class 8

Question 1

what is the normal birth weight for a newborn

Answer 1

• 3000-4000g

Question 2

low birth weight:

Answer 2

1500-2500g

Question 3

very low birth weight

Answer 3

1500-1000g

Question 4

extremely low birth weight

Answer 4

less than 1000g

Question 5

what are causes of fetal growth restriction (FGR) or intrauterine growth restriction (IUGR)

Answer 5

• Maternal: multiple gestation, high age, low SES, drug abuse, multiparity
• placental factors: small, infarcted, abnormal cord, placenta previa
• fetal factors
• effected by genetics and environment
• fetal growth is secondary to nutrients and oxygen

Question 6

complications to newborn with FGR or IUGR

Answer 6

• hypothermia, hypoglycemia, poor growth and development
• small for gestational age
• low in brown fats

Question 7

what is Symmetrical IUGR

Answer 7

• hyperplastic stage - early pregnancy
• baby size is uniformly small (head and body)
• chronic

Question 8

what causes symmetrical IUGR

Answer 8

• placental dysfunction
• hypertension, malnutrition, infections, substance abuse, anemia
• babies organs don’t develop as small growth starts early

Question 9

asymmetrical IUGR

Answer 9

• hypertrophic stage - late pregnancy
• baby size - head is normal and rest of body is small
• normal growth until third trimester

Question 10

what are the risk factors for having a large for gestational age (LGA)

Answer 10

• greater than 90%
• history, diabetes, pre-gravida obesity/increase BMI, multi-parity

Question 11

LGA newborn experience

Answer 11

• birth trauma - ecchymosis, bruising, jaundice
• congenital anomalies - less amniotic fluid and cramped intrauterine space
• hypoglycemia

Question 12

what happens to babies when they are post term in the womb

Answer 12

• inadequate nutrients
• use nutritional reserves
• long and thin, dry peeling skin, long nails, deeply wrinkled plantar and palmer surfaces, little lanugo and vernix

Question 13

what is meconium aspiration syndrome (MAS)

Answer 13

• post-term babies
• newborn breathes meconium and amniotic fluids at delivery
• occurs when fetus is stressed during labor

Question 14

what are types of birth trauma

Answer 14

• vaginal, C/S, instruments
• risk for LGA

Question 15

what to assess post trauma birth

Answer 15

• skin, bruising, clavicular fractures, hematomas, irritability, high pitched cry or seizure activity, movement, symmetry

Question 16

consequences of hypothermia

Answer 16

• increased O2 consumption, hypoxia - acidosis
• increased glucose utilization - release lactic acid - hypoglycemia
• decreased surfactant production - alveoli collapse and reopen fetal circulation

Question 17

what happens during respiratory distress syndrome

Answer 17

• lacks surfactant - alveoli collapse, WOB increases, tachypnea, grunting, retractions

Question 18

how to treat respiratory distress syndrome

Answer 18

• corticosteroids, exogenous surfactant, respiratory support

Question 19

what is transient tachypnea of a newborn

Answer 19

• fetal lungs filled with fluid
• see tachypnea, grunting, retractions

Question 20

what is treatment for transient tachypnea

Answer 20

• monitor, skin to skin, respiratory support

Question 21

what are the risk factors for hypoglycemia

Answer 21

• diabetic mothers, LGA, SGA, prematurity, sepsis, hypoxia, hypothermia
• increased insulin production for newborn, delayed feeding, infection, or cold stress

Question 22

signs and symptoms of hypoglycemia

Answer 22

• lethargy, feeding changes, weak cry, tremors, jitteriness, tachycardia, respiratory difficulties, central cyanosis
• severe is seizures

Question 23

how to treat hypoglycemia

Answer 23

• BS above 2.6, feeding plans, IV access and medications, parent education, bigger babies need more feeding

Question 24

how to treat neonatal jaundice

Answer 24

• light therapy, breast feeding, IV fluids, IVIG, exchange transfusion

Question 25

what is the source of early onset sepsis in infants

Answer 25

- within 72 hours - maternal genital tract (GBS)

Question 26

what is the source of late onset sepsis in infants

Answer 26

- after 72 hours - maternal genital tract and environment

Question 27

treatment for sepsis

Answer 27

- prevention - maternal screening - blood cultures - antibiotics

Question 28

what are the signs of perinatal substance exposure

Answer 28

irritable/crying, jittery, increased tone, diarrhea, vomiting, skin breakdown, poor feeding, weight loss, tachycardic

Question 29

pre term feeding challenges

Answer 29

- 32-34 weeks born - body is under developed, can aspirate, cant digest properly, fluid loss (dehydration), have weak suck, fatigue, lethargy, irritable

Question 30

what is bilary atresia

Answer 30

- happens in first month - liver disease - blocked bile duct (stool changes color) - liver damage - scaring and death in toddler years - impaired bili metabolism

Question 31

what does newborn screening screen for

Answer 31

- over first 24 hours - PKU-phenylketonuria - 27 specific diseases that can lead to mental handicap, growth problems, SIDs, cystic fibrosis

Question 32

how to do congenital heart defect screening

Answer 32

- pre/post ductal SpO2 measurments - normal will record 95% with differences of plus or minus 3% - borderline (mod) - 90-94% and difference over 3% - fail - below 90% readings

Question 33

What causes assymetrical IUGR

Answer 33

- compromise of uteroplacental blood flow - placental infarct - pre-eclampsia - poor maternal weight gain