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NPS - patient assessment > NPS- Assessment of the Neonate > Flashcards

NPS- Assessment of the Neonate Flashcards

1
Q

Dubowitz Method

A

Uses combo of 7 physical and 6 neurological findings

Higher scores indicate longer gestation

A maturity rating of 40 indicates a term infant ( 40 weeks gestational age)

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2
Q

When is the New Ballard Score used?

A

used when infant is less than 28 weeks gestation and/or birth weight is < 1500 g.

modification of dubowitz method

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3
Q

Describe Apgar scoring

A

How an infant is evaluated after birth

Done at 1 & 5 minutes

Five factors are evaluated: color, HR, reflex irritability, muscle tone, and RR

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4
Q

Explain APGAR Scoring

A

7-10 No depression

4-6 Moderate depression

0-3 Severe depression

Low is not good & if not breathing @ birth do not wait 1 minute to do second APGAR

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5
Q

When should you initiate compression’s on an newborn ?

A

If HR is less than 60, despite 30 seconds of effective positive pressure ventilation.

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6
Q

When should epinephrine be given in a newborn with a low APGAR score?

A

administer epi if HR is less than 60 despite giving PPV and chest compression’s

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7
Q

What is the main thing you should do for an infant with a moderate (4-6) APGAR score?

A

Continue monitoring and administer 02 according to target sp02.

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8
Q

what does the Silverman Anderson Scoring evaluate?

A

Evaluates severity of respiratory distress in neonates

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9
Q

Is a high score in the silverman anderson scoring good or bad?

A

Bad- indicates severe respiratory distress

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10
Q

What does Pre and Post Ductal blood gas show?

A

right to left cardiac shunt

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11
Q

What does a pre-ductal Pa02 of 15 or more indicate?

A

indicates a R to L shunt

Most common issue is a patent ductus arteriousus (PDA)

Can be evaluated using trans-cutaneous monitors or 2 pulse ox with an sp02 difference greater than 10%.

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12
Q

Normal infant temp (skin is most accurate)

A

36.0 C- 36.5 C

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13
Q

Infant body core temp is 36.0 C. What does that mean?

A

Hypothermia- most common problem in pre-term infants

Sometimes occurs with infection

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14
Q

Define NTE

A

Neutral thermal environment

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15
Q

Why is it important to maintain NTE in an infant?

A

to minimize oxygen consumption

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16
Q

What is the main thing to remember where there is a metabolism issue?

A

control diet

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17
Q

What is normal HC03 and why is it important?

A

normal bicarb is 19-24 mmol/L

Important because controls muscle function and can cause arrhythmias

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18
Q

Normal Na+ (sodium)

A

133-149 mmol/L

19
Q

Normal K+ (potassium)

A

Normal range 5.3-6.4 mmol/L

Higher in premature newborns

20
Q

What do BUN and creatinine relate to ?

A

Kidney function

Normal BUN- 4-17 mg/ dL

Normal creatinine- 0.11-0.68 g/24 h.

21
Q

Normal urine output in newborns

A

1 mL/kg/hour

If urine OP changes then this creates fluid OL

22
Q

Normal RBC in newborns

A

4.1-5.7 mm

23
Q

Define Polycythemia

A

high Hb

24
Q

Define anemia

A

low Hb

25
Q

What are the most common abnormal hemoglobin?

A

Hemoglobin S: present in sickle cell disease

Hemoglobin C: does not carry 02 well

26
Q

Hemaglobin F

A

Fetal hgb

Has higher affinity for oxygen than hbg A

27
Q

Hemoglobin A

A

Most common type found in adults

28
Q

What is an electrophoresis test?

A

It is a procedure to check for different types of hbg in the blood. Most abnormal and common are hbg s and c.

29
Q

What does a WBC count of 30k or higher indicate?

A

septic shock

30
Q

normal range of WBC

A

10-30,000 mm

31
Q

What is the byproduct of the breakdown of RBC by the liver

A

Bilirubin

32
Q

How does jaundice happen?

A

Jaundice occurs when bilirubin builds up faster than a newborn’s liver can break it down and releases it into the intestines as bile.

33
Q

What is normal bilirubin levels in cord blood range?

A

1.4-1.9 mg/ dL

34
Q

How is hyperbilirubienemia treated?

A

phototherapy, Vitamin E, and exchange transfusion

35
Q

Normal blood glucose levels in infants

A

50-100 mg/dL

36
Q

Hyperglycemia

A

glucose >160 mg/dL

37
Q

Hyperglycemia is an early sign of what in infants?

A

Septicemia

38
Q

Hypoglycemia

A

Glucose < 40 mg/dL

39
Q

Why is glucose is important ?

A

Maintaining glucose is important for development of baby’s brain

40
Q

What is hypoglycemia directly related to?

A

hypothermia

41
Q

What is the A/G ratio related to? and what is the AG ratio?

A

A- albumin G-Globulin
They are proteins present in the blood

Related to liver and renal failure

42
Q

When an infant has a fever and looks septic, what should be thought about ?

A

Group Beta Streptococcus (GBS)- weather or not mother has been treated can result in neonatal pneumonia

43
Q

What does GBS stand for?

A

Group B Steptococcus

NPS - patient assessment (9 decks)

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