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NURSING > 3340: PEDS PRETERM > Flashcards

3340: PEDS PRETERM Flashcards

(72 cards)

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1
Q

LBW Infant

A

less than 2500g (5lb 8oz) regardless of gestational age

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2
Q

VLBW

A

less than 1500g (3lb 5oz) regardless of gestational age

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3
Q

ELBW

A

less than 1000g (2lb 3oz) regardless of gestational age

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4
Q

Preterm

A

before 37 weeks

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5
Q

Full term

A

39-40 6/7 weeks

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6
Q

Post term

A

later than 42 weeks

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7
Q

SGA

A

below 10th percentile

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8
Q

LGA

A

above 90th percentile

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9
Q

AGA

A

between 10th and 90th percentile

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10
Q

Biggest problems with preterm infants

A

respiratory
thermoregulation
nutrition

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11
Q

Babies born before __ weeks have minimal to absent reflexes (sucking and swallowing included)

A

32

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12
Q

What position should you place an infant in to facilitate drainage of mucous, regurgitated feedings:

A

side-lying or prone position

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13
Q

To promote drainage of lung secretions in the preterm infant, the nurse should:

A

frequently change the infant’s position

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14
Q

The most common mode of O2 deliver in a newborn

A

hood therapy

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15
Q

Least invasive way to deliver O2

A

nasal cannula

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16
Q

Inhaled Nitric Oxide

A

gas used inboxed babies with pulmonary hypertension; relaxes blood vessels in the lungs without having any effect on vessels of the rest of the body

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17
Q

ECMO

A

the use of a bypass machine to oxygenated the infant’s blood while the infant’s lungs heal
requires anticoagulation

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18
Q

T or F: Premature baby’s blood oxygen can drop fast when agitated

A

True

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19
Q

Pulse Oximetry

A

percentage of hemoglobin that is bound by oxygen

simple, non-invasive, continuous monitoring of oxygen saturation by sensors attached to the skin

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20
Q

NTE

A

environment in which the infant can maintain stable body temperature without an increase in O2 consumption or an increase in metabolic rate
goal: infant maintains temperatures and growth using the least amount of energy

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21
Q

4 methods of heat loss

A

Evaporation
Conduction
Convection
Radiation

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22
Q

Conduction

A

loss of heat from direct contact with cold objects

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23
Q

Evaporation

A

loss of heat from drying the skin or insensible water loss

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24
Q

Convection

A

Loss of heat from air movement surrounding the infant

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25
Radiation
Loss of heat from being near cold surfaces (not touching)
26
Placing the newborn on cold, unpadded scale
Conduction
27
Using a cold stethoscope to listen to breath sounds
Conduction
28
Placing the infant's crib by the window on a snowy day
Radiation
29
Partially drying the infant's hair after a bath
Evaporation
30
Placing the infant's crib near an AC vent
Convection
31
Brown Fat Oxidation
``` Non-shivering Thermogenesis Maintains Temperature Increases Metabolism Increased O2 and glucose consumption May cause respiratory distress, hypoglycemia, acidosis, and jaundice ```
32
Cold Stress
Excessive loss of heat that results in increased respirations and non shivering thermogenesis to maintain core body temperature
33
Nursing Intervention : Cold Stress
Warm the baby and seek to identify causes
34
Indications of Inadequate Thermoregulation
Hypoglycemia and Respiratory Distress may be the 1st signs to show that the infant's temp is low
35
Metabolic acidoses r/t anaerobic metabolism is a major hazard of ______
Cold Stress
36
4 Consequences of Cold Stress
Respiratory Distress Acidosis Hypoglycemia Hyperbilirubinemia
37
Becoming cold can lead to respiratory distress primarily because the infant:
Needs more oxygen than he or she can supply to generate heat
38
75-80% of the nutrient stores in a newborn term infant are accumulated during the ___ trimester of pregnancy
3rd
39
The neonatal nurse should regularly assess the premature infant's ability to metabolize the TPN solution adequately by monitoring the infant for which of the following clinical manifestations?
Hyperglycemia
40
Normal Blood Glucose in an Infant
70-100
41
What is the preferred way of giving gavage feeding to an infant?
orogastric because they are obligated nose breathers
42
Signs of being ready to Nipple Feed
Strong sucking, Swallowing, Gag Reflexes present | @ least 32 weeks
43
Steady weight gain in an infant
20-30g/day
44
RDS
Neonatal Respiratory Distress Syndrome Insufficient production of surfactant, atelectasis, hypoxemia, hypercarbia, acidemia Incidence INCREASES as gestational age DECREASES
45
Manifestations of RDS
crackles, poor air exchange, pallor, retractions, apnea, grunting while breathing
46
What is the most common problem in premature infants?
RDS
47
LS Ratio 2:1
The baby's lungs are mature and the baby is ready to be born
48
How would the chest X ray of an infant with RDS appear
"ground glass" - reticulogranular appearance
49
RDS ABG
respiratory acidosis Decreased pH Decreased PaO2 Increased PaCO2
50
RDS Tx
Surfactant Replacement Therapy | Supportive Tx: Mechanical Ventilation, Correction of acidosis, Parenteral Feedings
51
ROP
Retinopathy of Prematruity Developing blood vessels in a premature infant's retina constrict and become permanently occluded in response to high oxygen concentrations; damages retina and may cause decreased vision, myopia, or blindness
52
What should be avoided in babies that weigh less than 1500gm
SpO2 > 95%
53
BPD
Bronchopulmonary Dysplasia | Lower airway: inflamed and scarred lungs
54
How is BPD defined and classified?
Gestational Age and O2 requirement: mild, moderate, severe
55
Most Common Chronic Lung Disease of Infancy
BPD
56
Clinical Manifestations of BPD
``` Irritability Tachypnea, Retractions, Coughing Failure to thrive Barrel Chest Pulmonary HTN ```
57
BPD Tx
``` Supplemental O2 Planned Rest Periods Small frequent meals to prevent overdistension Diuretics Bronchodilators Chest Percussion ```
58
IVH
Intraventricular Hemorrhage Immature, fragile blood vessels within the brain burst and bleed into the hollow chambers (ventricles) normally reserved for cerebrospinal fluid
59
IVH Dx
Ultrasound
60
IVH Grade 1-2
Usually no symptoms or long term damage
61
IVH Grade 3-4
Symptoms and Long term problems
62
IVH Grade 4
Extension into brains issue 50% mortality rate 90% neurologic disabilities
63
IVH Clinical Manifestation
Rising ICP: lethargy, poor muscle tone, decreased reflexes, irregular respirations, bradycardia, bulging fontanels Seizures if bleeding is severe Hydrocephalus
64
Tx for persistent Hydrocephalus
Ventriculoperintoneal Shunt (VP Shunt)
65
How to avoid increasing ICP
``` Keep infant calm Minimum stimulation Head elevated 15 degrees Avoid trendelenberg measure head circumference daily Be alert for subtle neurologic changes ```
66
NEC
Necrotizing Enterocolitis Life threatening inflammatory disease of intestinal tract Immature bowel damaged when blood supply decreased, bacteria then invaded damaged area
67
When does NEC usually occur
first 7-14 days
68
NEC Clinical Manifestations
Nonspecific: lack of energy, unstable body temp, apnea, bradycardia, hypotension, low urinary output GI symptoms: increased abdominal girth, bile colored vomiting, decreased or absent bowel sounds, loops of bowel seen through the abdominal wall
69
Dx of NEC
X-ray and clinical findings
70
NEC tx
``` STOP oral/tube feedings Relieve Gas Antibiotic Therapy Surgery if there is a hole Colostomy if full thickness dies ```
71
SBS
Decreased ability to digest and absorb a regular diet because of shortened small intestine Diarrhea, Dehydration, Malnutrition, FTT
72
Tx of NEC
STEP | LILT

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