High Risk Neonatal

Question 1

What two factors largely effect infants health and surviability.

Answer 1

1. Length of gestation
2. Birth weight

Question 2

How many weeks is considered very preterm

Answer 2

< 32 weeks

Question 3

How many weeks is considered preterm

Answer 3

32 to 34 weeks

Question 4

How many weeks is considered late preterm

Answer 4

34 to 36 weeks

Question 5

What is the primary reason for low birth weight?

Answer 5

prematurity

Question 6

What are the categories for low birth weights?

Answer 6

• Extremely low < 1000 g
• Very low < 1500 g
• Low < 2500 g

Question 7

Common characteristics of premature for the following

1. Hair
2. Tone & Flexion
3. Testes
4. Cries

Answer 7

1. Lanugo present (20 to 28 wks)
2. Decreased tone and flexion
3. Undescended
4. Weak cries

Question 8

Common characteristics of prematurity

1. Creases on foot
2. Blood pressure
3. Heart
4. Reflexes

Answer 8

1. Absent creases
2. Hypotension
3. Murmurs present
4. Diminished or absent

Question 9

What are the following a sign of?

Grunting, flaring, retracting, cyanosis

Answer 9

Respiratory Distress

Question 10

Identify the disorder

Small underdeveloped alveoli and insufficient levels of pulmonary surfactant

Answer 10

Respiratory Distress Syndrome

life threatening

Question 11

Nursing Actions for

Respiratory Distress Syndrome

(3)

Answer 11

1. Provide respiratory support
2. Monitor vital signs
3. Maintain neutral thermal environment (prevents cold stress)

Question 12

Identify this order

chronic lung disorder that have been treated w/ mechanical ventilation and O2 due to an inflammatory response from prematurity

Answer 12

Bronchopulmonary Dysplasia (BPD)

Question 13

How long can it take for the ductus arteriosus to close?

Answer 13

up to 96 hours (4 days)

Question 14

What is occuring with Patent Ductus Arteriosus (PDA)?

Answer 14

Ductus arteriosus remains open after birth

Question 15

What is intraventricular hemorrhage (IVH)

Answer 15

Bleeding in the ventricles of the developing brain.

Question 16

Identify this disorder

Inflammation and necrosis of the bowel

Answer 16

Necrotizing enterocolitis (NES)

Question 17

Identify this disorder

Respiratory failure induced when meconium fluid enters the fetal lungs and causes partial obstruction

Answer 17

Meconium Aspiration Syndrome (MAS)

Question 18

When can bilirubin be excreted?

Answer 18

When it becomes conjugated.

Question 19

Identify this disorder

Abnormal accumulation of unconjugated bilirubin in the brain cells

Answer 19

Kernicterus

Question 20

What type of bilirubin can cross the blood brain barrier causing neurological disorders?

Answer 20

unconjugated bilirubin

Question 21

What is conjugated bilirubin bound to?

Answer 21

albumin

Question 22

When serum bilirubin levels are greater than ? mg/dL, neonates will exhibit visible signs of jaundice.

Answer 22

> 5 mg/dL

Question 23

Which type of jaundice occurs after the first 24 hours and during the first week of life?

Answer 23

Physiological jaundice

Question 24

Which type of jaundice occurs within the first 24 hours of life.

Answer 24

Pathological jaundice

Question 25

What are two diagonistic tests for hyperbilirubinemia

Answer 25

1. Total serum bilirubin 2. Antiglobulin (Coombs) test | Additionally: transcutaneous bilrubinometry

Question 26

What is the treatment for hyperbilirubinemia

Answer 26

Phototherapy | converts bilirubin to water-soluble molecules that can be excreted

Question 27

What are the Five Rights of Teaching

Answer 27

1. Right Time 2. Right Context (*environment*) 3. Right Goal 4. Right Content 5. Right Method

Question 28

What is the risk with hyperbilirubinemia?

Answer 28

accumulation of unconjugated bilirubin in the brain causing neurological disorders (*deafness, delayed motor skills, intellectual deficits, and hypotonia) | hypotonia = decreased muscle tone

Question 29

What vulnerabilities do **preterm** babies have that put them at risk for infection (*e.g., necrotizing enterocolitis*) | Two vulnerabilities

Answer 29

1. Fetal lung maturity 2. Organ sensitivity

Question 30

# Signs and symptoms Newborn Respiratory Distress syndrome | (3)

Answer 30

1. Tachypnea 2. Gray or dusky skin 3. Lethargic and hypotonic

Question 31

What is breastfeeding jaundice? When does it occur? Why does it occur?

Answer 31

1. Caused by ineffective breastfeeding 2. Early onset (first few days of life) 3. Not receiving enough milk causes delay in meconium stool leading to reabsorption of bilirubin.

Question 32

What hormones are associated with lactogenesis?

Answer 32

Prolactin | High levels of estrogen and progesterone suppress lactation.