Professional Documents
Culture Documents
LGA INFANTS
Causes: a. Diabetic Mother b. Babies with Transposition of the Great Vessels c. Multiparous Mothers
Hypoglycemia
Threat to Brain Cells Less than 30 mg/100 ml of blood = harmful After birth levels fall Infants prone to hypoglycemia Treatment
Preterm Infant
Less than 37 weeks Less than 3500 g = LBW 1000 - 1500 g = VLBW 500 - 1000 g = Extremely VLBW
PRETERM INFANTS
SMALL AND SCRAWNY LARGE HEAD TRANSLUCENT SKIN, VISABLE BLOOD VESSELS ABUNDANT LUNAGO SOLES OF FEET- minimal creases MALES- few scrotal rugae, & testes undescended
POSTERM INFANTS
ABSENT LANUGO LITTLE VERNIX CASEOSA ABUNDANT SCALP HAIR SKIN CRACKED & PARCHMENTLIKE WASTED APPEARANCE
DEVELOPMENTAL INTERVENTION
BEFORE 33 WEEKS- minimum stimulation 34-36 WEEKS- stimulate senses but dont tire out
NURSING CARE
PAIN CONTROL FACILITATE PARENT-CHILD RELATIONSHIP NEONATAL LOSS- see, hold, photo; support groups, baptize
PRETERM INFANTS
GIRLS- labia and clitoris prominent INACTIVE & LISTLESS- extremities remain in any position placed IMMATURE LUNGS, SUCK, TEMP
HYPERBILIRUBINEMIA
INCREASED UNCONJUGATED FORM (0.2-1.4mg/dl) JAUNDICE WITHIN 24 HOURS AFTER 1-2 WKS. TERM; 2 WKS PRETERM TOTAL > 12-13 mg/dl INCREASE >5 mg/dl/day DIRECT >1.5-2 mg/dl
HYPERBILIRUBINEMIA
DIRECT COOMBS TEST- ABO/Rhdetect the infants antibodies coating the RBS (circulating erythrocytes)
TYPES OF HYPERBILIRUBINEMIA
PHYSIOLOGICAL JANUDICE BREAST-FEEDING ASSOCIATED JAUNDICE BREAST MILK JAUNDICE HEMOLYTIC DISEASE- Blood antigen incompatibility a. Treatment- phototherapy, exchange transfusion, prevention (RhoGAM) b. Nursing Care
EXCHANGE TRANSFUSION
CRITERIA- + Direct Coombs, Hg<12g/dl, Bilirubin > 20 mg/dl AMOUNT - 2X blood volume of infant UMBILICAL VEIN CHECK FOR HYPOCALCEMIA MONITOR VS, RADIENT WARMER
HYPOGLYCEMIA
SGA, LGA, IDM, STRESSED, INTERUTERINE MALNUTRITION JITTERY, HIGH-PITCHED CRY, LETHARGIC Dx- glucose <40 1st 24 hours or <50 after 24 hours, heel stick PREVENT- early feedings
HYPOCALCEMIA
RISK- preterm with hypoxia, IDM, hypoglycemic Dx- serum calcium <7 mg/dl Tx- increase milk feedings, cal. supplements, Vit D
NEONATAL SEIZURES
NOT ORGANIZED SIGN OF BRAIN DISTURBANCE MOST COMMON CAUSE- Asphyxia & Hypoglycemia Dx- EEG, lab test, CAT scan Treatment and Nursing Care
HYPOXIC-ISCHEMIC ENCEPHALOPATHY
COMPLICATION OF HYPOXEMIA
RISK SIGNS
SEPSIS
SUSCEPTIBLE- Diminished nonspecific and specific immunity ETIOLOGY- Infected amniotic fluid, +BGS DIAGNOSIS- Cultures TREATMENT- Ampicillin & Gentamycin
NECROTIZING ENTERCOLITIS
SICK PRETERM & HIGH-RISK ISCHEMIA & NECROSIS OF GI TRACT RELATIONSHIP WITH FORMULA SIGNS- Abdominal Distention, etc. TREATMENT- D/C oral feedings, Antibiotics, Observations
BULLOUS IMPETIGO
STAPHYLOCOCCUS AUREUS- red moist denuded area with very little crusting WARM SALINE COMPRESSES,
ANTIBIOTICS PREVENT SPREAD
NARCOTIC-ADDICTED INFANTS
WITHDRAWAL AUTONOMIC NERVOUS SYSTEMHyperirritability, suck vigorously but poor suckers TREATMENT- Sedative/Hypnotic, Antianxiety PROGNOSIS- Neuro and growth problems NURSING- Decrease stimuli, nutrition, snuggle, protect skin
COCAINE EXPOSURE
CNS STIMULANT RISK SIDS NEURO DEPRESSION/EXCITABILITY SMALL HEAD CIRCUMFERENCE, LBW, LOWER BIRTH LENGTH TREATMENT- Supportive, occ. sedative
MATERNAL SMOKING
GROWTH RETARDATION
INCREASED ABORTION EMOTIONAL DEFICITS INCREASED SIDS
MATERNAL INFECTION
T- Toxoplasmosis O- Other ( hepatitis, measles, mumps, HIV) R- Rubella- pregnant no contact C- Cytomegalovirus infection-pregnant no contact H- Herpes simplex- Stop transmission S- Syphilis (Gonococcal conjunctivitis & chylamydial conjunctivitis)
CONGENITAL ABNORMALITIES
DOWNS SYNDROME- Extra chrosome 21 a. GREATER RISK IN WOMEN >35 b. CHARACTERISTICS- Mental retardation, low set ears, head round, short stubby fingers, bridge of nose flat, tongue thick, heart defects
CONGENITAL ABNORMALITIES
CHEMICAL AGENTS a. BETWEEN 15-90 DAYS OF GESTATION
b. PREVENTION
CONGENITAL HYPOTHYROIDISM
INADEQUATE THYROXINE (T4)
CLINICAL SIGNS- Hypotonia, widespread fontanelles, large thyroid, prolonged jaundice
PHENYLKETONURIA
ABSENSE OF PHENYLALANINE HYDROXYLASE AFFECTS DEVELOPMENT OF BRAIN AND CNS SCREENING OF NEWBORNS, REPEAT SCREENING TREATMENT- Diet restricts phenylalanine (Lofenalac), meat and diary products restricted
GALACTOSEMIA
DISORDER OF GALACTOSE METABOLISM GLACTOSE ACCUMULATES IN BLOOD ORGANS SIGNS- Lethargy, hypotonia, diarrhea TREATMENT- Eliminate galactose (Prosobee)