Summary RNSG 2208 Ch.23 for Maternity and Women-s Health.

Chapter 23 Nursing Care of the Newborn with Special Needs

Factors Affecting Fetal Growth
 Maternal nutrition
 Genetics
 Placental function
 Environmental factors

Birth Weight Variations #1
 Appropriate for gestational age (AGA): approximately 80% of newborns; normal
height, weight, head circumference, body mass index
 Small for gestational age (SGA): weight <2,500 g (5 lb, 8 oz) at term or below the 10th
percentile
 Large for gestational age (LGA): weight >90th percentile on a growth chart; weight
>4,000 g (8 lb, 13 oz) at term

Small-for-Gestational-Age (SGA) Newborns #1
 Conditions affecting fetal growth
o Less 28 weeks leading to overall growth restriction (never catch up in size)
o More 28 weeks, intrauterine malnutrition (normal growth potential with optimal
postnatal nutrition)
 IUGR for some SGA newborns
 Fetal growth restriction (FGR)  placental insufficiency
 Contributing factors

, SGA Newborns: Assessment: Typical Characteristics
 identify maternal history to identify risk factors: smoking, drugs, alcohol, preeclampsia, etc
 Head disproportionately large compared to rest of body
 Wasted appearance of extremities, loose dry skin
 Reduced subcutaneous fat stores
 Jittery secondary to hypoglycemia
 Decreased amount of breast tissue
 Scaphoid abdomen (sunken appearance)
 Wide skull sutures  inadequate bone growth
 Poor muscle tone over buttocks and cheeks
 Thin umbilical cord

SGA Newborns: Common Problems
 Perinatal asphyxia
 Difficulty with thermoregulation
 Hypoglycemia
 Polycythemia
 Meconium aspiration
 Hyperbilirubinemia
 Birth trauma (Table 23.1 pg 843-845)