Review of NewBorn High-Risk Disorders – Flashcards
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List the major CNS danger signals that occur in the neonate.
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Lethargy high-pitched cry jitteriness seizures bulging fontenels
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A baby is delivered blue, limp and with a heart rate <100. The nurse dries the infant, suctions the orpharynx and gently stimulate the infant while blowing O2 over the face. The infant still does not respond. What is the next nursing action?
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Being oxygenation by bag and mask at 30 to 50 breaths per minute. If heart rate is <60, start cardaic massage at 120 events per minute [30 breaths and 90 compressions] Assiste healthcare provider in setting up for intubation procedure.
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What does the Silverman-Anderson index measure?
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Respiratory difficulty
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Waht are the two major complications of O2 toxicity?
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Retrolental fibroplasias and bronchopulmonary dysplasia
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Necrotizing enterocolitis results from what? And is manifested by what? Ischemia/hypoxia results in what?
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Ischemic hypoxia, abdominal dsitention, sepsis lack of absorption from intestines Injury to the intestinal mucosa
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Intraventricular hemorrhage is more common in what and results in symptoms of what?
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Premature neonates and VLBW babies increased intracranial pressure
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What conditions make oxygenataion of the newborn more difficult?
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Respiratory distress syndrome: alveolar prematurity and lack of surfactant anemia polycythemia
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In order to prevent problems with oxygenating the newborn what parameters can the nurse observe?
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PO2 50-90 SvO2 60-80mm
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What are the cardinal symptoms of sepsis in a newborn?
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Lethargy, temp instability, difficulty feeding, subtle color changes, subtle behavioral changes, and hyperbilirubinemia.
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A premature baby is born and develops hypothermia. State the major nursing interventions to treat hypothermia.
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Place under radiant warmer or in incubator with temp skin probe ove liver. Warm all items touching newborn. Place plastic wrap over neonate.
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Nurses often weigh diapers in order to determine exact urine output in the high-risk neonate. Explain this procedure.
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Diaper is weighed in grams before being applied to infant. Diaper is weighed after infant has wet it. Each gram of added wight is calculated and recorded as 1 ml or urine.
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What factors does a nurse look for in determining a newborn's ability to take in nourishment by nipple and mouth?
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Infant has good suck, has coordinated suck-swallow, takes less than 20 min to feed, gains 20-30g/day
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What complications are associated with total parenteral nutrition? [TPN]
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Hyperglycemia, electrolyte imbalance, dehydration and infection.
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In order to prevent rickets in the preterm newborn, what supplements are given?
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Calcium and Vitamin D
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List four nursing interventions to enhance family and parent adjustment to a high-risk newborn.
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Initiate early visitation at ICU. Provide daily information to family. Encourage participation in support group for parents. Encourage all attempts at care-giving [enhances bonding]
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List the risk factors for hyperbilirubinemia.
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Rh incompatibility, ABO incompatibility, prematurity, sepsis, perinatal asphyxia.
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List the symptoms of hyperbilirubinemia in the neonate.
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Bilirubin levels rising 5mg/day, jaundice, dark urine, anemia, high reticulocyte RBC count and dark stools.
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Write one nursing diagnosis generated from the data pertinent to hyperbilirubinemia.
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Risk for injury related to predisposition of bilirubin for fat cells in brain.
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List three nursing interventions for the neonate undergoing phototherapy.
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Apply opaque mask over eyes. Leave diaper loose so stools and urine can be monitored but cover genitalia. Turn very 2 hours. Watch for dehydration.
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List the symptoms of neonatal narcotic withdrawal.
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Irritability, hyperactivity, high-pitched cry, frantic sucking, coarse flapping tremors, and poor feeding.
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Neonates who are "sick" are prone to receive too much stimulation in the form of invasive procedures and handling and too little developmentally appropriate stimulation and affection. How might such an infant respond?
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Failure to thrive, absence of crying
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How should a nurse determine the length of a tube needed for the oral gavage feeding of a newborn?
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Measure from the bridge of the nose to the earlobe and then to a point halfway between the xiphoid and the umbilicus.
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What are the two best ways to test for correct placement of the gavage tube in the infant's stomach?
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Aspiration of stomach contents and pH testing Auscultation of an air bubble injected into the stomach
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What characteristics would the nurse expect to see in a neonate with fetal alcohol syndrome?
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Microcephaly, strabismus, growth retardation, short palperbral fissures, maxillary hypoplasia, abnormal palmar creases, irrigular hair, whorls, poor suck, cleft lip, cleft palate, small teeth!
