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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
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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!!!
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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
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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
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signs of RDS
- -cyanosis
- -tachypnea
- -grunting
- -nasal flaring
- -significant retractions
- -apnea
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patent ductus arteriosus (PDA)
-not closed-remains open longer because of preterm
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periventricular intraventricular hemorrhage
- -common forms of intracranial hemorrhage in the neonate
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necrotizing enterocolitis
gastrointestinal disease that affects neonates
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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
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transient tachypnea of the newborn (TTN)
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