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Nurs 368 > High Risk Newborn Pt. 2 > Flashcards

High Risk Newborn Pt. 2 Flashcards

1
Q

How long does it take for transient tachypnea of the newborn to resolve?

A

1-3 days

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2
Q

How is TTN diagnosed?

A

X-ray

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3
Q

Why is it important to treat TTN?

A

it may cause atelectasis

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4
Q

How is TTN treated?

A

Oxygen supplementation and NG tube feedings

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5
Q

What are s/s of TTN?

A

retractions, nasal flaring, grunting, mild cyanosis

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6
Q

When does meconium aspiration happen?

A

in utero

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7
Q

What can happen if meconium aspiration occurs?

A

complete atelectasis can occur

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8
Q

How can meconium be diagnosed?

A

chest x-ray that shows hyperexpansion and atelectasis

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9
Q

How is meconium aspiration treated?

A

intubate and suction immediately, mechanical ventilation/high frequency vent/ECMO, and antibiotics

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10
Q

S/S of meconium aspiration

A

Tachypnea, cyanosis, grunting, rales, retractions, barrel shaped chest, greenish staining to nails and skin

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11
Q

What does meconium aspiration syndrome casue?

A

chemical pneumonitis

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12
Q

What is the most effective way to get the meconium out of a baby’s lungs?

A

A meconium aspirator

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13
Q

If the baby is gasping, is tachypnic, cyanotic, grunting, and retracting, and the amniotic fluid was stained with meconium, what is the next thing that would be done?

A

intubation

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14
Q

Why are babies with meconium aspiration given antibiotics?

A

to treat chemical pneumonitis

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15
Q

What may a newborn look like if meconium has been leaking with the amniotic fluid for a while?

A

greenish stain on skin and nails

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16
Q

3 things to look at if meconium aspiration is suspected?

A

HR, tone, respiratory effort

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17
Q

What is the number 1 diagnosis for ECMO for a newborn?

A

meconium aspiration syndrome

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18
Q

What are the two types of jaundice?

A

physiologic vs pathologic

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19
Q

How is hyperbilirubinemia treated?

A

it is determined by bilirubin result and age of baby in hours as well as risk factors

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20
Q

What can happen if a baby’s bilirubin gets too high?

A

kernicterus

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21
Q

What is the main treatment for hyperbilirubinemia?

A

hydration/phototherapy

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22
Q

Which baby’s are at risk for pathological jaundice?

A

Rh negative or type O moms that have a baby that is Rh positive or type A/B/AB

23
Q

What might babies present with pathological jaundice?

A

hemolytic disease of the newborn, Sepsis, Cold stress, or a blocked bile duct

24
Q

What might babies present with physiologic jaundice?

A

increased RBCs, liver immaturity, delayed feeding, and bruising

25
Q

What is the treatment for an infant with RH disease?

A

treat anemia, remove sensitized RBC’s that would be destroyed, remove serum bilirubin, and provide bilirubin free albumin

26
Q

Why is feeding so important to decrease bilirubin levels in newborns?

A

feedings should make the baby poop, and bilirubin is excreted in the poop

27
Q

Can babies under phototherapy have lotion on them?

A

no

28
Q

What is the nursing care for a baby with hyperbilirubinemia?

A

expose as much skin as possible and keep under lights except for feedings, frequent feedings, eye protection, frequent diaper changes, monitor I & O’s, remove eye protection at feedings and promote bonding, check bili levels are ordered, monitor temperature

29
Q

What is the main bacterial neonatal infection that occurs?

A

GBS

30
Q

What are the main viral infections that neonates can transmit?

A

TORCH, Varicella-Zoster, ZIKA

31
Q

What is the main fungal neonatal infection?

A

candidiasis

32
Q

what is vertical trasmission?

A

something that is transmitted at birth

33
Q

What is a TORCH titer?

A

Toxoplasmosis, Syphilis, CMV, Hep B, HIV, HSV

34
Q

If a pregnant mom is changing cat litter, what is she putting herself and the baby at risk for?

A

toxoplasmosis

35
Q

Where can toxoplasmosis be found?

A

in cat litter and in soil

36
Q

When does herpes normally present itself on a newborn?

A

around 10 days of age

37
Q

What diagnoses a baby with sepsis?

A

hypothermia

38
Q

What swabs are done to diagnose a baby with herpes?

A

nasal and rectal

39
Q

What is used to treat HSV?

A

acyclovir

40
Q

How can HIV be transmitted to infants?

A

transplacentally, during birth, or via breastmilk

41
Q

What decreases the risk of transplacental transfer of HIV for a pregnant mother?

A

zidovudine

42
Q

When is HIV-DNA polymerase chain reaction testing done for babies that may have HIV?

A

1-2 months of age

43
Q

How long do maternal antibodies last in the infants blood?

A

up until 15 months of age

44
Q

HIV infant care for a newborn

A

Administer zuvodine
assess for infection, weight gain, failure to thrive, GI problems
Use standard precautions and provide standard newborn care

45
Q

Signs and symptoms of neonatal infections

A

hypothermia
apnea/bradycardia, retractions, cyanosis, lethargy, poor feed, immature to neutrophil ratio

46
Q

Which labs are ordered if a baby is suspected of being septic?

A

CBC with differential, blood cultures/urine/CSF, C-reactive proteins

47
Q

What is a diagnostic tool used for neonatal infections?

A

positive blood culture

48
Q

What is the medical management for neonatal infections?

A

antibiotics, IV fluids, monitor glucose/electrolytes, ventilation management/oxygenation

49
Q

What is the minimum and maximum amount of time to administer antibiotics?

A

minimum: 48 hours and maximum: 21 days
Normally given 10-14 days

50
Q

What needs to be gotten before antibiotics can be started?

A

blood culture

51
Q

Symptoms of neonatal abstinence syndrome

A

irritable, tremors, increased muscle tone, loose stools

52
Q

What are non-pharmacologic treatments for an infant suffering from neonatal abstinence syndrome?

A

swaddle, feed, aromatherapy, music therapy, and massage

53
Q

What is the pharmacologic treatment for infants suffering from neonatal abstinence syndrome?

A

narcotics

54
Q

How do you identify if a neonate has a been exposed to subtances?

A

cord blood, meconium, urine (1st, according to textbook), and hair

Nurs 368 (20 decks)

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