Class 10: Infants of Diabetic Birthers Flashcards
1
Q
what is the single most important factor influencing fetal wellbeing
A
- euglycemic status of the mother during pregnancy
2
Q
what impact can IDM have on size of the NB
A
- macrosomia
3
Q
macrosomia increases the risk for ..
A
- birth trauma & injuries (particularly shoulder)
4
Q
IDM have a…
A
- characteristics appearance
5
Q
IDM have an increased risk of what r/t BG?
A
hypoglycemia after birth
6
Q
describe the characteristic appearance of IDM (6)
A
- large for gestational age
- round, plump face
- reddish color
- lethargy
- hypotonia
- lots of vernix
7
Q
IDM have an increased risk for.. (9)
A
- hypocalcemia
- hypomagnesemia
- hyperbilirubinemia
- polycythemia
- RDS
- cardiac anomalies
- VSD
- congential hyperinsulinemia
8
Q
if IDM are >= 35 weeks gestation at birth, what do we want to do? (2)
A
- ensure we put them skin to skin w parent
- feed asap after birth
9
Q
when is BG checked for IDM >= 35 weeks at birth
A
- approx 2 hrs after birth & after the first feed
10
Q
what is the goal serum BG lvl for IDM
A
- > = 2.6
11
Q
what is included in nursing care for mnmgmt of IDM (8)
A
- check BG
- monitor for symptoms of hypoglycemia
- maintain neutral thermal enviro
- monitor for signs of resp distress
- assess for abnormalities on physical exam that suggest birth injuries or cardiac anomalies
- monitor for signs of jaundice
- assess latch & positioning
- assess for signs of effective feeding
12
Q
if S&S of hypoglycemia are present in the NB, what is done
A
- check BG
13
Q
how is BG checked on an infant
A
- heel stick
14
Q
describe the procedure to check BG on aqn infant
A
- warm feel for 5-10 min to increase blood flow
- wear gloves
- cleans w antiseptic & dry
- let them suck sucrose to minimize pain
- price outside aspect of heel (avoid bone d/t risk of infection)
- bandaid & return to parent
15
Q
describe ongoing monitoring of glucose for IDM and asymptomatic & when this continues until
A
- check BG q3-6 hrs prior to feeds
- continue until 2 consecutive BG >= 2.6 AND infant at 12 hrs of age
