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infants classified as large for gestaional age are |
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early term infant is born between |
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full term infant is born between |
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later term infant is born between |
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postterm infant is born beyond |
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a low birth weight infant weighs |
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standardized method used to estimate gestaional age within 1 to 2 wks is the |
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failur of the aveoli to expand |
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required o2 can be administered throug |
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nasal catheter,incubator or o2 hood |
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respiratory distress sysndrom is also called |
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Definition
hyalin membrane disease, or repsiratroy distress syndrom typoe 2 |
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a result of lung immaturity which leads to reduced gas exchange |
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in RSD ther is a deficient synthesis or release of |
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a fatty protein necessary for absorption of oxygen by the lungs |
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testing for this ratio provideds information about the amobunt of surfactant in amniotic fluid |
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Definition
lecithin/sphinogomylin ratio |
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tachypnea, grunlike sounds, nasal flaring, cyanosis, intercostal and sternal retractions |
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these symptoms occur if RDS becomes more sever |
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edema, lassitutd and panea |
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Term
furfactant begins to appear in the fetal alveoli at approx |
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surfactant is at a level to enable the infant to breathe adequately at birth by |
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in preterm newborns surfactant can be administered via |
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Definition
endotracheal tube at birth, or when RDS symptoms appear |
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after treatment of RDS improvement of lung function should be seen within |
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surfactant produciton is altered during episodes of |
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Definition
cold stress, hypoxia, porr tissue perfusion |
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a high risk for infants receiving prologned treatment with high concentraitons of o2 |
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the toxic respons of the lung to o2 therapy |
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Definition
bronchopulmonary dysplasia |
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symptoms of bronchopulmonary dysplasia that interfere with ventilation |
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Definition
atelectasis, edema, and thickening of the membranes |
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an apneic episode may be accompanied by |
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ways to stimulate breathing after apnea |
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Definition
gentle rubbing of the infant's feet, ankles and back |
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Term
ways to facilitat breathing if previos measures fail |
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Definition
suctioning of nose and mouth, raising of the infant's head and ambubag if breathing does not begin |
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Term
inadequate oxygenation at the cellualar level in a newborn infant |
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deficiency of oxygnet in the arterial blood is know as |
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a normal pulse oximetry saturation level |
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the amount of desatruated hemoglboin needed to produce clinical cyanosis |
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if the hemoglobin present is an abnormal fetal hemoglobin _ can be present even when the pulse is _ because fetal hemoglobin does not redily release _ to the tissues and _ |
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Definition
hypoxia, normal, oxygen, end organs |
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Term
signs of sepsis in newborn |
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Definition
low temp, lethargy, irritability, poor feeding, resp distress |
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treatment of sepsis involves |
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Definition
administration of IV antimicrobials, maintenance of warmth and nutrition, close monitoring of vital signs |
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Term
heat loss in the preterfm infant results from |
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Definition
lack of brown fate, excesive heat loss from radiation, imamture heat regulating center of the brain, sweat glands no funtioning, infant is inactive, has muscles that are weak and less resistant to cold and can't shiver, posture of preterm infant extrmities is lege extension, high metablolism |
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cold stress increases the need for |
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hypoglycemia is aggravated by the need ot for increased glycogen in the |
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Definition
brain, heart and other tissues |
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Term
hypoglycemia is agravated by the need for glycogen as a result of |
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Definition
asphyxia, sepsis, rds, unstable body temp |
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plasma glucose levels in the term infant that inicate hypoglycemia |
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plasma glucose levels in the preterm infant that inicate hypoglycemia |
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perterm infnats may need gavage or parenteral feedings to supply their needs of |
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also seen in preterm an dsick newborns |
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can result in infants with lower serum calcium levels |
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infants who are at risk for hypocalcemia |
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infants stressed by hypoxia, birth trauma or receiving sodium bicarb |
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usually occurs about 1wk of age in newborn or preterm infants who are fed cow's milk |
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increases serum phosphate levels which cause calcium levels to fall |
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treatment of for hypocalcemia |
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during IV therapy for calcium gluconate, the nurse should monitor the infant for |
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adding this also lowers phospate levels |
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calcium lactat tablets must not be used because they are |
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when calcium lactate powder is slowly discontinued from the formula, the nurse should again monitor the infant for signs o f |
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preterm infants are more prone to bleeding than fullterm infants because their blood is deficient in |
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a disorder of the devoloping retina in premature infants that can lead to blindiness |
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Definition
retinopathy of prematurity |
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Term
it is recommended that inants ge a routin retinal exam by certified ophthalmologists with a birth weight between |
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Definition
1500 and 2000g, or gest age <30 wks |
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treatments used with success in preventing blindness r/t retinopath of prematurity |
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Definition
retinal ablative theratpy using laser photocoagulation of the fibrous tissu, intravitreal injection of bevacizumab |
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infants must be provided with the level of o2 required to sustain life and prevent |
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abdominal girth should be measured and bowel sounds assessed in orderto detgect early signs of |
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necrotizing enterocolitis |
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signs that inidcate readiness for oral feedings include |
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Definition
strong gag, sucking and rooting reflexes |
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nipple feeding are started slowly and due to energy spent of oral feeding we may seen some |
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placing inaft on the right side or abdomen after feeding promots |
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gastric emptying and rduces apiration risk |
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an acute inflammation of the bowel that leads ot bowel necrosis |
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Definition
necrotizing eneterocolitis |
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factors that implicate necrotixing enterocolitis |
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Definition
diminished blood supply to the ling of the bowe wall (because of hypoxia or sepsis) |
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abdominal distention, bloody stools, diarrhea, bilious vomitous |
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important measures r/t NEC |
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Definition
measuring the abdomen, listening for bowel signs |
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treatment fo rNEC includes |
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Definition
antimicrobials and use of parenteral nutrition, removal of necrosed bowel may be inidcated |
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the urin output should be between |
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an increase of more than _ in 24 hrs or a bilirubin level greater than _ requires careful investigation |
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more serious and cocurs within 24 hrs of birth and is secondary to an abnormal condition |
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in preterm infants the normal rise in bilirubin is |
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slower than in full term infants and lasts longer |
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there is more evidence of jaundic in infants who are |
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causes of early onset jaundice of the breastfed infant |
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indadequate suckling at the breast |
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_ should not be offered to the infant because this practice may reduce milk intakea and can serve to further increase bilirubin levels |
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in late onet jaundice of the breastfed infant the breast milk itself may inhibit |
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in the breastfed infant formula may be substitued for _ to reduce bilirubin levels |
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total serum bilirubin level typically peaks _ after birht |
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the goals of treatment for hhyperbilirubinemea |
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Definition
prevent kernicterus, avoid the continued icnreas of bilirubin |
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immediate needs of newborn are |
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Definition
clear the airway and provide warmth |
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the nurse records the temp of the infnat and ithe incubatore every |
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the temp probe should not be palced over a |
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Definition
bony prominence, areas of brown fat, the extremites or an exoriated area of the body |
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the uses of a pexiglas shield with the radiant warmer is not recommended becauseint may |
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_ should be placed over the skin temp prove to ensure that the infant's skin temp reading is not affected by the infrared heat of the radiant warmer |
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the ability to coordinate breathing, sucking and swallowing doe snot develop before |
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infants wight more than _ may be able to bottle feed if a small, soft nipple with a large hole is used to minimize the energy and effort required for sucking |
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if the infant is gavage fed the tube is replaced every |
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signs that inidicat intestinal readiness for oral feedings |
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bowel sounds an passage of meconium |
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infant older than _ gestation usually have the digestive enzyme for the digestion fo breastmik |
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formulas designed for term inants are not well tolerated by preterm infants because they are a burden to their kidnesy and can cause |
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formulas designed for pretrm infants are not well tolerated by infants older than 34 wks gestation or term infants because _ may develop |
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proppint the infnat on the side or placing the infant pron can |
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Definition
reduce rep effor, improve oxygenation, promote a more organized sleep patttern, lessen physical activity that burns up energy needed for g&d |
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can provide a calming, supporting environment that promotes body flexion for the preterm infant |
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should not be used in the preterm infants thin and sensitive skin |
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Definition
alkaline based soap, alcohol, and medicated wipes |
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Term
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Definition
hydrocolloid adhesive or using gauze or cotton under adhesive tape |
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daily cleansing of the _ and bathes _ weekly promote skin integrity |
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Definition
eyes, mouth and diaper area, 2 or 3 |
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when clensing the infant _ promotes skin integrity |
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the preterm infant should be awakened _ for procedures or nursing care |
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_ is beneficial to the infant |
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problems associated with postmaturity |
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Definition
asphyxia, meconium aspiration, poor nutritional status, increase in red blood cell production, difficult delivery, birth defects, seizures |
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caused by chronic hypoxia while in the uterus because of a detoriorated placenta |
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seizure occur as a result of the |
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the postterm infant is _ and looks as though weight has been lost, skin is _ especially around _ |
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long and thin, skin, thighs and buttocks |
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