high risk neonate

Question 1

below 10th percentile on intrauterine growth curve

Answer 1

small for gestational age (sga) newborn

Question 2

premature newborn are at higher risk for

Answer 2

1.apnea (stops breathing >20 seconds
2. hyperglycemia
3.heart,intestinal, brain conditions

Question 3

born between 33 and 37 weeks

Answer 3

late preterm

Question 4

born between 24 and 34 weeks

Answer 4

early preterm

Question 5

physical signs of prematurity

Answer 5

1. less than 2500 grams
2. Hypotonic
3. Thin,shiny,pink able to see veins
   4.abundant body hair (lanugo)
4. more vernix caseosa
   6.abnormal breathing patterns
5. enlarged clitoris
   8.small penis, undescended testis
6. soft,flexible ear cartilage
7. small or absent nodules
   11.subcutaneous fat is deficient
   12.deep sole creases not present

Question 6

Respiratory
manifestation: Premature

Answer 6

1.Tachypnea
2. Grunting
3. Nasal flaring
4. Retractions
5.Cyanosis
6. Decrease 02 saturation
7. Decrease 02 level
8. Abnormal ABG (arterial blood gas) values

Question 7

cardiovascular manifestations

Answer 7

1.poor tissue perfusion
2.hypotension
3.patent ductus arteriosus

Question 8

potential complications (premature)

Answer 8

1.anemia of prematurity
2.acute bilirubin encephalopathy (ABE)
3.persistent patent ductus arteriosus
4.periventricular hemorrhage or intraventricular hemorrhage

Question 9

major complication premature

Answer 9

1. bronchopulmonary dysplasia (BPD)
2. periventricular leukomalacia
3. retinopathy of prematurity (ROP)
   4.Psychomotor retardation

Question 10

destruction of brain cells by invasion of indirect or unconjugated bilirubin

Answer 10

Acute bilirubin encephalopathy (ABE)

Question 11

A machine will help the baby to breathe, A machine that mechanically assists a patient in the exchange of oxygen and carbon dioxide, a process sometimes referred to as artificial respiration.

Answer 11

ventilator

Question 12

oxygen may be given by:

Answer 12

• nasal prongs
• oxygen hood over the baby’s
head
• Oxygen by mask

Question 13

the lost of heat through moisture (a major cause)
Ex. : wet newborn loss a great amount of heat when the amniotic fluid in their skin evaporates

Answer 13

evaporation

Question 14

the lost of heat to cooler solid objects in the environment that are not in direct contact with the infant
Ex: window surfaces or examination
tables

Answer 14

radiation

Question 15

loss of heat from the body because of direct contact of skin with a cooler solid object
• Ex- newborn is placed on a crib

Answer 15

conduction

Question 16

is similar to conduction except that heat loss is aided by surrounding air currents;
as direct flow of air from air conditioner vent
Ex. Aircondition (nursery ambient temp - 24’C or 75’F)

Answer 16

convection

Question 17

how can you prevent heat loss at the time of birth?

Answer 17

1.drying
2.wrapping
3.skin to skin
4. breast-feeding

Question 18

infant core temp

Answer 18

36.5- 37.2 ‘C

Question 19

above the 90th percentile of intrauterine growth curve

appears deceptively health with immature development

Answer 19

Large for gestational age (LGA)

Question 20

more than 3800 or4400 g

Answer 20

Large for gestational age

Question 21

Large for gestational age etiology

Answer 21

1.overproduction of growth hormone
2.multiparous women
3.congenital cardiovascular disorder
4.beckwith-wiedemann syndrome
5.omphalocele

Question 22

bw greater than 4000 or 4500g

Answer 22

extreme macrosomia

Question 23

lga appearance

Answer 23

prominent caput succedaneum, cephalohematoma, or molding.
- extensive bruising
• birth injury such as a broken clavicle or Erb-Duchenne paralysis from trauma to the cervical nerves
• immature reflexes

Question 24

lga complications

Answer 24

• Prolonged vaginal delivery time
• Difficult birth
• birth trauma due to CPD
• increased incidence of cesarean births/labor inductions
• hypoglycemia

Question 25

lga complications

Answer 25

Respiratory distress Meconium aspiration Hypoglycemia Polycythemia

Question 26

is a rare blood disorder that occurs when a newborn has too many red blood cells. This condition can cause the blood to thicken, making it difficult for blood to flow

Answer 26

Polycythemia

Question 27

Any newborn born after 42 weeks gestation post-term infant may be LGA, AGA, SGA, or dysmature, depending on placental function. An Infant who stays in utero past 42 weeks is at special risk because a placenta appears to function effectively for only 40 weeks.

Answer 27

post term infant

Question 28

post term assessment

Answer 28

•Less amniotic fluid and meconium-stained at birth. • Vernix and lanugo. completely disappeared • Dry, cracked, leather-like skin. •Depleted subcutaneous fat. •Hard nails extending beyond fingertips. •Signs of birth injury or poor tolerance of the birth process

Question 29

complications of post term

Answer 29

• Respiratory Distress Syndrome • Hypoglycemia • meconium aspiration • Polycythemia • congenital anomalies • seizures due to hypoxic insult • cold stress

Question 30

fetal factors

Answer 30

• fetal distress - associated with the decreasing efficiency of the placenta (aging placenta) •insufficiency and continued exposure to amniotic fluid • macrosomia •meconium aspiration syndrome. •stresses of labor and delivery

Question 31

either in utero or with first breath at birth. • Second release of meconium into amniotic fluid is possibly caused by pressure on buttocks • Release of meconium into amniotic fluid is caused by: 1. Relaxation of rectal sphincter 2. Pressure on buttocks

Answer 31

meconium aspiration syndrome

Question 32

causes severe rd in 3 ways

Answer 32

1.inflammation of bronchioles 2.block small bronchioles by mechanical plugging 3. decrease lung surfactant production through lung trauma

Question 33

can be used to dilute the amount of meconium in the amniotic fluid inside the utero

Answer 33

amnioinfusion

Question 34

ECMO

Answer 34

extracorporeal membrane oxygenation

Question 35

peak age of incidence in SIDS

Answer 35

2 to 4 months of age

Question 36

autopsy reveals sids

Answer 36

1.petechiae in lungs 2.mild inflammation 3.congestion in the respiratory tract

Question 37

sids tends to occur at a higher than usual rate in infants

Answer 37

1. of adolescent mothers 2. of closely spaced pregnancies. 3. who are underweight and preterm. 4. with bronchopulmonary dysplasia. 5. born twins. 6. of Native-American and Alaskan parents. 7. who are economically disadvantaged. 8. of narcotic-dependent mothers

Question 38

sids cause/etiology

Answer 38

•prolonged but unexplained apnea •viral respiratory or botulism infection •pulmonary edema •Possible lack of surfactant in alveoli •sleeping prone (respiratory muscles are restricted) •impaired arousal responsiveness to increased carbon dioxide or decreased oxygen

Question 39

newborn from diabetic mothers assessment

Answer 39

•greater chance of congenital anomaly (cardiac anomaly) •caudal regression syndrome •hypoplasia of lower extremities •macrosomia •cushingoid appearance

Question 40

rare congenital abnormality in which a segment of the spine and spinal cord fails to develop.

Answer 40

caudal regression syndrome

Question 41

complications (NFDM)

Answer 41

1. birth injury 2.severe hypoglycemia 3.hyperbilirubinemia 4. hypocalcemia

Question 42

Infants of drug-dependent women tend to be small for gestational age (SGA). • Will show withdrawal symptoms upon birth but onset and duration varies among different substances, maybe in

Answer 42

24 to 48 hrs up to 10 days

Question 43

characteristics of newborn from drug dependent mothers

Answer 43

1. Prenatal and postnatal growth restriction. 2. Central nervous system involvement such as cognitive challenge, microcephaly, and cerebral palsy. 3. Distinctive facial feature of a short palpebral fissure and thin upper lip. 4. During the neonatal period, an infant may be tremulous, fidgety, irritable, demonstrate weak sucking reflex, and have sleep disturbances. 5. Behavior problems such as hyperactivity may occur in school-age.