Neonatal Substance Withdrawal
This high-pitched behavior is a hallmark of CNS irritability in neonates experiencing withdrawal.
What is incessant or shrill crying?
This is the normal blood glucose range for a healthy term newborn.
What is 40 to 60 mg/dL?
A preterm newborn is born between these gestational weeks.
What is after 20 weeks and before completion of 37 weeks?
This term describes a newborn whose birth weight is at or below the 10th percentile for gestational age.
What is Small for Gestational Age (SGA)?
A postmature infant is defined as one born after this point in gestation.
What is after 42 weeks of gestation?
Tracheoesophageal Fistula (TEF) involves an abnormal connection between the esophagus and this structure.
What is the trachea?
This yellowish condition results from elevated serum bilirubin levels in newborns.
What is jaundice?
Neonates exposed to this opioid substitute are at increased risk for seizures, sleep disturbances, and SIDS, though they may have higher birth weights.
What is methadone?
A newborn with poor feeding, jitteriness, and an abnormal cry should be assessed for this metabolic complication.
What is hypoglycemia?
This NICU priority supports the most critical systems in a preterm infant.
What are the cardiac and respiratory systems?
Two common complications of SGA newborns related to oxygen and blood cell production.
What are perinatal asphyxia and polycythemia?
This condition in postmature infants results from placental aging and leads to chronic hypoxia and fetal distress.
What is dysmaturity due to uteroplacental insufficiency?
This gastrointestinal condition often coexists with TEF and results in a blind-ending esophagus.
What is esophageal atresia (EA)?
This type of jaundice is considered benign and typically appears 72–120 hours after birth.
What is physiologic jaundice?
This facial feature, a hallmark of fetal alcohol syndrome, appears as a flattened area between the nose and upper lip.
What is a smooth philtrum?
This condition may result if neonatal hypoglycemia is left untreated.
What are seizures, brain damage, or death?
This gastrointestinal condition in preterm infants results in necrosis and potential perforation of the bowel.
What is necrotizing enterocolitis?
This type of umbilical cord appearance is characteristic of SGA infants.
What is thin, dry, yellow, and dull?
Postmature infants may show this skin condition due to loss of vernix and prolonged exposure to amniotic fluid.
What is cracked, peeling, and dry (leathery) skin?
The presence of TEF places an infant at increased risk for this serious complication involving the lungs.
What is aspiration?
This dangerous type of jaundice occurs within the first 24 hours of life or persists beyond day 14.
What is pathologic jaundice?
This feeding strategy is used for newborns with poor coordination during withdrawal.
What are small, frequent feedings of high-calorie formula?
Name one maternal and one neonatal risk factor for hypoglycemia.
What are maternal diabetes and preterm birth?
This condition involves bleeding around the brain’s ventricles in premature infants.
Answer:
What is intraventricular hemorrhage?
SGA newborns often appear alert and wide-eyed due to this chronic in utero condition.
What is prolonged fetal hypoxia?
Meconium aspiration in postmature infants can lead to this serious circulatory condition where fetal circulation persists.
What is persistent pulmonary hypertension of the newborn (PPHN)?
This prenatal condition is a risk factor for TEF and involves excess amniotic fluid.
What is polyhydramnios?
This condition results from bilirubin being deposited in the brain and may cause irreversible neurologic damage.
What is kernicterus?
This opioid medication is commonly used to manage neonatal withdrawal symptoms.
What is morphine sulfate?
This intervention should be initiated when an asymptomatic at-risk newborn has a glucose level below 25 mg/dL within the first 4 hours.
What is offering oral feedings?
This vision-threatening condition in preterm infants is linked to excessive oxygen administration.
What is retinopathy of prematurity?
This lab test in SGA newborns helps confirm polycythemia due to intrauterine stress.
What is a complete blood count (CBC)?
This metabolic condition in postmature newborns occurs due to high insulin and low glycogen stores at birth.
What is hypoglycemia?
Signs of TEF in a newborn include excessive oral secretions, feeding intolerance, and this skin manifestation.
What is cyanosis?
This test detects antibody-coated Rh-positive red blood cells in the newborn, suggesting hemolysis.
What is the direct Coombs' test?
This primitive reflex is exaggerated in neonates with substance withdrawal.
What is the Moro reflex?
RDS in newborns occurs due to a deficiency of this substance in the lungs.
What is surfactant?
A preterm newborn may have this breathing pattern: short pauses followed by rapid respirations.
What is periodic breathing?
A newborn weighing more than 4,000 g (8.8 lb) or above the 90th percentile is considered this.
What is Large for Gestational Age (LGA)?
An alert appearance more typical of a 2-week-old newborn is a sign seen in this group of newborns.
What are postmature infants?
Infants with suspected TEF should be positioned in this way to minimize aspiration risk.
What is supine with the head of bed elevated?
This procedure uses special lights to reduce bilirubin levels and requires eye protection for the newborn.
What is phototherapy?
This term describes the slowed physical development seen before and after birth in infants with FAS.
What is growth delay?
This respiratory sign involves rhythmic chest retractions and nasal flaring in a newborn with RDS.
What is labored breathing?
This is a classic skin sign seen in preterm infants born around 22 to 24 weeks of gestation.
What are eyes fused shut?
This maternal condition is the leading risk factor for delivering an LGA newborn.
What is maternal diabetes mellitus?
This physical finding may appear on the umbilical cord and nails as a result of prolonged in utero meconium exposure.
What is meconium staining?
This type of tube is placed for low-continuous suction to manage oral secretions in TEF.
What is an orogastric tube?
Phototherapy lights should be turned off before doing this procedure.
What is drawing blood for testing?
This substance may lead to attention, memory, and motor skill deficits in exposed newborns.
What is marijuana?
This diagnostic test confirms RDS by showing signs of atelectasis or lung underinflation.
What is a chest x-ray?
These are physical characteristics of preterm newborns.
What are minimal fat deposits and a large head in relation to body size?
LGA infants are at risk for this nerve injury caused by birth trauma during delivery.
What is Erb-Duchenne paralysis?
Postmature infants may be either SGA or LGA depending on this factor.
What is placental function in the final weeks of pregnancy?
Feeding a newborn showing excessive oral secretions and respiratory distress should be avoided until this occurs.
What is consultation with a healthcare provider?
This is a common, noninvasive method used to screen bilirubin levels in newborns.
What is transcutaneous bilirubin measurement?
This nursing intervention helps prevent aspiration during feedings in a neonate with poor suck.
What is elevating the head during and after feeding?
This medication class, including beractant and calfactant, is administered via endotracheal tube to treat RDS.
What are lung surfactants?
This method of thermal support reduces stress and promotes bonding in preterm infants.
What is Kangaroo care (skin-to-skin contact)?
This blood condition may result from hypoxia-induced overproduction of red blood cells in LGA newborns.
What is polycythemia?
This elevated lab value in postmature infants is caused by polycythemia and dehydration.
What is hematocrit (Hct)?
This imaging test can detect TEF before birth.
What is prenatal ultrasound?
To promote bilirubin excretion, newborns should be fed at this frequency.
What is every 3 to 4 hours?
This scoring system is used to assess and monitor the severity of neonatal abstinence syndrome symptoms.
What is the Neonatal Abstinence Scoring System?
These are two complications of oxygen therapy in a newborn with RDS.
Answer:
What are retinopathy of prematurity and bronchopulmonary dysplasia?
What are retinopathy of prematurity and bronchopulmonary dysplasia?
This complication of prematurity is caused by immature neurological and chemical control of breathing and is marked by pauses in respiration lasting 20 seconds or more.
What is apnea of prematurity?
Before delivery of an LGA newborn, nurses should prepare for this position to assist in shoulder dystocia.
What is McRoberts position?
This nursing intervention helps prevent cold stress in postmature infants.
What is providing thermoregulation in an isolette?
The definitive treatment for TEF involves this type of procedure.
What is surgical intervention?
This serious neurologic condition caused by bilirubin toxicity is marked by dystonia, upward gaze, and hearing loss.
What is acute bilirubin encephalopathy?