High-Risk Newborns: Complications and Care

Intrauterine Growth Restriction

Limited fetal growth during advanced gestation.

Small for Gestational Age (SGA)

Weight below 10th percentile for gestational age.

Intrauterine Growth Restriction (IUGR)

Growth restriction due to various maternal factors.

Symmetrical IUGR

Proportional growth restriction in all body parts.

Asymmetrical IUGR

Normal head/body length, but low birth weight.

Hypoxia

Decreased oxygen supply to the fetus.

Aspiration Syndrome

Meconium aspiration before or during birth.

Hypothermia

Inability to maintain normal body temperature.

Hypoglycemia

Low blood sugar levels in newborns.

Polycythemia

Increased number of immature red blood cells.

Large for Gestational Age (LGA)

Weight above the 90th percentile for gestational age.

Complications of LGA

Includes birth trauma and hypoglycemia risks.

Diabetic Mother Newborn

May be SGA or LGA due to maternal diabetes.

Hypocalcemia

Low calcium levels in newborns.

Hyperbilirubinemia

Elevated bilirubin levels causing jaundice.

Birth Trauma

Injuries during delivery, such as shoulder dystocia.

Respiratory Distress Syndrome (RDS)

Breathing difficulties due to surfactant issues.

Congenital Malformations

Structural defects present at birth.

Cold Stress

Excessive heat loss leading to hypothermia.

Jaundice

Yellowing of skin due to bilirubin buildup.

Risk Factors for Neonatal Morbidity

Includes low socioeconomic status and no prenatal care.

Hypoglycemia

Blood sugar less than 40-45 mg/dl.

Signs of Hypoglycemia

Tremors, seizures, apnea, cyanosis, lethargy.

Apnea

Condition of forgetting to breathe.

Cyanosis

Skin turning blue due to oxygen deficiency.

Temperature Instability

Inability to maintain normal body temperature.

Nursing Considerations hypoglycemia

Check blood sugar at 1 hour of life.

Feeding Protocol

Feed baby or use IV dextrose if low.

Prematurity Definition

Newborn delivered before 38 weeks gestation.

Incidence of Prematurity

Occurs in 12% of live births.

Complications of Prematurity

Affects cardiovascular, respiratory, GI, GU systems.

Respiratory Distress Syndrome (RDS)

Insufficient surfactant causing breathing difficulties.

Patent Ductus Arteriosus (PDA)

Abnormal blood flow in the heart.

Thermoregulation Issues

High surface area to mass ratio causes heat loss.

Poor Feeding Reflexes

Includes poor sucking, swallowing, and gag reflex.

Necrotizing Enterocolitis (NEC)

Severe intestinal condition in premature infants.

Glomerular Filtration Rate (GFR)

Decreased in premature infants affecting fluid processing.

Hepatic Complications

Immature liver leads to low iron stores.

Hyperbilirubinemia

Excess bilirubin due to immature liver function.

Immunologic Risks

Higher infection risk necessitating maternal breastmilk.

Neurodevelopment Risks

Brain development interruption leads to IVH, ICH.

Apnea

Cessation of breathing for at least 20 seconds.

Prematurity

Birth before 37 weeks gestation.

Sudden Infant Death Syndrome

Unexpected death of an infant during sleep.

Retinopathy of Prematurity

Eye issues from hyperoxygenation in premature infants.

Cardio/Respiratory Monitoring

Continuous tracking of heart and breathing functions.

Nutrition for Premature Infants

Feeding every 3 hours as tolerated.

Thermoregulation

Maintaining body temperature in newborns.

Infection Prevention

Hand washing is crucial for newborn safety.

Postmaturity

Birth after 42 weeks gestation, rare occurrence.

Hypoglycemia

Low blood sugar due to depleted stores.

Meconium Aspiration

Inhalation of meconium causing respiratory distress.

Fetal Alcohol Syndrome

Disorder from maternal alcohol exposure during pregnancy.

Physical Features of FAS

Short stature, microcephaly, thin appearance.

Long-term Complications of FAS

Impulsive behavior, learning disabilities, cognitive issues.

Substance Abuse Risks

Includes asphyxia, infection, and low APGAR scores.

Withdrawal Symptoms

Occur around 24 hours post-delivery in infants.

Newborn Drug Screen

Urine test for drugs collected immediately after birth.

Social Service Consultation

Involvement for assessing maternal care capabilities.

Behavioral Problems

Emotional and social issues in substance-exposed infants.

Congenital Anomalies

Physical defects present at birth due to substance exposure.

Developmental Problems

Delayed physical, cognitive, or social growth in infants.

Skin-to-Skin Contact

Promotes bonding if infant is stable enough.

Withdrawal Symptoms

Signs like vomiting, diarrhea, and irritability.

Abstinence Scoring

Total score of withdrawal symptoms severity.

Small Frequent Feedings

Helps alleviate withdrawal symptoms in infants.

GI Status Monitoring

Observe for vomiting or diarrhea in infants.

Comfort Techniques

Swaddle, pacifier, and calm infant to soothe.

Skin Protection

Use desitin to prevent skin excoriation.

Decrease Stimulation

Quiet nursery to prevent infant agitation.

Metabolic Screening

Screening done after 24 hours of age.

Phenylketonuria (PKU)

Amino acid disorder causing cognitive disabilities.

Galactosemia

Carbohydrate metabolism disorder affecting newborns.

Homocystinuria

Cystathionine beta synthase deficiency disorder.

Congenital Hypothyroidism

Thyroid hormone deficiency present at birth.

Sickle Cell Anemia

Genetic disorder affecting red blood cells.

Cystic Fibrosis

Genetic disorder affecting respiratory and digestive systems.

Respiratory Distress Syndrome (RDS)

Common infant condition due to low surfactant.

Tachypnea

Rapid breathing rate over 60 breaths per minute.

Respiratory Effort Signs

Includes grunting, flaring, and retraction.

Management of RDS

Includes steroids, surfactant, and respiratory support.

Transient Tachypnea of the Newborn (TTN)

Breathing difficulty in term and late preterm infants.

Meconium Aspiration Syndrome

Aspiration of meconium during first breaths.

Cold Stress

Excessive heat loss affecting newborn temperature regulation.

Jaundice Management

Includes phototherapy and exchange transfusion.

Kernicterus

Brain damage from unconjugated bilirubin deposition.

Hydrops Fetalis

Severe anemia and edema due to maternal antibodies.