Preterm and Post-term Newborns PDF

8/22/2024 Preterm and Post-term Newborns Chapter 13 Niomi Quinteros, BSN, RN LGA Large for Gestational Age Over 8.8 pounds (4000 g) SGA Small for Gestational Age (Can be low birthweight) 1  8/22/2024 Preterm Newborn Gestation >...

8/22/2024 Preterm and Post-term Newborns Chapter 13 Niomi Quinteros, BSN, RN LGA Large for Gestational Age Over 8.8 pounds (4000 g) SGA Small for Gestational Age (Can be low birthweight) 1  8/22/2024 Preterm Newborn Gestation > 37 weeks 2  8/22/2024 Also applies to low - birthweight  Preterm Characteristics  Skin: Transparent & loose  Superficial Veins (abdomen & scalp)  Lack of SQ fat  Lanugo on forehead, shoulders, arms  Vernix caseosa abundant  Extremities appear short  Few creases on soles of feet  Protruding abdomen 3  8/22/2024 Respiratory  Causes  Oxygen  RDS  Surfactant  Vital Signs / Cluster Care  Apnea / Bradycardia  Neonatal Hypoxia  Pulse oximetry Temperature  Causes  Cold Stress  Skin Probe  Radiant Warmer 4  8/22/2024 Cold Stress Hypoglycemia  Causes  Signs  Glucose monitoring  Feedings 5  8/22/2024 Hypoglycemia Signs and Symptoms  Causes  Nursing Care  Monitor neurological status Bleeding  Bulging fontanelles, lethargy, poor feeding, and seizures (ICP)  Slight Fowler’s position  Cluster care 6  8/22/2024  Nutrition  Causes  Small stomach capacity  Immature sphincter muscles  Immature suck and swallow  Inadequate store of nutrients  Feedings  Gavage  Problem: Immature Kidneys  Causes  Nursing Care  I&O  Assess fontanelles, turgor, and weight Jaundice  Causes  Immature liver  Nursing Care  Observe infant’s skin, sclera, and mucous membranes for jaundice  Phototherapy At risk for brain damage 7  8/22/2024 Nursing Goals for Preterm Infant Box 13-1 Nutrition Thermoregulation Feedings Incubator / Warmer Kangaroo Care Bowel Sounds Special Meconium Supplemental Needs Vitamins Positioning: side-lying Prognosis & Family or prone Reaction 8 8/22/2024 9  8/22/2024 Nursing Care & Discharge Planning / Teaching  Post-term Newborn Problems  Asphyxia  Meconium aspiration  Poor nutritional status  Polycythemia  Difficult deliveries  Birth defects  Seizures 10