Maternal semi

• Breastfeeding


  Not contraindicated in Hirschsprung disease
• Diagnostic findings? You can palpate it
• Management of Hirschsprung disease

  Barium enema reduction
• Complication of delayed treatment of Hirschsprung disease
• Nursing action when patient experiences abdominal pain and vomiting


  Start IV resuscitation
• Appropriate nursing action is to encourage parents to ask questions and express concerns
• Priority nursing intervention to monitor complications of Hirschsprung disease


  Monitoring vital signs and response to interventions regularly
• Nursing action to assess hydration status

  Evaluate skin turgor and mucus membrane moisture
• Nursing intervention to address baby's discomfort and promote rest


  Encourage the parents to hold and comfort the baby as needed
• Down syndrome


  Chromosomal abnormality is Trisomy 21
• Individuals with Down syndrome

  • Epicanthal folds are commonly seen
• Developmental milestone delayed in babies with Down syndrome is walking
• Effect of third copy of chromosome 21 in Down syndrome


  Disrupts normal gene expression
• Accommodations for individuals with Down syndrome in school


  Providing visual aids and simplified instructions
• Common health conditions associated with Down syndrome

  • Hearing loss
  • Visual problems
• Prenatal screening for Down syndrome


  Testing the levels of specific markers in maternal blood
• Ethical considerations when discussing options for treatment of Down syndrome include the impact of test results on parental decision making
• Hyperbilirubinemia


  High levels of bilirubin in blood
• Complication of severe untreated hyperbilirubinemia is Kernicterus
• Hyperbilirubinemia in babies is dangerous and requires intensive care in the NICU under phototherapy
• Purpose of phototherapy


  Breaks down the bilirubin in the skin
• Physiologic jaundice is not dangerous as it appears within the first 2 days after birth due to the immaturity of the baby's liver, but pathologic jaundice refers to hyperbilirubinemia
• Management of hyperbilirubinemia

  Exchange transfusion
• Signs and symptoms of hyperbilirubinemia

  • Jaundice
  • Dark urine
  • Abdominal pain
• A balanced diet with plenty of fruits and vegetables is beneficial for patients with hyperbilirubinemia
• ABO incompatibility


  Cause of jaundice in the first few weeks of life
• ABO incompatibility between the mother and baby's blood type can cause the baby's jaundice
• ABO incompatibility differs from Rh incompatibility in that Rh incompatibility leads to maternal sensitization while ABO does not
• Lab test to confirm ABO incompatibility

  Direct Coombs test
• Nursing intervention for ABO incompatibility

  Initiate phototherapy
• Nursing intervention for breastfeeding to help jaundice


  Monitor bilirubin levels closely and adjust feeding schedules accordingly
• Hydrocephalus


  Accumulation of excess CSF in ventricles or subarachnoid space
• Reason for CSF accumulation in hydrocephalus is not the presence of infectious agents
• Transillumination


  Method of pointing a bright light against the skull
• Clinical manifestations of hydrocephalus

  • Bulging eyes
• Incision site for hydrocephalus surgery is at the posterior fontanelle
• Early detection of hydrocephalus

  Measure head circumference within an hour of birth and again before discharge
• A diuretic might be prescribed for hydrocephalus
• Increased intracranial pressure


  Most important nursing diagnosis for hydrocephalus
• Rationale for not allowing CSF to flow too rapidly during treatment is to prevent brain damage