The High Risk Newborn

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  • Topic: Childbirth, Bilirubin, Patent ductus arteriosus
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  • Published : October 10, 2012
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Rosdahl and Kowalski
TEXTBOOK OF BASIC NURSING

PART C – Nursing Throughout the Life Cycle

CHAPTERS: Unit 10
The High-Risk Newborn

New Terminology

ABO incompatibility

anencephaly

choanal atresia

cleft lip

cleft palate

congenital

endotracheal tube

epispadias

erythroblastosis fetalis

esophageal atresia

exstrophy

galactosemia

high-risk newborn

hydrocephalus

hyperbilirubinemia

hypospadias

New Terminology, cont.

imperforate anus

kangaroo care

kernicterus

LS ratio

macrosomia

microcephaly

pathologic jaundice

phototherapy

physiologic jaundice

polydactylism

postterm

preterm

pyloric stenosis

retinopathy of prematurity

New Terminology, cont.

Rh sensitization

spina bifida

syndactylism

talipes

thrush

toxoplasmosis

transient tachypnea of the newborn

respiratory distress syndrome

Acronyms

AGA

ASD

CMV

CPAP

CSF

ET tube

FAS

IUGR

LBW

LGA

NEC

PKU

RDS

ROP

SGA

SIDS

TORCH

TTN

VLBW

VSD

Figures

66-5 Grading of Neonatal Respiratory Distress

73-1 Child with Fetal Alcohol Syndrome

In Practice

Nursing Care Plan 68-1 The Preterm Neonate Experiencing Difficulty Regulating Body Temperature

Important Medications 68-1 For the Heroin-Addicted Newborn

Boxes

68-2 Risk Factors for Newborn Hypoglycemia

68-3 Typical Signs of Hypoglycemia

Small-for-Gestational-Age Newborn

Infant that does not grow normally in utero

Intrauterine growth restriction (IUGR)

Leading cause of small-for-gestational age (SGA) newborn

Causes of SGA Newborns

Maternal conditions related to pregnancy, eg,

Pregnancy-induced hypertension

Diabetes mellitus

Congenital defects

Chromosomal abnormalities

Causes of SGA Newborns, cont.

Poor maternal nutrition

Intrauterine infections

Maternal substance abuse, including alcohol

Maternal cigarette smoking

Causes of SGA Newborns, cont.

Multiple gestations (eg, twins, triplets)

Placental abnormalities, eg,

Placenta previa

Placental abruption

Causes of SGA Newborns, cont.

Maternal history of chronic problems, eg,

Cardiac disorders

Kidney disease

Hypertension

Malnutrition

Characteristics of SGA Newborns

Poor skin turgor

Loose and dry skin

Sparse or absent hair

Wide skull sutures

Diminished muscle and fatty tissue

Weight, length, and head circumference are below normal expectations

Characteristics of SGA Newborns, cont.

Common problems

Respiratory distress

Hypoglycemia

Thermal regulation

Other problems

Prolonged infantile apnea

Delayed neurologic development

Sudden infant death syndrome (SIDS)

Large-for-Gestational-Age Newborn

Macrosomia

Large for gestational age (LGA)

Birth weight exceeds 90th percentile

Mother diabetic

Elevated blood glucose levels in woman increase glucose available to fetus

Stimulates additional insulin production by the fetal pancreas

Problem arises when baby is delivered and supply of excess glucose terminated

Large-for-Gestational-Age Newborn, cont.

Newborn quickly uses all available carbohydrates and may develop hypoglycemia

Other problems

Birth injury (eg, fractured clavicle, skull fracture, and brachial nerve palsy)

Respiratory disorders

Brain injuries

Postterm Newborn

Gestation >42 weeks

Respiratory or nutritional problems

Placenta unable to provide adequately for them after the normal gestation...
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