Newborn Hyperbilirubinemia Flashcards Preview

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Flashcards in Newborn Hyperbilirubinemia Deck (51):
1

Causes of NB hyperbilirubinemia?

-hemolysis
- decreased serum albumin binding
- Impaired liver function

2

Condition resulting from a deposition of yellow pigmentation in the basal ganglia of the brain in NB?

Kernicterus (bilirubin > 25)

3

Therapy for hyperbilirubinemia?

- phototherapy
- hydration
- protect the eye
- observe for:
- dehydration, diarrhea, rashes

4

The NB presents with dimished Moro reflex, poor sucking, high-pitched cry, setting sun eyes, a sunken anterior fontanel and green stool, what do you suspect?

hyperbilirubinemia

5

How does phototherapy help tx hyperbilirubinemia in a NB?

speeds up conjugation of bilirubin

6

What is Iso-Immunization?

development of antibodies against antigens from the same species

7

What is the medication given to prevent Iso-immunization from Rh factor?

Rhogam

8

What is Erythroblastosis Fetalis?

when the fetus produces large amounts of immature erythrocytes to replace those lost due to anemia

9

What is hydrops fetalis?

- severe form of Erythroblastosis Fetalis
- fetus has marked anemia, cardiac decompensation, cardiomegaly, and hepatosplenomegaly
- tx is done in utero with a transfusion via the umbilical cord after 17 weeks of gestation

10

Why is a COOMBS test done?

- to determine presence of Rh/ABO serum antibodies
- Direct - tests cord blood
- Indirect - tests mom's serum

11

Why is the Kleihauer-Betke test done?

- measures the amount of fetal hemoglobin transferred to mothers bloodstream
- to test for the need for RhoGam

12

When is RhoGam given?

- only if woman is Rh- and not sensitized
- Anterpartum at 28 weeks
- Within 72 of:
- significant 1st or 2nd timester bleeding
- abortion or miscarriage
- CVS or amniocentesis
- birth of Rh+ baby

13

How long do the effects of Rhogam last?

12 weeks

14

Baby presents with elbow ectended, hand rotated inward, no moros' reflex and intact grasp in one arm. What do you suspect and how to treat?

- Erb Duchennes palsy
- immobility for 1st week, then passive ROM

15

What is the vector for toxoplasmosis?

cat feces (garden soil) and raw or undercooked beef or pork

16

How is an infection with toxoplasmosis dx in an NB?

elevated cord blood serum IgM

17

Group B Strep can lead to what in a newborn?o

sepsis, pneumonia, meningitis

18

How long is the NB observational period for GBS?

48 hrs after delivery

19

How is fetal alcohol syndrome diagnosed?

- facial characteristics
- growth delays
- CNS
- developmental delays
- mental retardation
- behavioral problems
- learning disabilities/hyperactivity

20

FAS facial features?

- microcephaly
- short palpebral fissures
- flat midface
- low nasal bridge
- epicanthal folds

21

NB withdrawal symptoms (CNS)?

- irritable
- jittery
- high pitched cry
- vomitting
- seizure activity

22

NB withdrawal symptoms (Resp)?

tachypnea, tachycardia, nasal stuffiness

23

4 defects of the Tetralogy of Fallot?

- pulmonary stenosis
- right ventricular hypertrophy
- ventricular septal defect (VSD)
- over riding aorta

24

Spina bifida; meningocele?

exposed sac contains meninges & CSF, no nerves

25

Spina bifida: myelomeningocele?

meninges, CSF and nerve

26

When does the neural tube normally close?

17-30 days after gestation

27

What is an Omphalocele?

abd organs are protruding from umbilicus, but covered by peritoneal membrane

28

What is a Gastroschisis?

abd organs are protruding from umbilicus and uncovered

29

The post partum period can last how long?

up to 6 weeks

30

What is the avg blood loss during a vaginal delivery and c-section?

300 - 500 mL & 500- 1000 mL

31

A positive Hohman's sign is an indicator of what?

thromboembolism

32

Uterus fundal height changes after birth:
1) by 12hr
2) day 1-8
3) day 9
4) by 5-6 weeks

1) 1 cm above umbilicus
2) decreases 1 cm / day
3) not palpable
4) near non-pregnant size

33

A "boggy" uterus is a sign of what?

internal bleeding

34

What does methergine do?

causes sustained uterine contractions

35

What is Lochia?

fleshy smelling, vaginal discharge after delivery

36

Lochia color changes:
1) 1st 2-3 days
2) 3 - 10 days
3) 10 - 21 days

1) rubra - dark red, some clotts
2) serosa - pink, brown
3) alba - yellow, clear

37

Lochia amounts:
1) scant
2) light
3) moderate
4) heavy

1) < 2.5 cm
2) < 10 cm
3) > 10 cm
4) 1 pad saturated w/in 1 hr

38

What is the acronym for the episiotomy scale?

REEDA

39

What does REEDA stand for?

Redness
Edema
Ecchymosis
Discharge
Approximation

40

3 types of placental adherent?

accreta, increta, percreta

41

Placental penetration into the uterine wall but not through to the muscle

placenta accreta

42

placental penetration to the uterine muscle?

placenta increta

43

placental penetration through the entire uterine wall and attaches to another organ?

placenta percreta

44

Initial care of post partum hemorrhage?

massage the fundus

45

What is a cardinal sign of a pp infection?

fever on 2 consecutive days during first 10 days pp

46

What is subinvolution?

uterus does not return to normal size pp and a major sign of endometritis

47

What is the most common PP infection?

endometritis

48

Symptoms of endometritis?

- foul smelling lochia
- tender, boggy uterus
- fever (chills)
- increased pulse

49

Mastitis usually occurs when?

2-4 weeks PP

50

How to differentiate mastitis from engorgement?

mastitis is unilateral with a fever, engorgement is bilateral without fever

51

PP Mental health?

1) baby blues = 2-10 days
2) PPD = sadness persists beyond 2 wks PP