N113 - Care of High-Risk Newborn
Help!
|
|
||||
|---|---|---|---|---|---|
| Premature | Infant born before completion of 37 weeks.
Major problem of preterm newborn is immaturity of all systems.
🗑
|
||||
| Characteristics of preterm infant | Small & scrawny-minimal subq fat, large head, skin-bright pink, abundant fine lanugo hair, soft & pliable ear cartilage
🗑
|
||||
| Male preterm | Undescended testes, few scrotal rugae
🗑
|
||||
| Female preterm | Labia minora is under-developed, labia minora & clitoris are prominent.
🗑
|
||||
| Preterm reflexes | Sucking is absent or weak, swallowing, gag & cough reflexes are absent or weak.
🗑
|
||||
| Respiratory alteration in preterm | Lungs not fully mature, lack of sufficient surfactant, increased respiratory distress syndrome.
🗑
|
||||
| Thermoregulation in preterm | Heat loss is major problem - prone to cold stress. Little subq fat, thinner more permeable skin
🗑
|
||||
| Clinical problems of preterm newborn | Apnea, Patent ductus arteriosis, RDS, intraventricular hemorrhage, hypoglycemia, necrotising enterocolitis, anemia, hyperbilirubinemai, infection
🗑
|
||||
| Post-mature newborn | Born after 42 weeks
🗑
|
||||
| Post-mature associated factors | 5 or more pregnancies, history of prolonged pregnancies
🗑
|
||||
| Post-mature infant characteristics | Absence of lanugo, little vernix, abundant scalp hair, long fingernails, cracked skin, wasted physical appearance (aging of placenta), depletion of subq fat
🗑
|
||||
| Large for gestational age (LGA) | Best known condition associated with LGA is maternal diabetes.
🗑
|
||||
| LGA complications | Birth trauma, increased chance of c-section & induction, hypoglycemia, polycthemia - increased # of RBC's
🗑
|
||||
| Small for gestational age (SGA) | Newborns at or below the 10th percentile, may be preterm or postterm, IUGR - intrauterine growth restriction
🗑
|
||||
| Maternal factors contributing to IUGR | Maternal factors - smoking, lack of prenatal care, age extremes (under 16 over 40)
Maternal disease - heart disease, substance abuse, PIH
🗑
|
||||
| Environmental factors contributing to IUGR | High altitude, exposure to x-rays, excessive exercise, work related exposure to toxins
🗑
|
||||
| Placental factors contributing to IUGR | Small placenta, infarcted area, abnormal cord intersections, placenta previa
🗑
|
||||
| Fetal factors contributing to IUGR | Congenital infections, malformations, chromosomal syndromes
🗑
|
||||
| Complications of SGA newborn | Prenatal asphyxia, aspiration syndrome, heat loss, hypoclycemia, polycythemia
🗑
|
||||
| Prenatal asphyxia - SGA | Chronic hypoxia in utero
🗑
|
||||
| Aspiration syndrome - SGA | In utero - fetus can gasp during birth aspirating amniotic fluid into lower airways
Hypoxia can lead to relaxation of anal sphincter & passage of meconium
🗑
|
||||
| Heat loss - SGA | Diminished subcutaneous fat, depletion of brown fat in utero, large surface area
🗑
|
||||
| Hypoglycemia - SGA | Inadequate supplies of enzymes to activate gluconeogenesis, increase in metabolic rate in response to heat loss, infant will have routine one touch
🗑
|
||||
| Polycythemia - SGA | Increased # of RBC's - considered a physiologic response to hypoxic stress, produce more RBC's to carry O2, causes an increase in bilirubin
🗑
|
||||
| Nursing care for high risk newborn | #1-Support respiratory function, thermoregulation, protect from infection, hydration, nutrition
🗑
|
||||
| Respiratory distress syndrome (RDS) | Also known as Hyaline membrane disease. Result of absence or deficiency in the production of surfactant.
🗑
|
||||
| RDS manifestation | Scattered atelectasis, overinflation of some areas, grunting, cyanosis on room air, tachypnea, nasal flaring
🗑
|
||||
| RDS management | Ventilator support, surfactant replacement therapy, in severe RDS - partial liquid ventilation
🗑
|
||||
| RDS complications | Too much O2 can damage retina
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
jrb265
Popular Nursing sets