndromes |
Postmaturity | Applies to any newborn born after 42 weeks gestation Most are of normal size and health |
Post maturity syndrome | Fetus is exposed to poor placental function, impairs nutrition and oxygenation, |
Post maturity syndrome characteristics | 1.Hypoglycemia 2.Meconium aspiration 3.Polycythemia 4.Congenital anomalies 5.seizure activity 6.Cold stress |
Pre term newborn Respiratory difficulties | 1. Lack of surfactant causes the alveoli to collapse, and the infant becomes hypoxic. 2. Incomplete development of the muscular coat of the pulm. blood vessels, leads to left- to- right shunting of blood through the ductus arteriosus back into lungs. |
Pre term newborn Temperature control difficulties | 1. Less able to produce heat b/c of the higher ratio of body surface to body weight. 2. Lack of brown fat 3. Thin skin, causes greater insensible water loss 4. Lack of flexion increases heat loss |
Pre term newborn Gastrointestinal difficulties | 1. Poor suck effort 2. High caloric needs & limited ability to take in nutrition 3. Increased basal met. rate & O2 needs related to increased effort at sucking 4. Increased chance of aspiration |
Pre term newborn Gastrointestinal difficulties continued | 5. Decreased ability to convert amino acids 6.Decreased ability to handle formula protein 7. Diminished blood flow to the intestines, resulting in necrotizing enterocolitis |
Nursing assessment and initial interventions for newborn w/ selected congenital anomalies focus on | 1. Respiratory 2. Nutritional 3. Neurologic 4. Parental involvement |
Respiratory focus for newborn with selected congenital anomalies | 1. Ability of infant to breathe 2. Maintain Respiratory function |
Nutritional focus for newborns with selected congenital anomalies | 1. Is infant able to suck and swallow 2. Does feeding cause Respiratory distress? 3.Intervention: Provide calories by breast, nipple, gastro tube, or IV |
Neurologic focus for newborns with selected congenital anomalies | 1. Is infant able to move all extremities? 2. Is head circumference normal size, and maintain normal size? 3. Intervention: Keep HOB elevated if head circumference is larger than normal |
Parental involvement for newborns with selected congenital anomalies | 1. Assess parents knowledge of infants anomaly 2. Keep parents informed about infants condition 3. Teach parents appropriate home care of infant |
Special care of the infant who was exposed to drugs or alcohol focuses on | 1. Assessment of the mothers last drug intake and dosage 2. Assessment for congenital anomalies and complications 3. Assess feeding difficulties 4. Provide low stimulus environment to minimized withdrawal complications |