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NCMN 109A - Pedia Lecture > PDA, Retinopathy of Prematurity, Macrosomia, Addicted Mothers and FSA > Flashcards

PDA, Retinopathy of Prematurity, Macrosomia, Addicted Mothers and FSA Flashcards

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1
Q

A congenital heart defect in which the ductus arteriosus, a blood vessel that allows blood to bypass the lungs in fetal circulation, fails to close after birth.

A

Patent Ductus Arteriosus

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2
Q

The ductus arteriosus usually closes ____________ of life.

A

24 to 48 hours

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3
Q

The ductus arteriosus usually closes 24 to 48 hours of life. If it remains open , it leads to

A

abnormal blood flow between the aorta and pulmonary artery

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4
Q

Common complication of severe respiratory disease in preterm infants

A

Patent Ductus Arteriosus

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5
Q

Occurs in the majority of preterm infants under 1200 g (2.6lb)

A

Patent Ductus Arteriosus

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6
Q

Patent Ductus Arteriosus occurs in the majority of preterm infants under __________

A

1200 g

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7
Q

PDA incidence diminishes in direct relationship to

A

increasing birth weight

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8
Q

Clinical Consequences of PDA

A

Increased Pulmonary Blood Flow
Left Heart Strain
Risk of Endocarditis

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9
Q

Increased Pulmonary Blood Flow results in

A

respiratory symptoms such as tachypnea, grunting, or cyanosis

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10
Q

Left Heart Strain can lead to

A

left ventricular hypertrophy or failure

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11
Q

Clinical Manifestations of PDA in infants

A

Tachypnea
Heart Murmur (often a continuous “machinery” murmur)
Poor feeding and growth
Sweating during feedings
Cyanosis (especially if there is a large PDA)

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12
Q

Clinical Manifestations of PDA in other children

A

Shortness of breath
Fatigue
Palpitations
Difficulty exercising

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13
Q

Assessment for PDA

A

Assess for systolic murmur at the second intercostal space, left upper sternal border, or out the clavicular area.

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14
Q

Large defect can cause

A

rales, congestion, increased work breathing, difficulty in feeding or failure to thrive.

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15
Q

Diagnostic Findings for PDA

A

Physical Exam
Echocardiogram
Chest X-ray
Electrocardiogram
Pulse Oximetry

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16
Q

Confirms the diagnosis by visualizing the patent ductus and assessing the amount of shunting.

A

Echocardiogram

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17
Q

May show enlarged heart or increased pulmonary vascular markings.

A

Chest X-ray

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18
Q

May show signs of Left ventricular hypertrophy or strain

A

Electrocardiogram

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19
Q

May show low oxygen levels if significant shunting occurs.

A

Pulse Oximetry

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20
Q

Nursing Interventions for PDA

A

Vital signs
Oxygenation
I&O
Feeding support
Medications
Preoperative care (if surgical closure is needed)

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21
Q

Medications used for PDA

A
  • Prostaglandin Inhibitors (e.g., Indomethacin or Ibuprofen)
  • Diuretics
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22
Q

help DA close in premature infants

A

Prostaglandin Inhibitors (e.g., Indomethacin or Ibuprofen)

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23
Q

to manage fluid retention and pulmonary congestion in more severe cases.

A

Diuretics

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24
Q

Nursing Diagnosis for PDA

A

Impared Gas Exchanges
Imbalanced Nutrition: Less than body requirements
Risk for infection

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25
Potentially blinding eye disorder that primarily affects premature infants.
Retinopathy of Prematurity
26
involves abnormal growth of retinal blood vessels, often leading to scarring and retinal detachment
Retinopathy of Prematurity
27
Retinopathy of Prematurity involves abnormal growth of retinal blood vessels, often leading to
scarring and retinal detachment
28
is one of the most common causes of vision impairment in children worldwide, particularly in very low birth weight preterm infants.
Retinopathy of Prematurity
29
ROP is one of the most common causes of vision impairment in children worldwide, particularly in
very low birth weight preterm infants
30
Risk Factors for ROP
- Prematurity (<32 weeks gestation) - Low birth weight (<1500g) - Oxygen therapy (excessive oxygen levels can lead to abnormal vessel growth) - Sepsis, blood transfusions, and long stays in NICU also contribute.
31
Mild, where blood vessels are slightly abnormal but without scarring
Stage I
32
Moderate, with more significant abnormal vessel development
Stage II
33
Severe, where abnormal blood vessels grow and cause scarring and retinal detachment
Stage III
34
Retinal Detachment, partial or total
Stage IV
35
Total Retinal Detachment, resulting in blindness
Stage V
36
Clinical Manifestations for ROP
abnormal eye movements, strabismus(crossed eyes), or visual disturbances
37
Diagnostic Test for ROP
Fundus Examination Staging and Classification
38
ROP is staged based on the
severity of the abnormal blood vessel growth
39
Treatment for ROP
Laser therapy Cryotherapy Anti-VEGF (Vascular Endothelial Growth Factor) Injections Vitrectomy
40
by destroying the peripheral retina, preventing further abnormal growth of blood vessels and retinal detachment
Laser therapy
41
medications that block signals causing abnormal vessel growth
Anti-VEGF (Vascular Endothelial Growth Factor) Injections
42
removal of the vitreous gel
Vitrectomy
43
Nursing Interventions for ROP
- Monitor for signs of ROP - Routine ROP screening - Oxygent regulation - Support for Family and Education - Post-Treatment Care - Promote optimal neonatal care
44
signs of ROP
abnormal eye movements or difficulty in tracking objects in older infants
45
Nursing Diagnosis for ROP
Risk for Impaired Vision Risk for infection Anxiety
46
Risk Factors for Infant with Diabetic (Macrosomia) Maternal Factors
poorly controlled diabetes, maternal obesity, or longstanding diabetes (pre-pregnancy)
47
Risk Factors for for Infant with Diabetic Mothers (Macrosomia) Genetics
Fetal genetic makeup can influence the degree of macrosomia
48
Complications for Infant with Diabetic Mothers (Macrosomia)
Birth Trauma Hypoglycemia Respiratory distress syndrome (RDS) Jaundice Obesity and metabolic syndrome in later life
49
Clinical Manifestations for Infant with Diabetic Mothers (Macrosomia)
- Large for Gestational Age (LGA) - Excessive subcutaneous fat - Round face and ruddy complexion - Birth injuries - Hypoglycemia - Respiratory Distress - Jaundice
50
how many grams is LGA
4000 grams
51
Nursing Interventions for Infant with Diabetic Mothers (Macrosomia)
1. Monitoring blood glucose levels 2. Early feeding and glucose management 3. Monitor for birth injuries 4. Respiratory support 5. Jaundice management 6. Education for parents
52
Nursing Diagnosis for Infant with Diabetic Mothers (Macrosomia)
- Risk for Imbalanced Nutrition: Less than body requirements - Risk for Injury - Risk Impaired gas exchange
53
Infants born to addicted mothers are at high risk for
withdrawal symptoms, developmental delays, and other health complications due to prenatal exposure to substances.
54
Maternal substance use during pregnancy affects fetal development, leading to
neonatal abstinence syndrome (NAS) and other complications.
55
Common Substance
Opioids (Heroin, Methadone) Cocaine Alcohol Marijuana Methamphetamines Nicotine
56
Fetal Growth Effects of Maternal Drug Use on the Fetus & Newborn
- Intrauterine Growth Restriction (IUGR). - Low birth weight and preterm birth. - Increased risk of stillbirth.
57
Clinical Manifestations of infants born to Addicted Mothers
Irritability Tremors Poor feeding High-pitched crying Seizures Respiratory distress
58
This is a severe form of Fetal Alcohol Spectrum Disorders caused by alcohol exposure during pregnancy
Fetal Alcohol Syndrome
59
is a substance that causes developmental abnormalities in a fetus
teratogen (alcohol)
60
Clinical Manifestations for FAS Physical fetaures
Smooth philtrum Thin upper lip Small palpebral fissures Short stature and low birth weight Microcephaly (small head circumference)
61
Clinical Manifestations for FAS Cognitive and Behavioral Effects
Learning disabilities Poor memory and attention span Hyperactivity Difficulty with problem-solving Poor impulse control
62
Clinical Manifestations for FAS Medical Conditions
Congenital heart defects (e.g., atrial septal defects. Hearing loss Kidney abnormalities Speech and language delays
63
Nursing Diagnosis for FAS
- Delayed growth and development - Risk for impaired Nutrition - Risk for impaired parenting
64
Before birth, the ductus arteriosus connects the __________________ to the ______, diverting the blood from the lungs (which aren’t in use yet) into _________________ After birth, the lungs become ______________, and the ductus arteriosus should close to allow _____________________. The failure of the ductus to close results in a __________________________________________________________________________________________________
pulmonary artery; aorta; systemic circulation; functional; normal circulation; persistent connection between the aorta and pulmonary artery
65
In PDA Blood flows from the ___________________ into the___________________________ This extra blood flow can lead to ______________________________________________________________________________________________________
higher-pressure aorta; lowest-pressure pulmonary artery; pulmonary hypertension, increased workload on the left side of the heart, and potentially heart failure
66
Confirms the diagnosis by visualizing the patent ductus and assessing the amount of shunting
Echocardiogram
67
May show enlarged heart or increased pulmonary vascular markings.
Chest X-ray
68
May show signs of Left ventricular hypertrophy or strain
Electrocardiogram
69
May show low oxygen levels if significant shunting occurs.
Pulse Oximetry
70
excessive oxygen levels can lead to
abnormal vessel growth
71
In full-term infants, retinal blood vessel growth is completed by ______________ of gestation
40 weeks

NCMN 109A - Pedia Lecture (14 decks)

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