OB section Flashcards
Causes of respiratory distress
coldness, surfactant deficiency in the lungs, poor gas exchange, ventilatory failure
Symptoms of respiratory distress
- cold stress = hypoglycemia + metabolic acidosis
- amniotic fluid is meconium stained
What are the types of jaundice
pathologic & physiologic
Pathologic jaundice
- appears within the first 24 hours of life due to underlying disease
- usually Rh incompatibility
Physiologic jaundice
- appears after 24 hours
- initiate early and frequent feedings
- stimulate the intestinal activity and passage of meconium which excretes bilirubin
- phototherapy used to fix
Normal bilirubin levels at 24 hours
2-6mg/dL
Normal bilirubin levels at 48 hours
6-7mg/dL
Normal bilirubin levels at 3-5 days
4-6mg/dL
What would cause hypoglycemia
mother has diabetes or baby small for gestational age
What are the early s/s of hypoglycemia
diaphoresis, jitteriness, lethargy
What are the late s/s of hypoglycemia
poor feedings, tremors, hypothermia, flaccid muscle tone, irregular respirations, apnea, cyanosis, weak shrill cry
What can happen if hypoglycemia is not caught and treated in a newborn
SEIZURES!
What are the treatments for hypoglycemia
- monitor BG using heel stick
- initiate feedings below 40mg/dL
- if baby does not respond to breast feeding move to formula
How to prevent hypoglycemia
early breast feeding
Therapeutic BG level
40-60
Pre-term newborn care
- cluster care
- minimum stimuli
- keep infant in natural flexion
- protect against infection
- minimize skin breakdown
- maintain thermoregulation
- maintain O2 at 93-95%
- watch for hydration
- administer food via NG tube
- non-nutritive sucking while on NG tube -> give pacifier
SGA
small for gestational age
LGA
large for gestational age
-also called macrosomia
SGA interventions
monitor BG and breathing
LGA characteristics
weight is above 90th percentile or over 4000g
-risk for birth injuries
LGA characteristics
- weight is above 90th percentile or over 4000g
- risk for birth injuries
SGA characteristics
- BW at or below 10th percentile
- intrauterine growth restriction
- placental insufficiency and infection are causes
- may be due to a birth defect
- wide skull sutures from inadequate bone growth
- sunken abdomen
- loose, dry skin
- thin, yellowish dull, dry umbilical cord
What is neonatal abstinence syndrome
- may take up to 24 hours to show withdrawal symptoms
- low stimuli environment
- score and interventions that are needed are based on the score
- see how well they soothe themselves
What are PP hemorrhage signs and symptoms
Leading cause PP morbidity
