The two umbilical arteries tell you what's happening with _____
Baby because they are taking waste away from baby.
The one umilical vein tells you what's happening with ____
MOM-the umbilical vein delivers O2 and nutrients to baby.
Preterm is considered under ____ weeks.
LBW, VLBW, ELBW
Late preterm is from ___ to ____ weeks.
34 to 36 6/7 weeks
Respiratory issues with preterm infant
- *decreased # of functional alveoli
- *deficient surfactant levels
Early signs of resp distress in perterm infant
- nasal flaring
- expiratory grunting (PEEP)
- retractions (subcostal, intercostal, or suprasternal)
- Paradoxic breathing- 5-10 sec pause followed by 10-15 sec rapid breathing
- apnea- cessation of resp for >20 sec
Cyanosis, what is normal and not normal in newborn?
Acrocyanosis (hands and feet) is normal, yet central cyanosis indicated poor oxygenation.
MAP should equal _____ to properly perfuse vital organs.
weeks of gestation
Signs of hypovolemia in newborn
prolonged capillary refill >3sec, pale color, poor muscle tone, lethargy, tachycardia then bradycardia
Why are preterm infants often times given gravage feeding?
Because they burn a tremendous amount of calories trying to eat. Gravage feeding is passive allowing them to conserve energy.
S&S of overheating in premature infant
- apnea, flushed color
- they are unable to sweat and being overheated is just as dangerous as being cold.
S&S of seizure in premature infant
Usually subtle-may be twitching of hand or half smile.
CNS, what to monitor?
- 1. seizure activity
- 2. hyperirritability
- 3. CNS depression
- 4. elevated intracranial pressure
- 5. abnormal movements such as decorticate posturing
Why do premature infants have an increased tendency to bleed (prolonged PT, PTT)?
They don't have vitamin K to help in clotting
All premature infants are treated for _____
Infection, because they don't give S&S making it hard to know if they have an infection.
O2 sate of premature infant
- 1min 60-65%
- 2min 65-70%
- 3min 70-75%
- 4min 75-80%
- 5min 80-85%
- 10min 85-90%
Coordination of suck and swallow occurs at ___to___weeks.
32-34 weeks & not fully synchronized until 36-37 weeks gestation
Why are premature newborns at an increased risk for necrotizing enterocolitis?
- NEC is an acuteinflammator disease of the GI mucose commonly complicated by perforation.
- 3 factors: intestinal ischemia, colonization by bacteria, and substrate(formula) in the intestinal lumen.
- Treatment: rest gut, TPN, treat infection, WASH HANDS!!!
Abd distention could indicate _____ in preterm infants.
Noise levels of ___ to ____ can cause hearing loss in premature infant.
- incubator produces 60-80db
Premature infants need a period of undisturbed sleep for _____.
50 minutes for a full sleep cycle
____ is shown to reduce stress of premature newborn.
skin to skin contact with parents
Monitor for pneumothorax because it often preceeds _____
Giving a preterm infant high amounts of arterial oxygen can cause ____
Post term infant is considered beyond ____
42 weeks gestation
What are risk factors for postterm infants?
- meconium aspiration
- Persistent pulmonary HTN of the newborn
If a postterm infant has meconium aspiration what is the immediate action of birth?
endotracheal suctioning before first breath to prevent chemical pneumonitis from meconium aspiration.
What is PPHN?
- Persistent pulmonary HTN of the newborn
- consists of: pulmonary HTN, right-to-left shunting, and a structurally normal heart.
- *they can revert to fetal circulation
- Treatment: INO & ECMO
Want moms with gestational diabetes to have an A1C of ____
- damage to the upper plexus from stretching or pulling away of the shoulder from head as in shoulder dystocia.
- arm paralyzed but grasp present
- severe stretching of upper extremity.
- hand paralysis
- entire arm paralyzed
- tx: prevent contractures and maintain correct placement, passive ROM
- recovery takes 3-6 months
- pressure on cranial nerve VII during delivery
- results in loss of movement on the affected side, facial drooping
- resolves within hours to days of birth
- diaphragmatic paralysis with parazixic chest movement and elevated diaphram
- usually unilateral causing respiratory distress
- place on affected side to allow expansion of unaffcted lung
- extended recovery time
Measure head q____
30 minutes to see changes