Chapter 15 - Phys + Behavioral Responses of Neonates (metab, GI, assessment) Flashcards
T/F large quantities of glycogen is stored in BB during pregnancy
T: in prep for meeting energy requirements when transitioning
rise + fall of gluc after delivery
1 hr: fall
2-3 hr: rise + stabilize
optimal range for glucose
70-100 mg/dL
why do neonates of diabetic moms have a higher risk of hypoglycemia?
in uterine, mom produces a lot of insulin in response to high levels of circulating maternal glucose
-neonates’ insulin level remains higher than normal leading to hypoglycemia
risk for hypoglycemia
- neonates of diabetic mom
- neonates weighing more than 4,000g or lga
- post-term bb
- preterm bb
- sga
- hypothermia
- infection
- resp distress
- neonatal resuscitation
- birth trauma
hypoglycemia s/s
- jittery
- hypotonia
- irritability
- apnea
- lethargy
- temp instability
hypoglycemia nursing actions
- monitor for s/s
- assess blood gluc level
- assist w breast feed or formula feed
- IV infusion of dextrose soln or buccal 40%
functions of liver
- carb metab
- amino acid metab
- lipid metab
- synth of plasma proteins
- blood coag
- conjugation of bilirubin
- phagocytosis by kupffer/macrophage
- storage of fat sol vit (ADEK) + Fe
- detox
carb metab of liver
- reg blood gluc by converting into GLYCOGEN (facilitated by insulin + cortisol)
- converts glycogen to glucose when low
blood coag factors that are synth by liver
factors 2, 7, 9, 10
-vitamin K influences activation of these factors
where is vit K synthesized in BB
intestinal flora
- absent in newborn
- develops thru introduction of microbes (feeding)
phytonadione [vit K, aquamephyton]
prophylaxis to prevent hemorrhagic disease
phytonadione [vit K, aquamephyton]
s/s
erythema
pain
swelling at injection site
phytonadione [vit K, aquamephyton]
route + dose
IM
0.5-1 mg w/ 1 hr of birth
cause of hyperbilirubinemia
incr in RBC turnover (shorter lifespan) + incr RBC count at birth
>leads to incr bilirubin production
2 forms of bilirubin
DIRECT (conjugated)
INDIRECT (unconjugated)
indirect/unconjugated bilirubin
fat soluble
- produced fr breakdown of RBC
- converts into direct bilirubin
direct/conjugated bilirubin
water sol
- bound to albumin
- can be excreted in urine/stool
physiological jaundice
fr hyperbilirubinemia that commonly happns AFTER 24 hr + during first week
-usually peaks at day 3
pathological jaundice
fr various disorders that exacerbate hyperbilirubinemia
- occurs WITHIN first 24 hr
- jaundice last more than a week
gastric capacity for first few days then day 7
5-10mL
>60 mL by day 7
stomach emptying time
2-4 hr
which has more stools per day? breastfed or formula fed
breasfed has more stools
4-8 stools per day
meconium stool
- passed in 1-2 days
- sticky, thick, black, odorless
- forms during 4th gestl month
