OB Exam 4: Newborn Complications

key manifestations of Respiratory Distress Syndrome (RDS): (8)

1. tachypnea

2. nasal flaring

3. grunting (trying to keep lungs open)

4. retractions

5. cyanosis

6. hypoxia

7. decreased cap refill

8. crackles

*premie babies dont haven enough surfactant

Whats Transient Tachypnea of the Newborn? (7)

• TEMPORARY, NORMAL respiratory manifestations w/in 1st hour of birth

1. rapid, shallow resp effort

2. nasal flaring

3. grunting

4. retractions

5. cyanosis

6. crackles

7. diminished breath sounds

3 ways Apnea of Prematurity can present as:

1. stops breathing for > 20 secs

2. stops breathing for < 20 secs w/ bradycardia of < 80 bpm

3. stops breathing for < 20 secs w/ O2 < 85% (cyanosis)

• basically immature brain forgets to tell body to breathe

main nursing interventions for Congenital Diaphragmatic Hernia? (4)

1. DONT bag mask ventilate (pushes air into stomach!!)

2. endotracheal intubation immediately!!!!

3. NG tube (decompress stomach)

4. turn on AFFECTED side

signs of Developmental Dysplasia of the Hip in newborns (DDH): (3)

1. uneven skin folds of the thigh/butt folds

2. leg length shorter and knee height lower

3. hip “click” when moving (Ortolani/Barlow Test)

clubfoot signs: (2)

1. one/both feet turned inward and downward

2. calf atrophy

tx:

• splinting

interventions for Developmental Dysplasia of the Hips in newborns: (4)

1. Pavlik harness (keeps hips in place (wear 1-3 mons consistently)

2. skin care from harness irritation

3. proper positioning (hips flexed/abducted)

4. assess perfusion

how can spina bifida occulta present:

• interventions: (3)

looks like deep dimple or tuft of hair at base of spine

1. sterile dressing w/ warm saline

2. occlusive dressing

• completely seals the wound from air and moisture

3. side/prone position

Esophageal Atresia (EA)/ Tracheoesophageal Fistula (TEF) signs: (4)

1. excess drooling

2. cyanotic w. respiratory distress

3. cough/choke related to excessive secretions in esophagus

4. NG tube doesnt pass into stomach

what is Omphalocele vs gastroschisis in newborns?(2)

Omphalocele

1. organs stick out through the umbilical cord

2. covered by thin sac

Gastroschisis

1. organs stick out 2-5 cm RIGHT of cord

2. NO sac covering so organs exposed

Omphalocele care: (2)

1. cover in sterile, saline soaked gauze

2. wrap lower half of body in clear sterile bag

when to give Rh to mom? (3)

1. 28 weeks gestation

2. w/in 72 hrs of birth

3. after any traumatic procedures/events (amniocentesis, ectopic preg etc…)

what does TORCH stand for?

• what are risk factors to this (5)

Toxoplasmosis

Other (syphilis, HIV)

Rubella

Cytomegalovirus

Herpes

1. chorioamnionitis

2. + GBS

3. preterm birth < 37 w.

4. ROM > 18 hrs b4 birth

5. STIs

key signs of Neonatal Abstinence Syndrome: (6)

1. mottled skin

2. excessive cries

3. hyperactive reflexes

4. hypertonia

5. seizures

6. feeding issues

nursing intervention for Neonatal Abstinence Syndrome: (2)

1. baby gets drug they’re addicted to via IV and weened off (morphine, methadone most common)

2. NO naloxone!!! (contraindicated)

physiological jaundice v. pathological jaundice:

physiological (normal)

• > 24 hrs after birth

• resolves 2-3 weeks

pathological:

• within 24 hr of birth (baaadd)

whats the Universal Screening Process based on PKU?

• heel stick needs to be done b/w 24-48 hrs after birth

  • AFTER baby eats

what are complications of newborns with diabetic moms? (4)

1. polycythemia

• infant makes more RBC bc insulins high d/t being exposed to moms high sugar → stressed/hypoxic = ⬆erythropoietin and H&H

2. macrosomia

3. plethora (ruddy, dusky skin d/t excess blood volume)

4. hypoglycemia after birth

Intervention for newborns w/ Diabetic moms:

• early frequent feeds to maintain blood glucose > 45 mg/dL

  • bc newborn will by hypoglycemic after delivery

Common neonatal infections: (10)

1. neonatal gonorrhea

• severe: ophthalmia neonatorum and sepsis

2. toxoplasmosis

3. cytomegalovirus

4. HSV

• vesicular lesions

5. syphilis

• lesions on palms and soles

6. zika virus

• microcephaly (has brain damage)

7. congenital rubella syndrome

• blueberry muffin rash

8. varicella

• skin lesions

9. HPV

• Hydrops fetalis

  • fluid builds up in 2+ fetal compartments

10. Sars-CoV-2

• resp. problems

• feeding intolerance