Ch.34 Neonatal Complications

• High-Risk Newborn:

  • B_ W_
  • G_ A_
  • Less than _ wks
  • B_ helps to regulate T_?

  birth weight, gest age, 37, bag, temperature
• Respiratory Function:

  • D_ A_
  • A_ G_ R_?

  decreased alveoli, absent gag reflux
• Cardiovascular Function:

  • Watch for C_ S_
  • L_ B_
  • P_ C_
  • R_?

  cv shock, low bp, poor cap, rds
• Thermoregulation:

  • N_ E_
  • Susceptible to H_ L_
  • Unable to increase M_ R_
  • P_ I_
  • R_ C_ in body T_ may cause A_?

  normal environment, heat loss, metabolic rate, prewarmed incubator, rapid changes, temp, apnea
• CNS Function:

  • T_ from birth
  • H_
  • Decreased A_
  • W_ C_
  • Inability to S_ and S_
  • Impaired B_ C_ process?

  trauma, hypotonia, activity, weak cry, suck, swallow, blood clot
• Physiologic Functions:

  • T_ and G_
  • Monitor W_ and I and O
  • Good H_ H_
  • Signs of Infection
  • T_, A_, J_, C_, P_ P_
  • F_ I_?
  • tpn, gavage, weight, hand hygiene, tachypnea, apnea, jaundice, cyanosis, poor perfusion, feeding intolerance
• Susceptible to Infection:

  • P_ L_ and R_
  • F_
  • Internal H_ M_?

  prolonged labor, rupture, formula, hr monitor
• Growth and Development:

  • Corrected Age
  • Adding G_ and P_ age
  • until _ age
  • VLBW have increased risk for N_ or C_
  • Discharge Criteria
  • Need to have A_ G_ P_
  • Ability to C_ V_ when H_
  • Ability to R_ H_ when P_
  • Can delay discharge if L_ o2?

  gest, post, 2 1/2, neurologic, cognitive, adequate growth pattern, cry vigorously, hungry, raise head, prone, low
• Respiratory Care:

  • Don't O_ O_
  • H_, N_ C_, C_, M_ V_
  • Keep oxygen saturation on low end of _ to _%
  • No A_?

  over oxygenating, hood, nasal cannula, cpap, mechanical vent, 88, 92, abg
• Nutritional Care

  • May lose up to _ % of W_ G_
  • P_ helps with C_ and C_?

  15, weight gain, pacifier, calm, comfort
• Skin Care/Environmental:

  • R_
  • P_ to B_
  • A_ S_
  • N_ scoring
  • Exposed to high levels of L_, N_, V_ concerns?

  reposition, prone, breakdown, avoid soap, nscs, light, noise, vision
• RDS (Respiratory Distress Syndrome)

  • C_ after delivery like _ hrs
  • Lack of P_ surfactant?

  close, 6, pulmonary
• ROP (Retinopathy of prematurity):

  • Affects development of R_ V_
  • Too much O_
  • Affects E_?

  retinal vessels, oxygen, eyes
• BPD (Bronchopulmonary Dysplasia):

  • Preterm infants require M_ V_
  • Unable to W_ from V_
  • After D_ with many I_
  • C_ D_
  • _ to _% spo2 levels?

  mechanical ventilation, wean, vent, deliver, issues, couple days, 88, 92
• PDA (patent ductus arteriosus):

  • Failure to C_ A_ B_
  • I_ can help
  • M_, C_, T_, and B_ P_?

  close after birth, ibuprofen, murmur, crackles, tachypnea, bounding pulses
• Necrotizing Enterocolitis:

  • Acute I_ D_ of GI M_
  • X_, G_ R_, A_, S_
  • N_ and T_
  • Symptoms
  • A_ D_
  • B_ S_
  • B_ S_
  • P_
  • A_
  • H_
  • D_ A_
  • B_?
  • inflam disease, mucosa, xray, gi rest, antibiotics, surgery, npo, tpn, abdominal distention, bloody stool, bile stained, pale, apnea, hypotonia, decreased activity, bradycardia
• ABO Incompatibility:

  • _ mom with _, _, or _ infant
  • Can lead to J_?

  O, a, b, ab, jaundice
• RH incompatibility:

  • C_ test
  • if _:_ or H_, Infant at risk for H_ D_
  • D_ C_
  • Antibodies A_ to B_ and cause H_
  • I_
  • Antibodies in B_ S_ that could A_?
  • combs, 1, 8, higher, hemolytic disease, direct combs, attach, blood, hemolysis, indirect, blood stream, attach
• Hyperbilirubinemia:

  • Physiologic - A_ _hrs of B_
  • Pathologic - W_ _hrs of B_
  • Risks
  • Rh N_ mom
  • A_ incompatibility
  • P_
  • B_
  • P_
  • P_?
  • after, 24, birth, within, 24, birth, negative, abo, polycythemia, bruising, petechiae, preterm
• Hyperbilirubinemia:

  • No G_ W_ between F_
  • No O_ on Phototherapy but C_
  • Encourage F_
  • M_ I and O
  • No L_?

  glucose water, feeds, ointment, circumcision, feeds, monitor, lotion