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Womens Health Exam 3 > Newborn at Risk > Flashcards

Newborn at Risk Flashcards

1
Q

What is small for gestational age (SGA)

A

Any infant who is less than the 10th percentile for birthweight

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2
Q

What is large for gestational and (LGA)

A

Any infant who is at or above the 90th percentile for birthweight

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3
Q

What is intra-uterine growth restriction (IUGR)?

A

Fetus with limited growth potential during pregnancy due to a variety of factors

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4
Q

What is IDM?

A

Infants of diabetic mothers

So any infant of a mother with pre-existing diabetes or gestational diabetes

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5
Q

What are maternal factors leading to SGA or IUGR?

A

Multiples

Smoking

PIH or CHTN

Maternal age less than 16 or greater than 40

More than six pregnancies

Malnutrition

Heart disease

Substance abuse

Diabetes

Sickle cell

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6
Q

Environmental factors leading to IUGR

A

Living at high altitudes

Exposure to x-rays

Exposure to toxins

Maternal use of medications such as anti-convulsants

Maternal use of drugs such as opioids

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7
Q

Placental factors leading to IUGR

A

Small placenta

Infarcted areas

Placenta previa or thrombosis

Abnormal cord insertion

Single umbilical artery rather than the normal pair

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8
Q

Fetal factors contributing to IUGR

A

Congenital viral infections such as torch infections

Congenital malformations

Metabolic issues

Chromosomal issues

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9
Q

What are torch infections?

A

Toxoplasmosis

Other

Rubella

Cytomegalovirus

Herpes

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10
Q

What are the two types of IUGR?

A

Symmetric and asymmetric

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11
Q

What is symmetric IUGR?

A

Caused by long-term maternal conditions

Chronic growth restriction throughout pregnancy

Baby is small all over including: organs, length, bodyweight, head circumference

Discovered as early as second trimester

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12
Q

What is asymmetric IUGR

A

Caused by acute compromise of utero placenta blood flow

May not be discovered until third trimester

Baby appears disproportionate:
-Head circumference and length may be within normal limits
-abnormal circumference and weight will be decreased

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13
Q

Factors leading to LGA?

A

Genetic predisposition
-large parents often have large babies and male infants are larger on average and female infants

Multiparity
-Much more common after the first pregnancy

Maternal diabetes that is poorly controlled during pregnancy
-macrosomia may occur in 40 to 50% of diabetic pregnancies due to high levels of glucose crossing the placenta, which is stored as fat by the growing fetus

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14
Q

What is post maturity syndrome?

A

Newborn delivered after 42 weeks gestation who have problems associated with an extended pregnancy

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15
Q

What kind of problems are associated with an extended pregnancy?

A

The placenta might begin to deteriorate after about 41 weeks

This can lead to poor blood flow, decrease nutrients and decrease oxygen to baby

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16
Q

What are characteristics of post mature newborn?

A

Dry, cracked, peeling skin (parchment like)

Long fingernails/hair

No vernix

No lanugo

Body long, thin, wasting

Heads circumference and length typically WNL

Meconium staining

17
Q

What is jaundice?

A

Occurs with elevated bilirubin levels, which is the end product of red blood cells breakdown. Many newborns have a mild version that resolves without problems.

18
Q

What is physiological jaundice?

A

Appears after the first 24 hours of life and typically resolved within one week

19
Q

What is breast-feeding jaundice?

A

Can occur in the first few days of life and is related to inadequate fluid intake

20
Q

What is hyperbilirubinemia

A

Is a more serious condition which also causes jaundice, and requires intervention.

Sometimes caused by ABO or RH incompatibility.

Intervention is necessary if bilirubin exceeds 13 to 15 mg/dL

21
Q

What does RH incompatibilities mean?

A

RH + infants of Rh negative mothers are at risk for destruction of red blood cells resulting in jaundice or worse

22
Q

What are the symptoms of jaundice?

A

Bilirubin level greater than 4-6 mg/dL

Yellow tint to skin when blanched at forehead

23
Q

What are the interventions for jaundice?

A

Prevention is best with early and frequent feedings to keep baby hydrated and help eliminate bilirubin via urine and stool

Phototherapy (protect babies eyes)

Exchange transfusion

24
Q

What is fetal alcohol syndrome?

A

Physical, behavioral, and cognitive abnormalities caused by exposure to alcohol during pregnancy

25
Q

What is the nursing management for fetal alcohol syndrome?

A

Quiet, dim environment

Consistent caregivers

Provide adequate nutrition

Support parents and provide positive reinforcement

26
Q

What is the nursing management for neonatal opioid withdrawal syndrome?

A

Provide quiet, dimly lit area

Perform neonatal abstinence scoring

Provide small, frequent feedings

Administer medication as ordered

Swaddle with hands near mouth and provide pacifier

27
Q

What are complications that occur more frequently in the SGA or IUGR newborn

A

Fetal hypoxia

Aspiration syndrome

Hypothermia

Hypoglycemia

Polycythemia

28
Q

What is aspiration syndrome?

A

In utero hypoxia can cause the fetus to gasp during birth, resulting in aspiration of amniotic fluid into the lower airways

29
Q

What is polycythemia?

A

The number of red blood cells is increased in the SGA newborn.

This finding is considered a physiological response to in utero, chronic hypoxic stress.

Polycythemia may contribute to hypoglycemia

30
Q

What are some common complications of the infant of diabetic mother?

A

Hypoglycemia
-blood sugar less than 40

Hypocalcemia
- tremors are the obvious clinical sign of hypocalcemia

Hyperbilirubinemia
-Maybe caused by slightly decreased cellular fluid volume, which increases the hematocrit level. This elevation facilitates an increase in red blood cell breakdown, thereby increasing bilirubin levels.

Birth trauma

Polycythemia

Respiratory distress syndrome

31
Q

What are signs and symptoms of hypoglycemia?

A

Usually present within one to two hours following delivery, include tremors, cyanosis, apnea, temperature instability, poor feeding, hypotonia

Seizures may occur in severe cases

Womens Health Exam 3 (6 decks)

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