CH.14 Flashcards
what is the main cause of neural tube defect, what is test is used to detect this, and how do we prevent this?
-not a lot of folate
-alpha-fetoprotein is collected and if the results are high that means that the baby will have a neural tube defect
-prevention is to take folate (400 mcg (0.4 mg)/ day) (dark leafy greens and legumes)
s/sx of hydrocephalus
s/sx:
classic sign: increase head size,
at birth the scalp is shiny, veins are dilated, the head is growing rapidly and fontanelles bulges
advance cases: pupils might appear looking down and sclera might be seen above the pupils
older kids: head cannot enlarge because the cranial suture is fused; therefore headache is a predominant sign, with slow cognitive, and personality changes, spasticity, and other neurologic sign
nursing care before and after surgery for hydrocephalus
before: elevated head up to increase cranial position when in bed. Make sure to change the position of the baby to prevent hypostatic pneumonia(circulation of the blood in the lungs is poor), the head must always be supported when turning. Observations: food take, vomiting, condition of the skin, motor abilities, restlessness, irritability, VS changes, fontanelles are inspected for size and signs of bulging, head circumference is measured around the occipital area and is recorded
after: Put baby in a flat position to regulate CSF bc can cause imbalance. Not side lying on affect side. Make sure to measure head, LOC, weight. Check for signs of ICP and infection at operative site
what is spina bifida cystica and what nursing care for it
-sack the lower back of the baby. The meninges protrude through this defect bony canal (Spina Bifida cystica meningocele). The meninges protrude and spinal cord protrudes through this defect bony canal (Spina Bifida cystica meningocele).
-nursing care: baby should be in prone position when lying down, keep sack intact, legs aligned to prevent contractions, assess urination because this is always affected
what is PKU and what is the nursing care
-phenylketonuria is where the baby cannot metabolize phenylalanine, which is found in all protein
-nursing care: avoid giving protein, this will not lead to jaundice, give formula with no protein, but the mother can still provide breast milk (low protein content)
what is maple urine disease and how to detect it early
-cannot metabolize branched -chain amino acids
-if urine has sweet aroma smell
-elevated leucine, isoleucine, and valine this results in acidosis
-can still breast milk
what is galactosemia and nursing care
-cannot use or absorb lactose and galactose
-galactosemia (high galactose in blood) and galactosuria (high galactose in urine)
-cannot give breastmilk, must be given lactose free milk
what is DS, what is the diagnostic to detect it early, and what are the manifestations
-chromosome 21 is affected
-AFP result is low
-manifestations: eyes higher than ears, one line on the palm (transverse palmar crease), small head, round face =, flat nose, limited intellect, develops slow, resp infections, acute leukemia, protruding tongue, short thick neck, hypotonicity of muscles, hands are short and thick and little finger is curved speech and hearing problems
erythroblastosis fetalis, what the medication is given, and what is it at risk for?
-secondary to RH incompatibility (destruction of RBCs), which leads to jaundice
-Rhogam is given to negative mother and positive infant (prevent production of antibodies). Given to moms 72 hrs within delivery IM before discharge. Can also be given 20 to 28 weeks of gestation.
-at risk for seizures because of bilirubin toxicity
what is kernicterus
accumulation of bilirubin in brain tissue (may cause brain damage and permanent disability)
treatment regarding hyperbilirubinemia and nursing care/treatment and how do you know that the treatment is effective
-blood transfusion is easier if done outside of the mother (IV admin of immunoglobulin is administered at birth reducing jaundice and the need for blood transfusion)
-nursing care: prevent dehydration (make sure that the baby is red regularly) during phototherapy. During phototherapy, you know it is working because the baby is pooping, bilirubin levels are low
what is coombs test
-measure RH-pos antibodies in the mom’s blood; directly measures antibodies in Rh-pos RBC in the infant’s blood
-blood test collected from cord
-blood test collected from mom is an indirect coombs test
what is MAS, what do you need to assess, and what medication tx is given?
-meconium aspiration syndrome is when infant aspirate meconium stained amniotic fluid
-assess vaginal discharge of mother and color of amniotic fluid
-med tx: antibiotics to treat infection
what is NAS
-baby has withdrawal from drugs from drug addicted mother
what is withdrawal syndrome look like to the baby and nursing care for NAS
-irritability, tremors, wakefulness, diarrhea , sneezing, yawning, long-term development,, neurologic deficits
-nursing care: quiet environment with swaddling, reduction of extra stimuli, observation seizures (by doing nursing this will prevent seizures)
