Test 3 week 7

Question 1

SGA

Answer 1

small for gest age, weight <10%, risk for hypothermia and hypoglycemia

Question 2

LGA

Answer 2

large for gest age, weight >90%, risk for birth injury, asphyxia, hypoglycemia

Question 3

AGA

Answer 3

appropriate for gest age, weight between 10-90%

Question 4

IUGR

Answer 4

intrauterine growth restrictions, symmetrical or assymetrical where head is bigger than body, something pathologic happened to stop growth

Question 5

Macrosomia

Answer 5

weight is 4000-4500g, very large baby

Question 6

macrosomia risk factors

Answer 6

mom - obese, dm, weight gain during pregnancy, previous pregnancy, AMA, postterm pregnancy, males

Question 7

risk for baby with macrosomia

Answer 7

RDS, mechanical ventilation, low apgar score, MAS, hypoglycemia, perinatal asphyxia, death, birth injury

Question 8

preterm

Answer 8

<37 wks

Question 9

etxremely preterm

Answer 9

<28wks

Question 9

late preterm

Answer 9

34-36 6/7 wks

Question 10

Postterm

Answer 10

> 42wks, placenta ages which decrease perfusion, can be sga, have meconium fluid, birth injury, oligohydramnios, low apgar, cerebral palsy

Question 11

apnea of prematurity

Answer 11

common, bad is apnea >20 sec or with bradycardia or desaturation, need continuous pulse ox, tactile stimulation to breathe, CPAP, give caffeine

Question 12

RR distress syndrome

Answer 12

from decrease surfactant and immature lungs. s/s are low O2, decrease lung sounds, nasal flaring, grunting, accessory muscles. tx with support (ET,CPAP,NC). risk for temp instability and malnutrition

Question 13

cardiovascular problem in nicu

Answer 13

low BP and decrease perfusion. tx with blood volume expanse, inotropic rx like dopamine or epi drip. complication is delayed ductus arterosus closure so give indomethacin and ibuprofen to close

Question 14

Neuro in NICU

Answer 14

IVH is bleed in ventricles. risk for preeclamp, chorioamnitis, cerebral palsy, hydrocephalus, cognitive disability, death. tx with supportive to normalize BP and grow baby.

Question 15

necrotizing enterocolitis

Answer 15

s/s are abd distention, poor feeding, bloody stool, high residuals. tx with abx, surgery to remove dead bowel

Question 16

retinopathy of prematurity

Answer 16

abnormal growth of vascular in retina that leaks and hemorrhages causing scar tissue or detachment. risk for with low birth weight, premature, excess O2. usually resolves on own

Question 17

immune system in nicu

Answer 17

risk for sepsis, poor skin integrity of mucus membrane and skin for bacteria to enter. s/s are rr distress, lethargy, glucose instability, tachycardia, poor perfusion. tx with abx

Question 18

temp regulation newborn

Answer 18

has decrease brown fat and muscle tone. use warm mattress, dry baby, plastic covering

Question 19

assessment of newborn

Answer 19

q3hr, VS, diaper weigh, abd girth, check residuals, rx

Question 20

NIPS scale

Answer 20

observation based, facial expression, cry, breathing pattern, arms, legs, state of arousal >4 is sever pain. tx pain with breastfeed, pacifier, contact, oral sucrose, topical anesthesia, acetaminophen, nerve blocl

Question 21

discharge criteria

Answer 21

maintain temp, rr w/o apnea or bradycardia, eat normally by mouth, growth, sleep on back, do all screenings and car seat test

Question 22

transient tachypnea of newborn

Answer 22

form of pulmonary edema. fluid causes tachypnea leading to air trapping then hypoxia and hypercapnia.

Question 23

risks and tx for transient tachypnea

Answer 23

cesarean, preterm birth, mom with dm. tx with O2 above 90%, ng tube feed, restrict fluids for 24hr, resolves in 24-72 hrs. s/s are tachypnea, nasal flaring, grunting, retractions, cyanosis

Question 24

O2 delivery for nicu

Answer 24

low flow NC <2L, high flow NC with humidifier weight based, CPAP, ET, oxygen hood

Question 25

Meconium aspiration syndrome

Answer 25

respiratory distress with meconium stained fluid aspirated. causes physical obstruction of airway, chemical irritation and infla, infection and inactivation of pulmonary surfactant.

Question 26

meconium aspiration syndrome s/s, tx

Answer 26

rales, rhonchi, pnuemothorax. tx with delivery before 41wks, O2, ventilator, surfactant therapy, nitric oxide, ECMO. dx with chest radiograph

Question 27

hyperbilirubinemia

Answer 27

physiologic is expected, pathologic is severe increase in bilirubin with jaundice. can cause brain damage. tx with phototherapy, baby needs eyes covered, monitor temp, fluids of baby.

Question 28

kernictus

Answer 28

permanent brain damage from high bilirubin levels

Question 29

Hypoglycemia

Answer 29

common in posterm, should be over 60, tx with oral feedings, severe with IV dextrose.

Question 30

fetal alcohol syndrome

Answer 30

1st tri - structural defects 2md tri - spont abortion and stillbirth 3rd tri - poor growth

Question 31

FAS s/s

Answer 31

facial difference like short palpable fissure, smooth philtrum, thin vermillion border. CNS involved like small head circumference, neuro, functional cognitive impairment, slow processing speed, hyperactivity, impaired motor function, poor social skills. growth retardation. cardiac, renal and skeletal defects

Question 32

neonatal abstinence syndrome

Answer 32

withdrawal from opioids. s/s are irritable, high pitch cry, tremor, poor feeding, V/D, sweating, hyperactive reflex, difficulty sleeping. tx with supportive care, morphine and buprenorphine.

Question 33

congenital diaphragmatic hernia

Answer 33

abdominal contents herniate through diaphragm into chest. interferes with lung expansion, left sided hole. s/s are RR distress, barrel shape chest with depressed abdomen, diminished breath sounds, heartbeat displaced. tx with repiar and ecmo for O2.