OB Quiz #5

Newborn Measuring

100

Intrauterine Growth Restriction (IUGR) is the most common underlying condition leading to a newborn being which gestation age:

Small for gestational age SGA

200

What does SGA, AGA, LGA stand for:

Small for gestational age

Appropriate for gestational age

Large for gestational age

300

3 measurements used to help determine gestational age after birth:

Weight

Length

Head Circumference

400

What are the 2 major categories of maturity assessed and what is the system called:

Ballard Scoring System

Neuromuscular maturity

Physical maturity

500

What is this called?

Ballard Scoring System

S/S for SGA and LGA

100

Maternal diabetes, genetic makeup, obesity, gender, multiparous are all contributing factors of:

LGA

200

What is this called?

Lanugo

300

Brown Fat

*Remember premature infants do not have this

400

Nursing care for a SGA newborn

Monitor respiratory status, maintain neutral thermal environment, monitor blood glucose levels, monitor other blood studies, observe feeding tolerance, monitor I&O and daily weights, observe for jaundice, encourage family caregivers to care for infant

500

Potential complications for a LGA birth:

Cesarean delivery, breech presentation and shoulder dystocia resulting in birth injuries and trauma: fractured skull or clavicles, cervical or brachial plexus injury or Erb palsy.

Preterm Newborn

100

What can happen after a gavage feeding

Gastric Residual

200

Name RDS treatments:

Surfactant replacement therapy, antenatal steroids, appropriate resuscitation techniques, immediate use of nasal continuous positive airway pressure, gentle ventilation procedures, supportive care

300

What complication might require laser surgery:

Retinopathy of prematurity

400

Common Complications of a Preterm Newborn:

RDS, thermoregulation, maintaining fluid and electrolyte balance, has high caloric needs but inadequate digestive system, hyperbilirubinemia, infections, intraventricular hemorrhage, retinopathy of prematurity, NEC, jaundice, and infection

500

Subtle and nonspecific s/s; no ORAL feedings, NG suctioning, IV fluids, TPN, Antibiotics; possible bowel perforation

Issues with feeding, maintaining a stable temp, and vomiting bile

Necrotizing Enterocolitis

Postterm and Respiratory

100

What gestation weeks is considered postterm and also the weight of the infant:

>42 weeks gestation

infant is postterm regardless of weight

200

Define Polycythemia related to Postterm newborns

due to intrauterine hypoxia

300

Which syndrome shows the following:

Amniotic fluid stained green/greenish black or seen on newborn

Difficulty initiating respirations after birth

low Apgar score

Tachypnea or apnea

Retractions

Grunting

Nasal Flaring

Cyanosis

Confirmed with CHEST x-ray

Meconium Aspiration Syndrome

400

The 5 contributing factors related to Transient tachypnea of the newborn

Cesarean delivery

prematurity

SGA

Maternal Diabetes

Maternal Smoking

500

Treatments for TTN and what do we monitor for:

IV fluids

Gavage feedings

Supplemental oxygen

Care:

Supportive

Monitor VS and oxygen saturation levels

IV fluids

Supplemental oxygen

Assist family to understand

Education about situation

Respiratory and Hemolytic

100

How should we teach families to lay their infant down to sleep until at least 6 months:

Supine

200

Related to Fetal alcohol syndrome...When should a mom stop drinking?

3 months prior to pregnancy and throughout pregnancy

300

Nursing care for Neonatal abstinence syndrome (NAS):

Providing physical and emotional support

Meds to assist with withdrawal and prevent complications such as seizure

Holding and gently rocking infant, swaddling

Minimize stimulation in environment

Maintain airway and monitor respiratory status

Frequent feedings, I&O, supplemental fluids

Non-judgement toward mother and family

400

S/S for infant with a congenitally acquired infection

Remember may not demonstrate usual s/s look for:

Cyanosis

Pallor

Thermal instability

Convulsions

Lethargy

Apnea

Jaundice

OR Just "not looking right"

500

Clinical manifestations for FAS:

When withdrawing:

hyperactive

Irritable

Trouble Sleeping

Tremors or seizures

FAS s/s:

LBWA

Small height and head circumference

Short palpebral fissures

Reduced ocular growth

Flattened nasal bridge

Newborn prone to respiratory difficulties

Hypoglycemia

Hypocalcemia

Hyperbilirubinemia

Growth during infancy and childhood below average

Brain damage permanent resulting in intellectual disability

CNS

100

Nurses assess what for a patient with Hydrocephalus:

Head Circumference DAILY

200

Failure of the posterior laminae of the vertebrae

Spina Bifida

300

When is the last week of gestation will a doctor perform a intrauterine surgery to fix spina bifida:

26 weeks

400

Clinical manifestations with Hydrocephalus:

Rapid head growth with widening cranial sutures

Anterior fontanelle becomes tense and bulging

Skull enlarges in all diameters

Scalp becomes shiny and veins dilate

Eyes appear to be pushed downward slightly, sclera visible above iris

Neck muscles fail to develop sufficiently, newborn has difficulty raising or turning head

Increasingly helpless, increased intracranial pressure

500

Treatment options for Hydrocephalus:

Surgical Intervention

Ventriculoperitoneal Shunting

Cardioand Chromosomal

100

BP in upper extremities are higher than the lower extremities

Coarctation of the aorta (constriction or narrowing of aortic arch)

200

Loud harsh murmur associated with systolic thrill

Ventricular septal defect

300

When the ductus arteriosus remains open after birth, shunts blood from aorta to pulmonary artery

Corrected by medication and/or surgery

Patent Ductus arteriosus

400

Extra X chromosome present (characteristics not evident until puberty); most common in males

Klinefelter Syndrome

500

Clinical Manifestations:

Brachycephaly; short stature; upward and outward slanted eyes with epicanthic fold at inner angle; short, flattened bridge of nose; thick, fissured, protruding tongue; dry, cracked, fissured skin that may be mottled; small hands with short broad fingers and curved fifth finger; single deep crease on palm of hand; wide space between first and second toes; lax muscle tone; heart and eye anomalies; greater susceptibility to leukemia

Down Syndrome

GI/GU

100

How do you feed an infant with an omphalocele

TPN

200

What needs to occur if an infant is born with a diaphragmatic hernia

surgery to repair

300

Cleft lip and palate

Diagnosis:

Treatment (surgery)-what should you teach the caregiver

Diagnosis:

Physical appearance

Trouble feeding/sucking

Treatment teaching:

After feeding keep incision clear of crusting

400

If an infant has a hypospadias or epispadias why does the pt have to wait for a circumcision

The foreskin is used in the repair

500

Difficulty feeding, chocking, cyanotic and frothy sputum

Esophageal Atresia and tracheoesophageal fistula

Skeletal and Metabolism

100

Diagnosis and Treatment for Congenital Hypothyroidism

Diagnosis:

T3 and T4 levels

Treatment:

Replacement of thyroid hormone (Levothyroxine); monitor levels

Therapy must be continued for life

200

Gluteal fold higher on one side than the other

Dysplasia of the hip

300

Congenital Talipes Equinovarus (clubfoot)

Treatment

Nonsurgical and when is surgical done

Nonsurgical: use of plastic splint or cast; casts changed frequently until radiographic evidence of correction

Surgical: used if no response to nonsurgical treatment

400

Early feeding difficulties with vomiting and diarrhea, producing dehydration, weight loss, jaundice

Galactosemia

500

Phenylketonuria (PKU)

Clinical Manifestations:

Frequent vomiting, aggressive and hyperactive traits, severe, progressive mental disability, convulsions, eczema, musty smell to urine