Upgrade to remove ads
NICU StaRN Module 1.1
Terms in this set (58)
What is not enough fluid in the amniotic sac? What about too much?
Intrauterine growth restriction may be associated with what that a mom might do?
recreational drug use
Birth trauma may cause the baby to have low _____ at birth
A condition that happens when a pregnant woman's blood protein is incompatible with the baby's, causing her immune system to react and destroy the baby's blood cells.
Preeclampsia is defined as a pregnancy -specific syndrome occuring after the _____ week of gestation
Preeclampsia is a systolic BP greater than _____mmHg or a diastolic BP greater than _____mmHg on at least how many occasions? At least _____ hours apart while the woman is in what physical state?
Does preeclampsia involve proteinurea?
yes- there is USUALLY protein in the urine but there are new guidelines in which protein does not have to be found in urine, however there must be new onset of thrombocytopenia, renal insufficiency, impaired liver function, pulmonary edema, or cerebral or visual symptoms
What organ function does creatinine measure?
Preeclampsia has two classifications, preeclampsia with _______ features and preelcampsia without _______ features.
severe- multiorgan dysfunction because of damage to blood vessels
A sign of Preeclampsia with severe features is a Systolic BP greater than ____ mmHg or greater than _____mmHG diastolic? (on two occasions at least 4 hours apart while the woman is on bedrest)(Without antihypertensives)
(this is life threatening)
how much fluid can you inject in an IM in a newborn in the vastus lateralis?
Why is the liver function impaired with Preeclampsia with severe features?
Because hepatic cells are damaged by the high BP
Liver enzymes AST and ALT will be high
What are signs of liver rupture caused by preeclampsia with severe features? (2 main things)
epigastric pain or right upper quadrant pain
Does urine output increase or decrease with preeclampsia with severe features? Why is there protein in the urine?
decreases- the kidneys are damaged and filtration rate slows down
Becuase the tubules are broken like a net and protein escapes into the urine
Will thrombocytes (platelets) be high or low with Preeclampsia with severe features?
low- damage to cells and tissue causes RBC destruction, platelet aggregation, and consumption of clotting factors to repair damaged cells
Why does preeclampsia with severe features cause headache, blurred vision, dizziness, altered LOC, and hyperreflexia?
Increased intracranial pressure
What two conditions can preelcampsia lead to as it gets worse?
IUGR is associated with decreased uterine _________ in women with chronic hypertension and severe preelcampsia
perfusion or oxygenation
Why is a mom with preeclampsia given magnesium?
to prevent seizures and lower maternal BP
Why do antihypertensives used to treat preeclampsia lead to fetal distress?
because they lower BP which lowers oxygen supply to baby
What should you look for in an infant whose mother had magnesium to treat preeclampsia?
respiratory and neuromuscular depression- weakness, flaccidity, poor suck
Gestational bleeding in the _____ or _______ trimester is associated with increased risk of preterm labor, premature ROM, and low birth weight.
What are the two most common causes of maternal bleeding in the third trimester?
Placental abruption and placenta previa can cause low ______ in the fetus and varying degrees of _______ at birth.
After 20 weeks of gestation, changing maternal hormonal levels _____________(increase or decrease) cellular resistance to insulin? What does this result in?
This can be good for the fetus to grow and add to fetal fat stores
The fetal response to excess glucose load is to increase _________ production.
Between what weeks gestation is the glucose challenge test (non-fasting) performed? How long after the glucose was consumed is the BG checked?
Fasting glucose should not be above what?
Respiratory distress in the infant of a mother with diabetes may be seen, as insulin interferes with ________ production.
Hypoglycemia- it is important to evaluate the growth pattern early to anticipate when the highest risk of hypoglycemia may present. For example, the LGA infant tends to become hypoglycemic early, often within the first ______ minutes, while an IUGR newborn may present with hypoglycemia s late as _____-_____ hours postnatal.
___________________ occurs in 19% of infants of mothers with diabetes because there are more RBCs to break down.
Hyperglycemia is a powerful stimulus to fetal erythropoietin production, mediated by decreased fetal oxygen tension. This results in ____________.
relating to childbirth and the processes associated with it.
How serious is shoulder dystocia? The shoulder is usually stuck against what?
very bad- an emergency
the pubic symphysis
When the infant's shoulder is trapped in the maternal pelvis, the nerves of the neonate's _______ plexus may be stretched and injured
Shoulder dystocia can result in broken _____ or _____ and _______ palsy
Infants with shoulder dystocia may have decreased oxygen which may make them candidates for _______ treatment
Many cases of brachial plexus palsies are transient with the newborn recovering ______ function in the first week of life
While the fetus is in the mother's uterus, the _______ serves as the fetal lungs and is responsible for oxygen and CO2 exchange.
Surfactant is secreted into the amniotic fluid by the fetal lung before _____ weeks gestation. There is enough surfactant to support extrauterine respiration by week ____ gestation.
In the days leading up to the onset of labor, _____________ are release from the maternal circulation and cross the placenta. These signal the fetal lung to stop producing fetal lung fluid and begin reabsorbing fluid.
Once the umbilical cord is clamped, oxygenated blood flow to the infant stops which causes a decrease in O2 pressure, an increase in CO2 pressure, and a decrease in pH (similar to respiratory acidosis). These changes cause stimulation of the fetal aortic and carotid chemoreceptors that in turn stimulate the respiratory in the _____ and neonatal respiration. The brief episode of hypoxemia that occurs during normal birth therefore helps stimulate respiration.
Is it normal to hear fine crackles in the first 12-24 hours of life?
yes- fetal lung fluid can take 12-24 hours to fully reabsorb
If respiration does not occur after a _____ (how long) period of vigorous tactile stimulation, resuscitative efforts should begin right away.
Lung compliance improves in the few hours after birth due to an increased level of circulating ______. These decrease fetal lung secretion and increase fetal lung fluid absorption.
What is an example of a catecholamine? Where are these made?
adrenal gland above the kidneys
The ability to build functional residual capacity in the lungs depends on the presence of adequate ________. Lung compliance improves as airway resistance _______( increases or decreases)?
Does an infant's initial breath take a little bit of work or a lot?
think of a balloon that has never been blown up compared with one that has been expanded several times; inflation becomes easier with each expansion. If a child has spit into the balloon before blowing it up, the initial effort to expand the balloon is even greater, just as it is with sticky alveloli
________, possibly as a result of positive pressure ventilation in the resuscitation area, is suggested by the combination of tachypnea, increasing oxygen requirement, irritability, shift of the point of maximum impulse, and distant heart tones.
Retained lung fluid is also termed ________ ________. When is this concerning?
if the infant appears to be in distress (RR>120) and oxygen requirement is above 40%
It is important to check the patency of nares for what possible condition?
Asymmetry of breath sounds may indicate what?
air leak syndrome (Pneumothorax)
What is a common cause of pneumothorax?
PPV (Positive pressure ventilation)
Retained lung fluid or transient tachypnea should not be concerning unless the infant appears to be in ______ and the FiO2 requirement is above _____%
If respiratory distress is severe, there may also be ________ involvement.
If there is airway obstruction from meconium or gas trapping, the chest may become ________-shaped along with increasing distress.
Upper airway obstructions often occur in neonates with _________ anomalies.
congenital (E.g. Pierre Robin- small mandible)
You might also like...
NUR 253 Maternal Final- Lehrian
High Risk Pregnancy
Exam 3: Adaptive Quizzing
Other sets by this creator
Drone Certification USA
ACLS StaRN Flashcards
Other Quizlet sets
POLS 2306 Cumulative Exam study
Management ch 10
Developmental Psych Ch 1-7 Review