2019_HiRisk Infant Outline.docx - NEWBORNS AT RISK OUTLINE...

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NEWBORNS AT RISK OUTLINE Objectives 1. Identify factors that help the nurse anticipate an at-risk newborn 2. Identify, compare, and contrast physiologic complications of the SGA, LGA, IUGR, post-dates, IDM and preterm newborn 3. Explain nursing care of the substance exposed newborn 4. Discuss newborn birth-related stress (cold stress, hypoglycemia, hyperbilirubinemia, and sepsis) 5. Discuss the nursing care of infants at-risk CONDITIONS PRESENT AT BIRTH ANTICIPATE What information, if found on the Prenatal record, would alert the intrapartum or newborn nursery nurse to possible neonatal problems? - rhogam status - vaccinations - diabetes - high levels of sugar → may have increased their levels of insulin to respond they are removed from the source (mother) and have a high amount of insulin, their blood sugar with drop - substance abuse - hypertension What may have compromised the fetus in utero? Maternal medical and prenatal history prenatal care socioeconomic status maternal medical disorders gestational age maternal age congenital abnormalities? older moms have chromosomal abnormality pregnancies older moms also have more chronic diseases younger moms have psychological issues (not developed yet) What occurred in labor? Duration and course Maternal well-being did mother have any medications during labor? Fetal well-being
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NEWBORNS AT RISK OUTLINE Case Study ( underline concerning aspects of Baby James history ): Baby James was born via a normal spontaneous vaginal delivery at 36 weeks gestation in a small community hospital. The mother arrived at the emergency room at 9 cm, 100% effaced, reporting ruptured membranes for 22 hours. Baby’s fetal heart tones were 170 bpm . The mother delivered in the emergency room 30 minutes after being examined. This is her seventh pregnancy and she did not have prenatal care . Baby James was admitted to the observation nursery from the emergency room where he was born. He weighed 5 lbs and was 19 inches long. His APGARS were 6 at one minute and 8 at 5 minutes. He has acrocyanosis. His initial glucose at 30 minutes of age was 35 and vital signs were HR 150, RR 76 temp 97.2 (axillary) . The nurse noted nasal flaring, grunting and coarse breath sounds . - respiratory distress - tachypnea - ruptured membrane, exposure to infection - seventh pregnancy - low glucose - 36 weeks - no prenatal care - precipitous delivery = delivery that was unattended - precipitous labor = less than 3 hours - fast delivery or C section delivery may cause baby to have course breath sounds because they have excess fluid in lungs - TTN - transient (temporary) tachypnea of newborn IDENTIFY Neonatal Mortality: possibility of death within 1 st 28 days Neonatal Morbidity: poor health outcome as a result of adverse influences or treatments acting either on the fetus during pregnancy and/or the infant during the first four weeks of life.
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  • Fall '19
  • Neonatal jaundice, Hyperbilirubinemia

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