ch. 17 from notes

  1. preterm (premature) infant
    • -born before 37 weeks regardless of weight
    • -5.5 lbs or less
    • -cause: preterm labor
    • -survival improved with modern technology but unlikely if less than 24 weeks
    • -poor gag reflex, sucking and swallowing
  2. complications of preterm infant
    • -resp. distress: lungs lack surfactant
    • -cardiac alterations: ductus arteriosis remains open-causing pulmonary congestion, increases respiratory effort, CHF
    • -thermoregulatory problems: lack of brown fat and glycogen can lead to cold stress syndrome
    • -prevent heat loss!!!
  3. complications
    • -at risk for intraventricular hemorrhage and intracranial hemorrhage
    • -altered nutrition: immature gi tract causes problems with ingestion, digestion and absorption of foods
    • -altered elimination: immature kidneys unable to concentrate urine, unable to excrete drugs, unable to buffer
  4. respiratory distress syndrome (RDS)
    • -pathophysiology
    • -pulmonary surfactant
    • -test used to evaluate lung maturity
    • -phasphatidylglycerol ???
    • -lecithin/sphingomyelin (l/s) ratio-helps mature lungs (betamethazone and dextamethazone)
    • -atelectasis
  5. signs of RDS
    • -cyanosis
    • -tachypnea
    • -grunting
    • -nasal flaring
    • -significant retractions
    • -apnea
  6. patent ductus arteriosus (PDA)
    -not closed-remains open longer because of preterm
  7. periventricular intraventricular hemorrhage
    • -common forms of intracranial hemorrhage in the neonate
    • -
  8. necrotizing enterocolitis
    gastrointestinal disease that affects neonates
  9. meconium aspiration syndrome
    • -physiologic response to asphyxia is : increased intestinal peristalsis, relaxed anal sphincter which leads to passage of meconium into amniotic fluid
    • -aspiration of meconium into alveoli, occurs in utero, during or after birth.
    • -inspired air trapped in alveoli which leads to fetal hypoxia
    • -leads to respiratory distress, possible CNS damage, kidney damage, etc.
    • -can be prevented by: amnioinfusion prior to delivery
    • -md suctions infant after head delivered
    • -if meconium aspiration suspected, infant is intubated and direct suctioning of trach done
    • treatment:high o2, controlled ventilation, surfactant therapy, chest pt, ECMO
  10. transient tachypnea of the newborn (TTN)
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ch. 17 from notes