Hondros RN NUR220
Terms in this set (67)
What are S/S of RDS (respiratory distress syndrome)?
Tachypnea (>60 breaths per minute)
Pronounced intercostal /substernal retractions
Fine inspiratory crackles
If an infant was found to have RDS, what nursing interventions would be acceptable?
Maintain ventilation/oxygenation/tissue perfusion
Maintaining acid/base balance
Maintaining a neutral thermal environment
Prevention of hypotension
S/S of Apnea of Prematurity
Persistent apneic spells
Management of apnea of prematurity
Complications related to apnea of prematurity
Retinopathy of prematurity
What causes transient tachypnea of the newborn (TTN)?
Lower levels of catecholamins
Risk factors for TTN?
C/S delivery (fluid retention- they do not undergo normal hormonal changes and are unable to absorb fluid)
Materal asthma or diabetes
How is a diagnosis of TTN made? What treatments/nursing interventions would we use?
Chest x-ray; appears streaky and fluid can sometimes be seen
What is a post term infant?
When gestation goes beyond 42 weeks
Which s/s would a newborn with meconium aspiration syndrome exhibit?
Meconium stained skin/umbilical cord
How do we treat meconium aspiration syndrome?
Intubate if infant shows poor respiratory effort, low heart rate, and poor tone
Suction and resuscitate
What affects can be seen in a neonate exposed to Herpes?
Clusters of lesions, opthalmologic, neurologic-meningitis, organ involvement (liver, adrenal glands and lungs)
Neonate exposure to CMV shows which kinds of affects?
Microcephaly, chorio, jaundice, enlarged liver/spleen, rash, seizures or hearing loss
If a neonate is exposed to Gonorrhea, which affects could be seen?
Neonate exposure to Chlamydia can cause what?
Suppose a neonate is exposed to Hep B, what problems could you anticipate?
Changes in liver function
What affects can GBS cause in a neonate?
List some risk factors for a pneumothorax
Assisted ventilation (including CPAP)
Meconium aspiration syndrome
Risk factors for spontaneous preterm birth
History of preterm birth
Genital tract infections
Multifetal gestation (twins, triplets, etc)
Bleeding in the second trimester
Low pre-pregnancy weight
Preterm infants are classified as
Birth before 38 weeks
Full term infants are classified as
Birth at 38-42 weeks
Small for gestational age
Appropriate for gestational age
Large for gestational age
Treatment for Chlamydia
Treatment for Gonorrhea
Treatment for Syphillis
Treatment for Herpes
Treatment for Trichomonas
What kind of characteristics are present in the newborn respiratory system
Thicker alveolar wall
Decreased lung elasticity and recoil
Increased O2 consumption
What are some S/S of abuse?
Dysfunction family dynamics
Controlling significant other
What are the three phases of abuse?
Honeymoon (promises to never do it again, showers her with gifts/love, etc)
What are the signs and symptoms of chorioamnionitis (chorio)
Foul odor to amniotic fluid
What are the risk factors for Chorio?
Internal FHR monitoring
Young maternal age
Low socioeconomical status
Infections in the GI tract
What are the clinical manifestations of NEC?
Abdominal distension; bloody stool
Gastric retention/increased residuals
Localized abdominal wall erythemia
How do we treat NEC?
Continuous monitoring of abdominal circumference
Surgery (if necessary)
When giving Mag Sulfate to suppress uterine activity, what should be considered?
Possibility of mag toxicity (levels above 8)
depressed deep tendon reflexes
What considerations must be made when administering Terbutaline?
What should be considered when giving Indomethacin to suppress uterine activity?
Premature closure of PDA
Which tests are common in pregnancy?
Blood type; RH
Hep B antigen
What is the name of the test performed during pregnancy to test for Syphilis?
What are some nursing considerations for GBS?
Associated with poor pregnancy outcomes
Important factor in neonatal morbidity/mortality
Screening at 35-37 wks can decrease risks to infant
Can lead to newborn sepsis if not treated
How would we go about managing an inevitable preterm birth?
Administer mag sulfate (prevents neonatal neurologic sequelae)
Malpresentation is common
Preparation for neonatal resuscitation
Preparation for loss
Steroids for fetal lung maturity
Which vaccines are common during pregnancy?
Hep A/B (usually recommended)
What do we look for when an infection is suspected in a newborn?
Respiratory status: Grunting, nasal flares, decreased O2 stat
Cardiac: Decreased cardiac output, tachy/bradycardia
Temperature instability, lethargy, irritability
Feeding intolerance, abdominal distension, V/D
Jaundice, pallor, petechiae, mottling
Interventions for PROM
Induction of labor
Avoid frequent vaginal exams
What nursing interventions are done after the baby is born?
Erythromycin on eyes
Vitamin K and Hep B shot
What is the antidote for Mag Sulfate toxicity?
What is the therapeudic window of Mag Sulfate?
What are some distinct characteristics of a preterm infant?
What is TORCH?
Tests that check for several different infections in a newborn
Other- STI's Rubella
What is BPD and what does it do?
Stands for biparietal diameter; which measures the baby's head from side to side via ultrasound. Usually done after the 13th week of pregnancy.
When do the lungs develop during gestation?
What is Naegle's rule?
A tool that is used to estimate the due date of pregnancy by subtracting three months from the last menstrual period and adding seven days.
Based on Naegle's rule, what is the estimated due date if her last menstrual period was 8/12/17?
Based on Naegle's rule, what is the estimated due date if her last menstrual period was 9/22/17?
Based on Naegle's rule, what is the estimated due date if her last menstrual period was 5/18/17?
What is GTPAL?
Tool used on every pregnant patient to assess pregnancy outcomes.
You are caring for a woman in the postpartum unit. She just delivered twins at 35 weeks. She previously delivered two children; one at 38 weeks and a stillborn at 30 weeks. What is her GTPAL?
3, 1, ,3, 0, 3
A woman is currently pregnant. She previously lost a child at 12 weeks. What is her GTPAL?
2, 0, 0, 1, 0
You are taking a pregnancy history, she states she is pregnant now, delivered one child at 38, one at 40, one at 16 and one at 32. What is her GTPAL?
5, 2, 1, 1, 3
What are some presumptive signs of pregnancy?
What are probable signs of pregnancy?
Positive PG test
Hegar's sign (softening of cervix)
Chadwick's sign (Bluish tint to vagina)
Goodall's sign (Softening of cervical lip)
Braxton Hick's contractions
What are some positive signs of pregnancy?
Fetal movement felt by examiner