Infant Abnormality
Infant with-high pitched cry, jitteriness, seizures, respiratory difficulty, poor muscle tone, lethargy, poor suck.
What is s/s infant hypoglycemia. Blood glucose is less than 40mg/dL.
Infants of diabetic mothers are more prone to hypoglycemia.
Firm/midline/size of grapefruit.
Fundus after birth of placenta.
Check frequently for firmness/if boggy, massage to return firm tone. Decends 1 cm/day(involution).
Atonic uterus may lead to post partum hemorrhage.
Boggy fundus usually due to full bladder.
Medication given if fundus is boggy(atonic), and does not respond to massage.
What is Methergine.
Managed with phototherapy(light breaks down bilirubin). Due to buildup of bilirubin in blood/brain tissue. Bilirubin of 15 is elevated-REPORT.
Physiologic jaundice appears within 2nd-3rd days of life. Pathologic jaundice-within 24hrs of life.
What is kernicterus. page 346-349
Can cause severe brain damage.
Green tinged fluid seen when fetus has been "distressed", due to decrease in oxygen 2* nuchal cord/cord prolapse, inadequate placenta.
What is meconium in amniotic fluid.
Leg on affected side appears shorter, assymetric skin folds,diagnosed with Ortolani's sign(click), limited ABduction.
What is hip dysplasia.
Managed with Pavlik's harness.
Page 338.
Rubra x 3 days, serosa x 3-10 days, alba 10-21st day postpartum.
What is lochia.Page 210/211.
Concerning if: > 1 peri-pad saturated in 1 hour, lochia is foul smelling, lochia is absent following delivery.
Return of lochia to rubra after has been serosa-fundus boggy-uterine atony/retained placenta-risk postpartum hemorrhage
Return of lochia to rubra after has been serosa-fundus firm-cervical laceration.
The body naturally releases endorphins which act similarly to morphine. This may be reason doses of pain medications in laboring woman may be decreased.
What is endorphins.
Late FHR decelerations, variable decelerations, marked variability, absent variability, tachycardia, bradycardia, abnormal uterine activity.
What are non-reassuring FHR patterns.Pg.141
Does not cross suture lines/buildup of blood in periosteum of infants head.
Swelling of soft tissue of infants head, does cross suture lines. Normal occurrence due to "molding" of head during birth.
What is cephalohematoma. page 288
What is caput succedaneum.
Normal: Milia (white areas on face), Mongolian spots(bluish discoloration on skin),lanugo/vernix caseosa.
Infant's normally lose 5-10% of birth weight in first 3-4 days of life.
Error of neural tube development...gibbus(cystica) or hairy patch at area on spine(occulta).
What is spina bifida. page332-333
Infant placed prone in incubator/moist saline dressing over gibbus.
Keep hips lower than lesion/frequent repositioning to avoid pressure areas.
BUBBLEH/REEDA
What are "acronyms" used for post partum nursing assessment.
Breast/Uterus/Bowel/Bladder/Edema/Homans
REEDA-assess episiotomy/laceration/incisionReddness/Edema/Ecchymosis/Drainage/Approximation
Medication that crosses the placenta and may cause respiratory depression in infant.
What are narcotic analgesics.
Infant has large head(must be supported-change position to prevent pressure areas)
Infant has bulging fontanelles/sunset eyes, due to increased intercranial pressure
What is hydrocephalus Page 330-331
Manage with ventriculo-peritoneal shunt-increased risk for infection-watch temp/watch abd. girth-if increases CSF not being absorbed.
Infant is prone to vomiting/poor feeder-feed slowly-lay on side, prone to overstimulation-calm environment.
Most common type of birth injury, precipitate birth, prolonged labor, may result from trauma/anoxia, more often seen in preterm infants. High pitched cry/convulsions/opisthotonos,tense fontanelles.
What is s/s intercranial hemorrhage. Pg. 349-350
Alternate feeding necessary to protect incision(spoon/dropper).
Elbow restrains may be needed.
What is cleft palate/lip care post cheiloplasty.
Prone to dental disorders & ear infection.
Surgical repair (cheiloplasty) done at 3 mos. when stable.
Medication given for pre-eclampsia which may cause respiratory depression.
What is Magnesium sulfate infusion.
Glucocorticoids given to mother pre-delivery, steroid inserted through nasal tube within 72 hours of birth.
What are meds used for premature infant with insufficient surfactant.
Close set/upturned eyes/simian crease in hands, increased risk of heart defects, increased resp. secretions..
What is Down's syndrome. Page 342-343.
Other characteristics: protruding tongues, curved small fingers, space between. second and first toe.
<38 wks. gest. Sucking/swallowing weak, surfactant is deficient, skin is thin/shiny, prone to heat loss/hypoglycemia 2* immature brain/inadeq. glycogen stores. Ears return slowly if folded.
By second year of life growth rate nears term infant.
What is s/s preterm infant. Page 311.
Infant had time to ingest proteins,blood tests done on infant 48-72 hrs. after birth.
Infants have sweet smelling urine,cerumin.
Infants unable to metabolize lactose/galactose.
What is PKU(phenylketonuria).
Synthetic food substitute(phenex) for protein/avoid foods with phenylalanine.
What is MSUD(maple sugar urine disease).
What is galactosemia.
page 341-342.
Infant condition which occurs after child has been fed, resulting in bilious vomiting, abdominal distention, diarrhea and bloody stools.
What is necrotizing enterocolitis (NEC)
Monitor infant for bradycardia if on this infusion.
What is calcium gluconate.
Poor feeder, excessive yawning/sneezing, tremors, hyperirritable.
What is neonatal abstinence syndrome.
Decreases during contractions.
May be decreased due to "aged" placenta in post-term pregnancy.
May be decreased in placenta abruptio/placenta previa.
What is blood flow to placenta.