High Risk Newborn Conditions- EXAM 2

Question 1

Aspyxia

Answer 1

Lack of oxygen and increase in carbon dioxide

Question 2

Transient tachypnea

Answer 2

Rapid respirations after birth

Question 3

Meconium aspiration syndrom

Answer 3

Meconium in the infants lungs, Can lead to fetal hypoxia
Baby will have green stained amniotic fluid and dyspnea at birth

Question 4

PPHN

Answer 4

Persistent fetal circulation

Question 5

Hyperbilirubinemia

Answer 5

Non physiologic or pathologic jaundice
May lead to bilirubin encephalopathy and if severe, kernicterus
Caused due to excessive hemolysis results in erythroblastosis fetalis

Question 6

Managing hyperbilirubinemia

Answer 6

Phototherapy:
Most common treatment, involves placing infant under special fluorescent lights
Exchange transfusions: Performed when phototherapy cannot reduce dangerously high bilirubin quickly enough
Removes sensitized RBC, maternal antibodies and unconjugated bilirubin

Question 7

Infections passed in utero

Answer 7

Rubella, cytomegalovirus, Syphilis, HIV and taxoplasmosis

Question 8

Infections passed during labor and birth bacteria

Answer 8

Group B herpes and hepatitis

Question 9

Sepsis general signs

Answer 9

Temperature instability, usually low
Nurse’s feelings that infant is not doing well
Poor feeding
Irritability
Lethargy
Decreased muscle tone
Hypotension
Decreased respiratory distress
Nasal flaring
Retractions
Grunting
Apnea
Tachypnea

Question 10

Sepsis gastrointestinal signs

Answer 10

Decreased oral intake
Vomiting
Increased gastric rediduals
Diarrhea
Abdominal ditension
Hypoglycemia or hyperglycemia

Question 11

Signs that may indicate advanced infection

Answer 11

Jaundice
Evidence of hemorrhage
Anemia
Enlarged liver and spleen
Respiratory failure
Shock
Seizures

Question 12

Polycythemia

Answer 12

TOO MUCH BLOOD
When hematocrit is greater then 65% and hemoglobin is greater than 22 g/dL
Thromboemboli
Stroke
CHF
Hypoglycemia

Question 13

Hypocalcemia

Answer 13

TOO LITTLE CALCIUM
A total serum calcium concentration of less than 7 mg/dL
Jitterness
Irritability
Muscle twitching
Poor feeding
High-pitched cry
Often asymptomatic

Question 14

Nursing care for infants with NAS

Answer 14

Decreased stimuli from lights or noise to prevent seizures
Keep handling to a minimum
Baby-wearing or other soothing techniques
Increasing feeding abilities with slow and frequent feedings

Question 15

Phenylketonuria

Answer 15

Genetic disorder where babies lack enzyme to break down phenylalanine
Causes CNS injury from toxic levels of animo acid in the blood
Body isn’t able to convert the amino acid

Question 16

Phenylketonuria Symptoms & TX

Answer 16

Mental retardation
Convulsions
Behavior problems
Skin rash
Musty body odor
Heart defects
Failure to thrive
Hyperactive

TX= PKU formula
Limit protein intake, NO meat, dairy, dry beans, nuts or eggs
PKU test when born, then retest in 7-10 days

Question 17

What is NAS
S.S
Tx

Answer 17

Infant disorder due to maternal use of drugs
S.S: High pitch cries, tremors, jitteriness, convulsions, fear, irritability, poor feeding, weight loss, diarrhea, constant sucking, increased muscle tone, tachypnea, Nasal stiffness, sneezing, excessive activity
exaggerated moro reflex
TX: Morphine Sulfatem Buperenophrine, Methadone, Anticonvulsants