High Risk Newborn PowerPoint Flashcards
birth weight <1000g or 2.2lb
ELBW (extremely low birth weight)
risks of ELBW & preterms
All systems are underdeveloped
- CNS
- Renal
- Maintaining adequate nutrition
- Low body temperature
- Decreased hematologic status
- Immune system
- Retinopathy
- Decrease in growth and development milestones
signs of ELBW & preterms
- Transparent skin
- Low APGAR
- Periodic breathing
- Bradycardia
- Inadequate muscle mass
- Fragile capillaries
- Weak or absent suck reflex
- Unable to excrete toxins
infant born after 42 weeks regardless of birth weight
post-term
postterm risks
- Meconium aspiration
- Fetal distress
- Placental dysfunction
signs of postterm
- Little to non vernix caseosa
- No lanugo
- Abundant scalp hair
- Long fingernails
- Wasted physical appearance
- Depletion of subcutaneous fat
care of the preterm infant
Have airway - with warmed humidified O2
- Especially if there was meconium aspiration
May be on ventilator, under an O2 hood, or have binasal cannula
Wrap in polyethylene
As the baby improves, care is advanced SLOWLY
- Kangaroo care
- Gavage feedings
- Continue glucose monitoring
preterm complications
- RDS (Respiratory Distress Syndrome)
- ROP (Retinopathy of Prematurity)
- BPD (Bronchopulmonary Dysplasia)
- PDA (Patent Ductus Arteriosus)
- NE (Necrotizing Enterocolitis)
macrosomia associations
BIG baby
Maternal Diabetes
types of hyperbilirubinemia
- Physiologic
- Pathologic
- Breastfed
breastfed hyperbilirubinemia
Benign and beings at 2-5days (early onset) or 5-10 days (late onset
- Caused by inadequate or poor breastfeeding leading to decreased hepatic clearance
Treatment = good breastfeeding
Usually declines at week 2 but can persist 3-12wks
- No signs of hemolysis or liver dysfunction (meaning the infant has wet &/or dirty diapers after each feeding)
test to determine if the mother has built up antibodies to Rh antibodies
Indirect Coombs test
- at first prenatal visit and again at 28 weeks
- can cause hemolysis of the RBC in the infant
test on fetal cord blood after delivery to determine if there are any maternal antibodies in the fetal blood
Direct Coombs test
- if the titer is high, an exchange transfusion may be necessary (not many have to do this)
hemolytic and congenital anomalies
CNS defects
Neural tube defects
- encephalocele
- anencephaly
- spina bifida
- myelomeningocele
Hydrocephalus
Microcephaly
Respiratory
- choanal atresia
GI
- esophageal atresia
- cleft lip/palate
- omphalocele
- gastroschisis
- imperforate anus
GU
- hypospadias
- ambiguous genitalia
Musculoskeletal
- polydactyly
- oligodactyly
- syndactyly
- clubfoot
- developmental dysplasia of the hip
too many digits (usually hereditary)
polydactyly
