OB Exam 6 Questions and Answers Latest Update Graded A+

OB Exam 6 Questions and Answers Latest Update Graded A+ When is an infant considered preterm? - Answers born prior to 37 weeks preterm birth prevention - Answers PRENATAL CARE Risk factors that can lead to a preterm birth - Answers LOW SOCIOECONOMIC STATUS (harder to get prenatal care) and other barriers to prenatal care What characteristics make premature babies at higher risk as compared to newborns? - Answers 1. Decreased surfactant in lungs can lead to respiratory difficulties 2. Immature brain development can lead to decreased respiratory drive 3. weak muscles can lead to decrease in spontaneous breathing 4. thin skin and decreased fat leads to rapid heat loss 5. increased likelihood of being born with infection 6. fragile blood vessels in brain increase risk of brain bleeds 7. small blood volume leads to increase susceptibility to hypovolemia 8. increased body surface area in proportion to weight can increase heat loss 9. immature tissues can be more easily damaged by excessive O2 Common problems with preterm infants - Answers -RESPIRATORY DISTRESS -thermoregulation -fluid and electrolyte balance (urine output, weight, dehydration/overhydration) -skin -pain (especially from procedures) -infection (monitor for s/sx) -overstimulation (monitor s/sx) -developmental needs what is the role of surfactant? - Answers keeps alveoli open in lungs nursing interventions for preterm infants with respiratory difficulties - Answers working with equipment/monitoring O2 positioning, suctioning maintaining hydration complications for preterm infants with respiratory difficulties - Answers retinopathy of prematurity (d/t oxygen administration) respiratory distress bronchopulmonary dysplasia (BPD) What is bronchopulmonary dysplasia (BPD)? - Answers damage to lungs due to Positive Pressure Ventilation (PPV). requiring chronic O2 administration. less common d/t prenatal steroids and surfactant administration What are findings in history that put infants at risk for respiratory distress syndrome? - Answers preterm or late preterm birth, diabetic mom (especially when maternal glucose control has been poor) physical exam findings in respiratory distress syndrome - Answers crackles, pallor, retractions, decreased O2 sats, increased work of breathing nursing interventions for respiratory distress syndrome - Answers RESPIRATORY SUPPORT: O2 admin (PPV, nasal cannula, intubation) Decrease O2 needs (temperature controls, stress, etc.) O2 and respiratory monitoring (ex. least amount of O2 possible) signs of overstimulation in preterm infants - Answers OXYGENATION CHANGES: BP, pulse, respiratory instability, cyanosis, pallor, mottling, flaring nares, decreased O2 saturation, apnea, sneezing, coughing BEHAVIORAL CHANGES: stiff, extended arms and legs; fisting of the hands or splaying (spreading wide apart) of the fingers; arching; alert, worried expression, turning away from eye contact (gaze aversion), regurgitation, gagging, hiccupping, yawning, fatigue signs interventions to prevent overstimulation in preterm infants - Answers -schedule cares (cluster) -reducing stimuli -promoting rest -promoting motor development -individualizing care -communicating infant needs -keep painful procedures SEPARATE from other cares (don't want to create that mental association) goal of interventions for preterm infant environmentally-caused stress - Answers infant shows decreased s/sx of overstimulation