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OB ch. 28
Newborn at Risk: Acquired/Congenital Probs
Question | Answer |
---|---|
s/s of dystocia | limit motion of arm, crepitus over bone, absence of Moro reflex |
What causes Erb Palsy? | stretching/pulling away of shoulder from head and damage upper plexus. |
s/s of Erb Palsy | arm hangs limp and adducted and hands turn outward. Recovery in 3-6mos |
Which cranial nerve causes facial nerve paralysis | CNVII |
Prenic nerve innervates what and paralysis causes waht? | innervates diaphram, resp affected |
What are 4 types of CNS injuries? | intracranial hemorrhage, subdural hematoma, subarachnoid hem, spinal cord injuries. Often missed |
What r two patterns of neonatal bacterial infections | early onset/congenital: 24-48hrs, rapid progress, Ecoli, PROM, maternal fever, chorioamnionitis Late onset: 7-30days, nosocomial/maternal |
What is septicemia | infection in bloodstream. Pneumonia most common cause of perinatal death |
When is time frame to determine nosicomial vs prenatal cause of infection | nosicomial: after 2-3 days prenatal: First 48 hrs of life |
what are earliest s/s of neonatal sepsis | lethargy, poor feeding, poor wt gain, irritability |
When do you screen for Strep B? | 36 wks Tx: antibiotics for mom, watch baby |
What protections does human milk offer? | colostrum has IgA: protect GI milk has: bacteriostatic effect on Ecoli and has macrophages/lymphocytes |
Perinatally acquired infections can be remembered by TORCH | Toxoplasmosis Other: gonorrha/HepB/syphillis/varicella-zoster/parvovirus/HIV Rubella Cytomegalovirus Herpes simplex virus |
s/s of syphilis | copper-colored maculopapular dermal rash on sole/palms/diaper area/mouth/anus |
what is rhagades | rough, cracked mucocutaneous lesions of lips |
when should infants have HepB immune globulin? | infants whose mothers have antibodies the HBsAg or dev hep during preg. After birth/w/in 12 hrs then 1mo, then 6mos |
what is leading cause of neonatal sepsis and meningitis? 2nd? | Group B Streptococcus. Shows mostly in first 24 hrs. Ecoli |
define addiciton | person seeks the drug to exp a high, achieve euphoria, escape from reality, satisfy personal need. |
what is used in tx of opioid addiction | Buprenorphine |
what are some hemolytic diseases | RhD factor- Rh- mom has Rh+ fetus, dad is Rh+. Mom forms antibodies called maternal sensitization. ABO incompatibilities- fetus A/B/AB adn mom is O bc have anti A/B |
What hemolytic disorders can cause jaundice? | G6PD Galactosemia: milk intolerant Crigler-Najjar disease: can't breakdown bilirubin hypothyroidism |
what is an encephalocele/anencephaly | enceph: Herniation of brain/meninges thru skull defect at base of neck Anen: absence of both cerebral hemishpere and overlying skull(death) |
what is most common CNS defect | spina bifida- failure of neural tube to close |
what is choanal atresia, a resp system anamoly | bony/membranous septum bn nose adn pharynx. Cyanosis, but pink when cries and breaths thru mouth congenital diaphragmatic hernia: intestines protruding out lungs |
what is microcephaly | small head |
congenital Anomalies | Congenital heart disease, abd wall defects, neural tube defects, cleft lip/palate, clubfoot, dysplasia of hip |
What is second major cause of death next to prematurity w/in 1st eyar of life? | cardiovascular system anomalies |
what is omphalocele | infant's intestine organs stick out of belly button and covered by layer of tissue |
what is imperforate anus | rectum is malformed, no out to anus |
Name some musculoskeletal anomalies | dysplagia, subluxation, clubfoot, polydactyly |
Genitourniary system anomalies | hypospadias/episadias: opening of penis is below penis ambiguous genitalia: extra genitalia |