Exam 2 study guide

What is the definition of preterm labor?

Uterine contractions and cervical changes occurring between 20 and 37 weeks gestation.

What percentage of perinatal morbidity and mortality is accounted for by preterm births?

85%

What is the leading cause of death within the first month of life?

Prematurity

What are the physical characteristics of premature infants?

Thin, transparent skin; abundant vernix; plentiful lanugo; soft skull bones; undescended testes in males; prominent labia in females.

What does fetal fibronectin indicate?

It helps predict delivery risk when found in cervico-vaginal fluid.

epogen

given for iron deficiency anemia to stimulate RBC production

What cervical length indicates that delivery within the next 14 days is unlikely?

A length greater than 3 cm.

What are some nursing management techniques for premature newborns?

Monitor vitals every 15-30 minutes, continuous electronic fetal monitoring, hourly intake and output.

What respiratory challenge do premature newborns face?

Underdeveloped lungs and insufficient surfactant lead to difficulty breathing.

What is the normal temperature range for newborns?

97.9°F to 99.7°F (axillary).

What is a common complication associated with premature newborns?

Respiratory Distress Syndrome (RDS) due to lack of surfactant.

What is the purpose of administering corticosteroids to a mother in preterm labor?

To reduce the risk of complications in the newborn, such as RDS.

What are the signs of respiratory distress in a newborn?

Tachypnea, grunting, nasal flaring, retractions.

What is the Apgar score used for?

To evaluate the newborn's condition at 1 and 5 minutes post-birth.

What does a 0 score in the Apgar appearance category indicate?

The newborn is blue or pale.

What is the significance of administering Vitamin K to newborns?

It prevents Vitamin K deficiency bleeding (VKDB).

What is the normal heart rate range for newborns?

120-160 bpm.

What is the typical weight range for newborns?

2,500-4,000g (approx. 5lb 8oz to 8lb 14oz).

What is a common nursing intervention for jaundiced newborns?

Phototherapy and encouraging frequent feedings.

What is the difference between caput succedaneum and cephalhematoma?

Caput succedaneum crosses suture lines and heals in 24-48 hours; cephalhematoma does not cross suture lines and resolves in about 6 weeks.

What are Epstein's pearls?

Normal cysts found in the mouth of newborns, occurring in about 60% of infants.

What is the role of tocolytics in preterm labor?

They are used to stop contractions.

What is the primary risk factor for respiratory distress in C-section babies?

Lack of chest compression during delivery, leading to more lung fluid.

What does the presence of lanugo indicate in a premature newborn?

It is a sign of immaturity and is typically present in premature infants.

What is the function of surfactant in the lungs?

To reduce surface tension and prevent alveolar collapse.

What are the signs of fluid retention in premature newborns?

Signs may include edema and difficulty regulating fluids and electrolytes.

What is the purpose of monitoring CBC in premature newborns?

To screen for infection and anemia.

What are the potential effects of maternal smoking on premature newborns?

Increased risk of low birth weight and complications.

What is the primary purpose of daily umbilical cord care?

To keep the cord dry and clean, avoiding infection.

What should be done with the diaper in relation to the umbilical cord stump?

Fold the diaper below the cord stump.

What type of baths should be given until the umbilical cord falls off?

Sponge baths only; tub baths are avoided.

What substances should NOT be applied to the umbilical cord?

No alcohol, powders, lotions, ointments, or herbal remedies.

What indicates a potential issue with the spine in newborns?

Dimples or tufts of hair may indicate spina bifida.

What are the normal characteristics of female genitalia in newborns?

Labia majora should be larger than minora and may be edematous due to maternal hormones.

What should be assessed in male newborns regarding genitalia?

Testes should be palpable in the scrotum.

What reflexes should be checked in newborns?

Moro (startle), Grasp, and Babinski reflexes.

What maneuvers are used to check for hip dysplasia in newborns?

Ortolani and Barlow maneuvers.

What is the definition of thermoregulation?

The process of maintaining a balance between heat loss and heat production to maintain a stable core internal temperature.

What is the ideal temperature range for newborns?

97.9°F to 99.7°F.

What is a neutral thermal environment for newborns?

An environment where body temperature is maintained without increasing metabolic rate or oxygen use.

What factors predispose infants to heat loss?

Large body surface area relative to weight, lack of insulating fat, and close blood vessels to the skin surface.

What conditions increase the risk of hypothermia in newborns?

Preterm, SGA infants, medical abnormalities, and environmental factors.

What is the primary method of heat production in newborns experiencing hypothermia?

Nonshivering thermogenesis.

What triggers the sympathetic nervous system in newborns during cold exposure?

Cold exposure activates the sympathetic nervous system, leading to norepinephrine release.

What are the four primary mechanisms of heat loss in newborns?

Convection, Radiation, Conduction, and Evaporation.

What should be monitored to assess a newborn's temperature?

Axillary or rectal temperatures.

What is the first-line treatment for newborn hypothermia?

Skin-to-skin contact with the mother.

What should be done to maintain a newborn's temperature immediately after birth?

Dry the baby quickly to prevent evaporative heat loss.

What is the nursing intervention for hyperthermia in newborns?

Remove excess clothing or blankets and move the infant to a cooler environment.

What is the purpose of circumcision in newborns?

Medical indications, cultural/religious reasons, and hygiene.

What should be applied to the penis tip after circumcision?

Petroleum jelly to prevent sticking to the diaper.

What are normal signs post-circumcision?

Slight redness, small amounts of blood spotting, mild swelling, and yellow film/scab on glans.

What is the expected duration for healing after circumcision?

7-10 days.

What is the significance of monitoring for signs of cold stress in newborns?

Signs include lethargy, relaxed muscle tone, and jaundice.

What should be done to prevent dehydration in newborns?

Promote fluid intake through frequent breastfeeding or IV/tube fluids.

What is the continuum of addiction during pregnancy?

It ranges from social recreational use to physiological dependence.

What percentage of pregnant women in the U.S. are estimated to use illicit drugs?

Up to 10%.

What is the prevalence of alcohol use among pregnant women?

>20%.

What is the prevalence of cigarette use among pregnant women?

19%.

What percentage of pregnant women consume caffeine daily?

~80%.

What challenges exist in reporting substance use during pregnancy?

Many women are reluctant to disclose use due to fear of social or legal consequences.

How does substance abuse in the first trimester affect maternal and fetal health?

It negatively impacts maternal health and fetal development.

What are some complications associated with substance abuse during pregnancy?

Preterm labor, abortion, IUGR, placental abruption, low birth weight, and long-term neurobehavioral abnormalities.

What is a key legal concern for pregnant women using substances?

Fear of being reported to Child Protective Services or facing incarceration.

What is the recommended nursing management for assessing substance use in pregnant women?

Use nonjudgmental screening questionnaires to routinely ask about substance use.

What is Fetal Alcohol Spectrum Disorder (FASD)?

A condition caused by alcohol exposure in utero, leading to various physical and cognitive disabilities.

What are some physical characteristics associated with FASD?

Small eyes, thin upper lip, flattened midface, low nasal bridge, and micrognathia.

What are the effects of nicotine on the fetus?

Causes vasoconstriction, fetal hypoxia, and increases the risk of SIDS and perinatal death.

What are the effects of cocaine on fetal development?

Causes tachycardia, hypertension, and is linked to neural tube and heart defects.

What is Neonatal Abstinence Syndrome (NAS)?

A drug dependency acquired in utero, manifesting as neurologic and physical behaviors in newborns.

What assessment tool is used to track symptoms of NAS?

The Modified Finnegan Neonatal Abstinence Score Sheet.

What are some key symptoms to monitor in newborns with NAS?

High-pitched cry, tremors, sweating, poor feeding, and projectile vomiting.

What is the role of genetics in the study of inheritance?

Genetics is the study of genes and their specific role in inheritance.

What does genomics study?

All of a person's genes (the genome) and their interactions with each other and the environment.

Who is known as the father of genetics?

Gregor Mendel.

What are genes?

The basic units of heredity located on chromosomes that direct cell operation and repair.

What is the structure of DNA?

A double helix with a phosphate deoxyribose backbone and four nucleotide base pairs: G, C, A, T.

What factors can affect genetics?

Gene mutations, advanced maternal and paternal age, teratogen exposure, and maternal habits.

What are some examples of autosomal dominant genetic disorders?

Neurofibromatosis, Huntington's disease, Achondroplasia, and Polycystic kidney disease.

What is the most common chromosomal abnormality associated with intellectual disability?

Trisomy 21 (Down Syndrome).

What are some physical assessment findings for Down Syndrome?

Round face, flat nasal bridge, upslanted palpebral fissures, and small mouth with protruding tongue.

What are the craniofacial features of Down Syndrome?

Round face, flat nasal bridge, upslanted palpebral fissures, small mouth with protruding tongue, and small ears.

What musculoskeletal feature is commonly associated with Down Syndrome?

Hypotonia (poor muscle tone).

What is a common characteristic of the extremities in Down Syndrome?

Single palmar crease (simian line) and a wide 'sandal gap' between the big and second toe.

At what gestational age can Down Syndrome be screened?

Between 11-14 weeks in utero.

What are the least invasive tests for Down Syndrome screening?

Maternal serum sampling and fetal nuchal translucency tests.

What surgical interventions are recommended for Cleft Lip/Palate?

Cleft lip repair typically by 2-3 months of age and cleft palate repair by 6-9 months of age.

What is perfusion in the context of maternal and newborn care?

The flow of blood through arteries and capillaries, delivering nutrients and oxygen to cells and removing waste.

What is the most common type of shock in obstetrics?

Hypovolemic Shock, caused by inadequate intravascular volume due to severe bleeding.

What are late signs of shock?

Systolic blood pressure drops below 90 mmHg, and the patient may progress to a coma.

What factors can impair blood flow during prenatal and postpartum periods?

Hypertension, vascular resistance, mechanical obstruction, and uterine atony.

What are the key assessment findings for Preeclampsia?

Blood pressure readings of 140/90 mmHg or higher, severe headaches, blurred vision, and clonus.

What are signs of HELLP syndrome?

Epigastric pain, upper right quadrant pain, nausea/vomiting, and elevated liver enzymes.

What is Meconium Aspiration Syndrome (MAS)?

Occurs when a baby inhales meconium-stained amniotic fluid, leading to respiratory distress.

What are the primary nursing actions for a miscarriage?

Monitor bleeding and provide emotional support.

What is the key assessment for Ectopic Pregnancy?

Abdominal pain and amenorrhea.

What should be monitored in cases of Placenta Previa?

Painless, bright red bleeding and fetal heart rate (FHR).

What diagnostic test checks for infection or blood loss?

CBC with Differential.

What does a serum transaminase level greater than twice the normal indicate?

Severe preeclampsia or HELLP syndrome.