68C_PP03L011_The Newborn with a Congenital Malformation or Perinatal Injury_V 2.0.pdf

Introduction to Maternity and Pediatric Nursing, 8th Ed., pp. 328 - 353 Structure Function Metabolism congenital malformations Hydrocephalus Spina bifida Newborn infant with Spina Bifida Acetazolamide Furosemide Bypass Shunt Myelodysplasia FIG. 14.4 Types of Spina Bifida. (A) Spina bifida occulta. T...

Introduction to Maternity and Pediatric Nursing, 8th Ed., pp. 328 - 353 Structure Function Metabolism congenital malformations Hydrocephalus Spina bifida Newborn infant with Spina Bifida Acetazolamide Furosemide Bypass Shunt Myelodysplasia FIG. 14.4 Types of Spina Bifida. (A) Spina bifida occulta. There is a defect in the bony canal. The meninges and spinal cord are normal. (B) Spina bifida cystica meningocele. The spinal cord is normal, but there is a defect in the bony canal. The meninges protrude through this defect. (C) Spina bifida cystica meningomyelocele. There is a defect in the bony canal. The meninges protrude, and the spinal cord protrudes through the defect. A child with a hairy patch in the lumbosacral region, indicating the site of spina bifida occulta Meningocele Meningomyelocele An infant with a unilateral cleft lip and palate Treatment Surgical repair Cheiloplasty Ortolani’s sign Barlow’s Test Pavlik harness Spica cast Pavlik harness Spica cast sapropterin dihydeochloride (Kufan) Ketoacidosis Galactose and lactose Galacotsemia Galactosuria What confirmation test is done positive results on a screening test? a. low in fatty acids to promote intellectual development b. high in soluble fiber to reduce constipation c. low in phenylalanine to limit buildup of the protein d. fluid restricted to reduce the wastes delivered to the kidneys Trisomy 21 Mosaicism Translocation Three Nondisjunction piece of chromosome in the pair Amniocentesis Simian line ERYTHROBLASTOSIS FETALIS Rh- positive fetus RhoGAM Kernicterus Bilirubin toxicity- excessive amounts of bilirubin in brain tissues What is the appropriate nursing action in response to these signs and what treatment might the health care provider order? Subdural Subarachnoid Intraventricular PATHOPHYSIOLOGY TRANSIENT TACHYPNEA OF THE NEWBORN Occurs after cesarean birth or rapid vaginal delivery Associated with slow absorption of lung fluid after birth MANIFESTATIONS Tachypnea Chest retractions Grunting Cyanosis Resolves after three days TREATMENT Supportive Provide warmth Conserve energy Supplemental oxygen MECONIUM ASPIRATION SYNDROME PATHOPHYSIOLOGY MANIFESTATIONS Newborn aspirates meconium-stained amniotic fluid into lungs Fetus expels some meconium in utero Occurs when infant takes first breath Prior to suctioning of nose and mouth Respiratory distress Resolves after three days TREATMENT Supportive care Provide warmth Conserve energy Supplemental oxygen Intubation and mechanical ventilation (if necessary) NEONATAL ABSTINENCE SYNDROME PATHOPHYSIOLOGY Occurs with prenatal exposure to drugs while fetus is in utero Ex. Opiates, amphetamines, tranquilizers, or multiple illicit drugs MANIFESTATIONS Body tremors Hyperirritability Wakefulness Poor feeding Sneezing Yawning TREATMENT Provide quite environment Swaddle infant Reduce external stimuli Observe for seizures PATHOPHYSIOLOGY INFANT OF A DIABETIC MOTHER Depends on degree and control of maternal diabetes Petal pancreas produces large amounts of insulin Newborn weighing more than 4082 g (9lb) Macrosomia MANIFESTATIONS Infant prone to injuries at birth After birth infant has low blood glucose levels Infant is lethargic Infant presents with round face May suffer from respiratory distress syndrome (RDS) Hypoglycemia, hypocalcemia, and hyperbilirubinemia NURSING CARE Close monitoring of vital signs Early feeding Frequent assessment of blood glucose levels Observe for irritability, tremors, and respiratory distress Believe in yourself and all that you are. – Christian D. Larson