Newborn Adaptations and Complications

follow-up indications in newborn

resp. distress, muscle tone abnormalities, developmental dysplasia of hip, new born measurements, seizures, jitteriness, feeding difficulty

resp. distress in newborn

grunting, tachypnea, cyanosis, nasal flaring, retractions

muscle tone abnormalities newborn

hypotonia, hypertonia, assymetrical movements

newborn measurements

-Weight: 2500-4000 g (avg. 3400g female, 3500g male)

-Length: 45-55cm (avg. 50cm)

-Head Circumference: 32-38cm (avg. 33-35cm)

colostrum

"first milk", thick, yellow, highly nutritious

how often should newborns be fed?

every 2-3 hr

hunger cues newborn

rooting reflex, lip smacking, hands to mouth, crying (late sign)

good latch

lips outward, chin touching breast, nose free, no pain

critical congenital heart disease (CCHD) s/s

cyanosis, tachypnea, increased work of breathing, poor weight gain, lethary, tachycardia, heart murmur, low feeding

critical congenital heart disease diagnosis

O2 sat <90% in either extremity

O2 sat 90-94% repeatedly

3% difference between hand and foot

omphacele

herniation of abdominal organs through umbilical ring, smooth sac covering organs

gastroschisis

herniation of abdominal organs through opening beside umbilicus (commonly right side), exposed bowel edematous and irritated

difference between gastroschisis and omphalocele

gastroschisis has no protective membrane and organs exposed to amniotic fluid

why do gastroschisis and omphalocele occur?

during fetal development, failure of abdominal wall closure

RF of gastroschisis and omphalocele

smoking, alcohol, young maternal age (gastroschisis), maternal obestity or meds (omphalocele)

s/s of gastroschisis and omphalocele

visible organs outside of body at birth, increased risk for infection, bowel obstruction

complications of gastroschisis and omphalocele

hypothermia, dehydration, infection/sepsis, impaired bowel function

meconium aspiration syndrome

meconium into amniotic fluid due to stress and inhales

what can meconium aspiration syndrome cause?

airway obstruction, inflammation of lung tissues, inactivation of surfactant, alveolar collapse

what can meconium aspiration syndrome lead to?

hypoxemia, increased pulmonary vascular resistance, right-to-left shunting, persistent pulmonary HTN

RF for meconium aspiration syndrome

postterm pregnancy, fetal distress, maternal HTN/diabetes, prolonged labor

s/s of meconium aspiration syndrome

resp. distress, cyanosis, apnea, course crackles, green staining, limp

NA for meconium aspiration syndrome

stimulate, provide O2, cardiac/resp status, maintain mechanical ventilation, glucose

meds for meconium aspiration syndrome

O2, surfactant, inhaled nitric oxide, chest x-ray, blood gas, CBC, cultures

transient tachypnea of the newborn (TTN) cause

delayed clearance of fetal lung fluid

s/s of transient tachypnea of the newborn (TTN)

tachypnea, resp. distress

how long is the onset of transient tachypnea of the newborn (TTN)

24 hr

how long does transient tachypnea of the newborn (TTN) to resolve?

24-72 hr

tx of transient tachypnea of the newborn (TTN)

O2, monitoring

congenital diaphragmatic hernia (CDH)

hole in diaphragm, abdominal organs move into chest

effects of congenital diaphragmatic hernia (CDH)

lung compression, severe resp. distress

s/s of congenital diaphragmatic hernia (CDH)

scalophold (sunken) abdomen, absent breath sounds on the affected side, bowel sounds in the chest, severe hypoxia

tx of congenital diaphragmatic hernia (CDH)

intubation and mechanical vent, gastric tube (decompression), avoid bag-mask ventilation, surgical repair after stabilized

assessment on newborn who has experienced birth trauma

symmetry, reflexes, cranial nerve function