NURS 2866 - Week 2 Seminar

What are the gestational age ranges for preterm, late preterm infant (LPI), and post-term infant?

Preterm: <37 weeks, Late preterm infant (LPI): 34–36 weeks + 6 days, Post-term: ≥42 weeks.

What are key characteristics of preterm infants?

Immature organ systems, poor thermoregulation, weak suck, respiratory instability, increased risk for hypoglycemia, infection, and feeding difficulties.

What are key characteristics of late preterm infants (LPI)?

Appear mature but physiologically immature, poor feeding, weak suck, temperature instability, hypoglycemia risk, jaundice risk, and possible respiratory distress.

What are key characteristics of post-term infants?

Dry/peeling skin, decreased subcutaneous fat, long nails, possible meconium staining, increased risk for hypoglycemia and respiratory distress.

What nursing interventions are indicated in the delivery room for a late preterm infant?

Dry immediately, provide skin-to-skin contact, maintain neutral thermal environment, delay bathing, monitor respiratory status, assess for distress, monitor blood glucose, support early feeding, and closely observe transition.

What should the mother be taught regarding feeding a late preterm infant?

Feed every 2–3 hours, wake infant if sleepy, monitor feeding cues, ensure proper latch, watch for fatigue, and track wet/dirty diapers.

What education is appropriate when a late preterm infant appears “fine” but is sleepy and feeding poorly?

Educate that LPIs are high-risk despite appearance, emphasize risks of hypoglycemia, jaundice, and poor feeding, stress importance of frequent feeding and monitoring, and explain that excessive sleepiness may indicate a problem.

What is priority discharge teaching for a late preterm infant?

Feed every 2–3 hours, monitor for jaundice, ensure adequate output, maintain warmth, watch for hypoglycemia signs, and ensure early follow-up care.

What are the possible risks to the fetus/newborn in a pregnancy with heroin use and limited prenatal care?

Neonatal abstinence syndrome (NAS), low birth weight, preterm birth, infection, poor feeding, respiratory distress, and developmental issues.

What are the possible risks to the mother with heroin use during pregnancy?

Infection, poor nutrition, inadequate prenatal care, risk of overdose, and complications during labor and postpartum.

How does the nurse determine what a newborn has been exposed to in utero?

Maternal history, prenatal records, urine toxicology, meconium testing, and umbilical cord drug screening.

Can a mother who used heroin breastfeed?

No, breastfeeding is contraindicated with active illicit drug use such as heroin due to risk of drug transmission to the infant.

When should signs of neonatal abstinence syndrome (NAS) be expected?

Typically within 24–72 hours after birth, depending on the substance.

What signs and symptoms of neonatal abstinence syndrome (NAS) should be monitored?

Tremors, irritability, high-pitched cry, poor feeding, vomiting, diarrhea, sweating, sneezing, yawning, sleep disturbances, seizures, and hypertonia.

What type of supportive care can be provided for a newborn with NAS?

Swaddling, minimizing stimulation, dim lighting, skin-to-skin contact, frequent small feedings, non-nutritive sucking (pacifier), and maintaining a quiet environment.

What does the Finnegan Score indicate?

It is a scoring system used to assess the severity of neonatal abstinence syndrome and determine the need for pharmacologic treatment.

Why did the nurse notify the social worker for this patient?

Due to maternal substance use, limited support, and concern for infant safety, requiring evaluation for safe discharge planning and possible protective services involvement.

What type of treatment is available for a newborn with neonatal abstinence syndrome?

Supportive care first, and if severe, pharmacologic treatment such as morphine or methadone to manage withdrawal symptoms.

What are concerning signs in Abby’s condition on day 2 of life?

Tremors, loose stools, poor feeding, inability to latch, excessive weight loss (9%), irritability, inconsolability, and sleep disturbances.

Why is weight loss of 9% in 24 hours concerning in a newborn?

It indicates inadequate feeding and possible dehydration or worsening withdrawal symptoms.