High-Risk Newborn
What is the primary physiological reason a premature neonate is at high risk for respiratory distress syndrome (RDS)?
Immature lungs and an abnormal development or lack of surfactant, which is essential for alveolar stability and function.
What is anticipatory grief, often seen in parents with a high-risk newborn in the NICU?
Grieving the potential or impending loss of the idealized healthy child or actual loss, which can help prepare for a negative outcome but also complicates bonding.
What is the definition of Neonatal Abstinence Syndrome (NAS)?
A drug withdrawal syndrome after discontinuation of chronic fetal exposure to substances (e.g., opioids).
Breathing disorder in premature infants due to lack of surfactant.
Respiratory Distress Syndrome (RDS)?
What lab monitoring is crucial for LGA newborns (especially from diabetic mothers)?
Frequent blood glucose monitoring for hypoglycemia.
Compared to a term neonate, why do premature neonates have difficulty maintaining body temperature?
They have a larger surface area in proportion to their weight, less subcutaneous fat (insulation), and immature thermogenesis mechanisms
What is meant by "complicated grief," an alteration in the normal process?
Grief that is prolonged, intense, and interferes with the individual's ability to function in daily life for a significant period.
What are key assessment findings for NAS?
High-pitched cry, irritability, tremors, and feeding difficulties.
Explain the difference between hospice and palliative care
Palliative care can be combined with curative treatment at any stage, while hospice care is only for terminal patients who have ceased curative treatment efforts.
Rapid breathing (tachypnea, >60 bpm), mild retractions/nasal flaring/grunting, normal oxygen saturation, symptoms resolve within 24-48 hours.
Transient Tachypnea of the Newborn (TTN)
What makes premature neonates more susceptible to infections like sepsis?
They have an immature innate immune system and poor immunological responses.
What are common assessment procedures used to examine grief responses across different age groups?
Observation, interviews, validated grief assessment scales
What defines newborn hypoglycemia?
Abnormally low blood glucose levels (e.g., <40 mg/dL).
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What is the definition of Small for Gestational Age (SGA)?
Birth weight/length below the 10th percentile for gestational age, often due to IUGR.
What are potential long-term health outcomes associated with prematurity?
Chronic lung problems (like asthma), developmental delays, cerebral palsy, vision/hearing impairments, and behavioral issues.
What are common metabolic issues in high-risk/premature neonates related to nutrition?
Poor feeding coordination (suck-swallow immaturity), low glycogen stores leading to hypoglycemia, and hyperbilirubinemia due to an immature liver's ability to conjugate and excrete bilirubin.
What is a key nursing intervention for a client with an alteration in grief, such as denial?
Therapeutic communication, active listening, validating feelings, and providing consistent, honest information to help them process reality at their own pace.
What is the first-line treatment for an alert newborn with hypoglycemia?
Oral feeding (breast milk/formula) or buccal glucose gel.
What are common lab findings associated with SGA newborns?
Hypoglycemia and polycythemia (high red blood cell count).
When managing Meconium Aspiration Syndrome (MAS), what medication might be administered to prevent pneumonia?
Antibiotics
What are common respiratory therapies for premature neonates?
Antenatal steroids for lung maturity before birth, surfactant administration after birth, and non-invasive ventilation like continuous positive airway pressure (CPAP).
What type of therapy is often used for complicated grief?
Psychotherapy, support groups, and sometimes medications (e.g., for depression or anxiety).
What is polycythemia in a newborn?
High red blood cell count (hematocrit >65%), leading to thick blood.
What is the definition of Large for Gestational Age (LGA)?
Birth weight above the 90th percentile for gestational age, often >4000g.
Besides poor feeding, what are other symptoms of newborn hypoglycemia?
Jitteriness, lethargy, hypothermia, hypotonia, apnea, and seizures.