Prematurity: growth and development Flashcards

Question

FPAL L

Answer 1

number of pregnancies

Answer 2

appropriate for gestational age birth weight between 10th and 90th percentile

Answer 3

small for gestational age birth weight below 10th percentile

Answer 4

large for gestational age birth weight above 90th percentile

Answer 5

2500-3999g 5 lbs 8 oz TO 8lbs 13 oz

Answer 6

<5 lbs, 8 oz 2500g

Answer 7

< 3lbs 4 oz <1500g

Answer 8

extremely low birth weight | < 2lbs 3 oz

Answer 9

1500-2500g 3lbs 5 oz TO 5lbs 8 oz

Answer 10

about 23 weeks 750g or 1lb 10oz

Answer 11

1) born before 37 weeks 2) SES: low income, lack education 3) maternal health problems (DM, HTN) 4) multiple births, triplets...

Answer 12

1) prematurity 2) medications given to mother during labor 3) rapid delivery

Answer 13

1) neurologic (28-32 weeks neurologic damage): IVH, PVL, Seizures 2) respiratory: RDS, BPD, apnea 3) cardiac: patent ductus arteriosus, bradycardia 4) gastrointestinal: necrotizing enterocolitis, jaundice, kernicterus, athetoid CP 5) sensory: retinopathy of prematurity, hearing impairment

Answer 14

1) IVH: intraventricular hemorrhage 2) PVL: periventricular leukomalacia 3) Seizures

Answer 15

intraventricular hemorrhage: bleeding into the brain's ventricular system *** lateral ventricular bleed, most common occurs in premature infants WHO: occurs in premature infants less than 32 weeks and less than 1500g (VLBW) OUTCOME: spastic hemiparesis, quadriparesis, cognitive deficits ***CP DX: cranial sonogram

Answer 16

periventricular leukomalacia: white matter necrosis surrounding ventricles secondary to decreased oxygenation and blood flow to brain WHO: premature before 32 weeks OUTCOMES: spastic diplegia or spastic quadriparesis, cognitive deficits ***CP DX: CT wiki: form of white-matter brain injury, characterized by the necrosis (more often coagulation) of white matter near the lateral ventricles.[1][2] It can affect n

Answer 17

1) RDS: respiratory distress syndrome 2) BPD: bronchopulmonary dysplasia 3) apnea (lack of breathing for 20 or more seconds bc system immaturity, in 90% ELBW that weigh <1000g birth, may indicate systemic medical issue)

Answer 18

there is no association between apnea and sudden infant death syndrome = SIDS

Answer 19

apnea lack of breathing for 20 or more seconds bc system immaturity in 90% ELBW that weigh <1000g birth may indicate systemic medical issue there is no association between apnea and sudden infant death syndrome = SIDS caffeine to minimize frequency

Answer 20

Respiratory Distress Syndrome = hyaline membrane disease WHEN: age < 34 weeks (60% at 29 weeks) PROBLEM: surfactant deficit: surfactant decreases surface tension of smaller airways so that the alveoli do not collapse TX: 1) surfactant replacement 2) O2 3) mechanical ventilation in some cases [online: Respiratory distress syndrome (hyaline membrane disease) is a breathing disorder of premature newborns in which the air sacs (alveoli) in a newborn's lungs do not remain open because the production of a substance that coats the alveoli (surfactant) is absent or insufficient.]

Answer 21

Bronchopulmonary Dysplasia WHO: 1) born more than 10 weeks premature 2) weigh less than 2lbs or 1,000g (ELBW) 3) Hx of RDS CAUSE: walls of lung thicken, making O2/CO2 exchange difficult CONSEQUENCES 1--limited physical activity tolerance leads to developmental delays 2--chronic upper respiratory problems-chronic lung disease Tx: REQUIRED SUPPLEMENTAL O2 AND/OR MECHANICAL VENTILATION

Answer 22

Bronchopulmonary dysplasia (BPD) is a lung disease that occurs most often in babies who were born severely premature—more than 10 weeks before their due date. Babies with BPD have inflammation and scarring in the lungs. BPD usually is a complication in premature infants being treated for respiratory distress syndrome (RDS). RDS is a condition in which the baby's lungs are not developed enough to take in the air they need. Babies with RDS must have oxygen and often need to be on a breathing machine to prevent brain damage and to save their lives. But the oxygen premature babies need can damage their lungs. When it must be delivered into the babies' lungs by a machine, it may be even more damaging. The infants whose lungs require this treatment are at risk for developing BPD. Many infants with BPD recover and improve with time, achieving normal or near normal function.

Answer 23

1) patent ductus arteriosus (unclosed hole in the aorta) - heart murmur 2) bradycardia

Answer 24

1) Necrotizing Enterocolitis (NEC) 2) Jaundice (kernicterus, athetoid CP) - kernicterus (brain damage due to exces jaundice) - athetoid CP (caused by excess bilirubin)

Answer 25

Athetoid cerebral palsy or dyskinetic cerebral palsy (sometimes abbreviated ADCP) is a type of cerebral palsy primarily associated with damage, like other forms of CP, to the basal ganglia in the form of lesions that occur during brain development due to BILIRUBIN encephalopathy and hypoxic-ischemic brain injury.[1] Unlike spastic or ataxic cerebral palsies, ADCP is characterized by both hypertonia and hypotonia, due to the affected individual's inability to control muscle tone.[2] Clinical diagnosis of ADCP typically occurs within 18 months of birth and is primarily based upon motor function and neuroimaging techniques.

Answer 26

--small intestines wall necrosis exact cause unknown, suspect MULTIFACTORIAL causes: 1. bacteria 2. intestinal mucosal immaturity/dysfunction 3. intestinal ischemia 4. formula feeding increases the risk of NEC by 10x compared to infants breastfed alone !!!!!

Answer 27

Necrotizing enterocolitis (NEC) is a medical condition primarily seen in premature infants,[1] where portions of the bowel undergo necrosis (tissue death). It occurs postnatally (i.e., is not seen in stillborn infants)[2] and is the second most common cause of mortality in premature infants,[3] causing 386 deaths in the United States in 2011, down from 472 in 2010.[4]

Answer 28

1) retinopathy of prematurity | 2) hearing impairment

Answer 29

-retinal vasculariztion is not complete until near term!! preterm delivery may interfere with this process, resulting in abnormal blood vessel development and cause retinal detachment can lead to blindness HIGHEST RISK: (risk increase with lower birth weight ) <1800g (MLBW) also increased risk if supplemental O2 for RDS

Answer 30

hyperbilirubinemia - bilirubin accumulates in blood because immature liver cannot process it - ---bilirubin is the end product of Hgb breakdown COMPLICATIONS ***prevent KERNICTERUS: a form of brain damage caused by excessive jaundice --can develop athetoid CP (bc high biliruin) TX phototherapy

Answer 31

a form of brain damage caused by excessive jaundice consequence of hyperbilirubinemia, a GI complication of prematurity

Answer 32

(bc high biliruin) consequence of hyperbilirubinemia, a GI complication of prematurity

Answer 33

infant does not want to be held - -physiologic - -skin color change - -hiccups - -finger splaying - -LE stiffness and extension - -frowning - -turning away from face or sound

Answer 34

The baby will salute you – essentially this looks like a baby stretching out their hand toward you, (usually the back of the hand toward you) and up towards their face. Parents will say, “How cute! He is waving at me!” Nope, nope and nope. The baby will extend the arm and splay the fingers apart. The baby will frown, grimace, grunt. The baby will all of the sudden start yawning, hiccupping, or sneezing multiple times. (Yes, babies do yawn, hiccup, or sneeze but this is more like 10 times in a row or more all of the sudden). The baby will arch the back and neck and push away (and yes, some babies with gastroesophageal reflux disease will also arch and push away). The baby will look away suddenly and for a long period after having a period of wonderful eye contact on a caregiver’s face – think about this one carefully. We ourselves do not maintain focused eye contact on others when we are in conversation, but often our eyes are scanning and resting, scanning and resting. The looking away is a sign the baby needs a break and less focus. The baby will cry. This is usually a last sign when all other signs have been ignored. The baby will become frantic and move all extremities wildly. Or, conversely, the baby will just shut down, shut his or eyes and tune everything out.

Answer 35

position in flexion in all positions 34 weeks and older infants can lift and turn their head in prone <32 weeks: difficulty coping with light and noise, eye patches Sidelying: promotes hands together and hand to mouth exploration

Answer 36

<32 weeks: difficulty coping with light and noise, eye patches

Answer 37

1) skull deformities 2) preferential head turning to 1 side 3) fine motor delays: - shoulder girdle tightness "W" arm positioning - scapula retracted and humerus ER 4) gross motor delays - LE tightness "M" positioning --frog legged - hips abducted and ER

Answer 38

a method of holding a baby that involves skin to skin contact naked infant except for diaper and a peice of clothing covering their back (either a receiving blanket or parents clothing) the infant is placed in an upright position against the parents bare chest - -NICU - -MEdical team

Answer 39

1. HR stabilize 2. improve BREATHING pattern, decreased apnea 3. improve O2 sat levels 4. more SLEEP time 5. more rapid WEIGHT gain 6. decreased CRYING 7. ANALGESIC during painful procedures such as heel stick 8. IMPROVED THERMOREGULATION 9. improved behavioral state-promotes CALMING behaviors 10. decreased environmental NICU stressors 11. more successful BREASTFEEDING episodes

Answer 40

1. opportunity / exposure: prone positioning, stair climbing 2. motivation to move 3. environmental pollutants 4. inadequate nurturing and bonding 5. parental / cultural childrearing--lack of tummy time

Answer 41

lack of tummy time associated with 1) gross motor delays 2) plagiocephaly --flattening of a baby's skull [develop gross-->fine-->speech]

Answer 42

sudden infant death in infants < 1 year old

Answer 43

unexplained cause ``` possible explanation: abnormal serotonin production and use serotonin regulates: 1. breathing 2. BP 3. body heat 4. ability to wake ```

Answer 44

1. young maternal age 2. late or no prenatal care 3. premature birth and/or LBW 4. maternal smoking during pregnancy 5. second hand smoke 6. male 7. prone sleeping 8. sleeping on a soft surface 9. overheating

Answer 45

1. SUPINE, vary head position to avoid plagiocephaly * ***side sleeping is NOT AS SAFE as supine and is NOT ADVISED 2. FIRM sleep SURFACE: do not place any soft object or material under the sleeping infant - ---no pillows, quilts, comforters, sheepskins, wedges: keep out of crib - ---no bumper pads (suffocate/strangle sleeping infant) 3. use FITTED SHEETS designed for mattress never use crib sheets unless it fits securely on the crib mattress ---loose bedding ie blankets and sheets can be hazardous 4. Blanket: make up bedding so feet reach the foot of the crib (FEET TO FOOT) with the blankets TUCKED in around the crib mattress and reach only to the level of the infants CHEST * ******Sleep clothing such as sleepers, sleep sacks, and wearable blankets are better alternatives to blankets

Answer 46

make up bedding so feet reach the foot of the crib (feet to foot) with the blankets tucked in around the crib matress and reach only to the level of the infants chest *sleep clothing such as sleepers, sleep sacks, and wearable blankets are better alternatives to blankets

Answer 47

products: ---infant sleep positioner device: BAD: risk of suffocation, AAP doesnt recommend any sleep positionor device to prevent SIDS --nap nanny: injury and death associated, infant fell out despite restraint cribs: - --canopy: BAD: used to prevent crawling out and animals in but risk death and injury ---drop down side rails: BAD: safety risk--hardware break or fall allowing the drop side to detach from the crib --this newly created space allows the head/body to get caught between the mattress and side railing

Answer 48

place crib or bassinet in parents room close to the bed infants should not share the bed with parents during sleep no one should sleep with infant on a couch or armchair

Answer 49

consider it for nap and bedtime

Answer 50

avoid overheating infant should be lightly clothed bedroom temp kept comfortable for a lightly clothed adult baby should not sleep next to a radiator or heater or in direct sunshine

Answer 51

started 1994 and SIDS declined more than 50% EDUCATE PARENTS AND etc ABOUT BACK TO SLEEP CAMPAIGN AND ABOUT... TUMMY TIME!!!!!!!!!

Answer 52

when awake play in prone roll up a towel and place the infant prone over the towel begin placing the infant in prone when they are a few days old and awake (post birth asap) start with a few minutes a few times a day, work up to an hour a day by the end of three months place them prone after each diaper change and each bath

Prematurity: growth and development Flashcards

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