CNUR 303| QUESTIONS WITH VERIFIED ANSWERS 100% SOLVED| LATEST UPDATE
GUARANTEED PASS
Nonphysiological jaundice oAlso known as "pathological jaundice"
oBilirubin levels exceed accepted norms
oCan present 24 hours post birth
oRapidly rising
oPathologic causes include:
oBirth trauma
oErythroblastosis fetalis
oSepsis
oRubella
Birth trauma- vacuum- bruising, broken down RBC, higher level of bilirubin, spontaneous-
delivered quickly- decreased RBC, Isoimmunization- Erythroblastosis fetalis- lysis of RBC,
elevated bilirubin, infection
Signs and symptoms of hyperbilirubinemia oJaundice
oYellowish pigment to skin & sclera
oLethargic
oPoor feeding
oMinimal or no stool
Treatment of hyperbilirubinemia More Frequent Feeds:
oSolution for physiological jaundice
oIncreasing input = Increasing output
Help the body clear the bilirubin, enzyme for unconjugated to conjugated- requires glucose,
feeds can provide glucose. Phototherapy
,oHelps to breakdown the bilirubin
oMakes it easier to excrete
oBiliblanket
oBased on transcutaneous & serum results, for pathological,UV lights breaks bilirubin, helps
with excretion, Criteria corresponds with therapy recommendations, Transcutaneous Bilirubin
Protocol
oGreen
oYellow
oRed
neonatal resuscitation •Neonatal resuscitation are a set of interventions at the time of birth
to support the transition from intra to extrauterine life through the establishment of breathing
and circulation.
•Only about 10% of neonates require some respiratory assistance at birth. Less than 1% need
extensive resuscitation. Indications- •Abnormal/Atypical FHR (bradycardia, complicated
variable and late decelerations)
•Meconium-stained amniotic fluid
•Prolonged or difficult delivery
•Asphyxia
•Poor respiratory effort
•Inadequate ventilation
•Weak cry
•Sternal Retractions
NRP Algorithm-Every neonate requires stimulation and drying
Cord blood gases Cord Blood gases can be a useful clinical indicator of intrapartum asphyxia,
and therefore has strong medicolegal utility.
,As such, various clinical information in combination with arterial and venous cord blood gas
results can usually provide a strong defense against a suggestion that an infant had an
intrapartum hypoxic‐ischemic event. Five essential indicators of Intrapartum Asphyxia:
1.Umbilical cord arterial ph <7.0
2.Base excess/deficit > +12/-12
3.Apgar score 0-3 >5
4.Seizures, hypotonia, coma
5.Evidence of multi-organ system dysfunction in the immediate neonatal period. Arterial-
reflects fetal status, venous- reflects placental status. SOGC recommends that blood gases
should be obtained following births.
Neonatal Respiratory Distress Initiation and maintenance of resp effort is essential for the
neonates transition to extrauterine life. Any infant is at risk of resp distress, however there are
some factors that put a neonate at higher risk:
•Meconium Aspiration: If there was meconium passed in the intrapartum period or during
delivery, neonate could be at risk.
•Cold Stress: There is a direct relationship between hypothermia, blood glucose and resp
status.
•Low Blood Glucose: Neonates that are SGA, LGA or born to diabetic mothers may be at risk for
low blood glucose. Cold stress can cause this as well.
•Transient Tachypnea of Newborn (TTN): Will be discussed later.
•Resp Distress Syndrome (RDS), Indicators- •Tachypnea
•Apnea
•Cyanosis: Perioral, facial, central
•Grunting
•Nasal Flaring
•Retractions: Intercostal, xyphoid, tracheal
•Poor feeding
, Abdominal breathing - blood cultures, oxygen, antibiotics, PICU admission
transient tachypnea of the newborn Wet Lung Syndrome"
•Excess fluid or delayed reabsorption
•Present around 4-6hrs post birth
•Self limiting within 12-72hrs
TTN will cause impaired gas exchange which may present as follows: •Tachypnea
•Tachycardia
•Cyanosis (perioral or central)
•Grunting
•Nasal flaring
•Use of resp accessory muscles
•Crackles or diminished breath sounds on auscultation
This newborn should be moved to an observation unit or Neonatal Intensive care for diagnostic
work-up and oxygen, intravenous and antibiotic therapy!! Diagnostics may include:
•Chest xray (Screen for presence of fluid, pneumonia or other differentials being considered)
•CBC, blood cultures (rule out sepsis)
•ABG (Insight into oxygen, carbon dioxide and pH levels- may dictate acuity and guide
treatment)
•Echo (Rule out congenital heart defects)
Presentation of TTN may mimic infection or shock, therefore antibiotics may be appropriate.
True or False: A newborn with TTN may present with perioral cyanosis True: Due to
impaired gas exchange the newborn may have perioral cyanosis. If the TTN is not identified and
treated facial and central cyanosis may occur.
GUARANTEED PASS
Nonphysiological jaundice oAlso known as "pathological jaundice"
oBilirubin levels exceed accepted norms
oCan present 24 hours post birth
oRapidly rising
oPathologic causes include:
oBirth trauma
oErythroblastosis fetalis
oSepsis
oRubella
Birth trauma- vacuum- bruising, broken down RBC, higher level of bilirubin, spontaneous-
delivered quickly- decreased RBC, Isoimmunization- Erythroblastosis fetalis- lysis of RBC,
elevated bilirubin, infection
Signs and symptoms of hyperbilirubinemia oJaundice
oYellowish pigment to skin & sclera
oLethargic
oPoor feeding
oMinimal or no stool
Treatment of hyperbilirubinemia More Frequent Feeds:
oSolution for physiological jaundice
oIncreasing input = Increasing output
Help the body clear the bilirubin, enzyme for unconjugated to conjugated- requires glucose,
feeds can provide glucose. Phototherapy
,oHelps to breakdown the bilirubin
oMakes it easier to excrete
oBiliblanket
oBased on transcutaneous & serum results, for pathological,UV lights breaks bilirubin, helps
with excretion, Criteria corresponds with therapy recommendations, Transcutaneous Bilirubin
Protocol
oGreen
oYellow
oRed
neonatal resuscitation •Neonatal resuscitation are a set of interventions at the time of birth
to support the transition from intra to extrauterine life through the establishment of breathing
and circulation.
•Only about 10% of neonates require some respiratory assistance at birth. Less than 1% need
extensive resuscitation. Indications- •Abnormal/Atypical FHR (bradycardia, complicated
variable and late decelerations)
•Meconium-stained amniotic fluid
•Prolonged or difficult delivery
•Asphyxia
•Poor respiratory effort
•Inadequate ventilation
•Weak cry
•Sternal Retractions
NRP Algorithm-Every neonate requires stimulation and drying
Cord blood gases Cord Blood gases can be a useful clinical indicator of intrapartum asphyxia,
and therefore has strong medicolegal utility.
,As such, various clinical information in combination with arterial and venous cord blood gas
results can usually provide a strong defense against a suggestion that an infant had an
intrapartum hypoxic‐ischemic event. Five essential indicators of Intrapartum Asphyxia:
1.Umbilical cord arterial ph <7.0
2.Base excess/deficit > +12/-12
3.Apgar score 0-3 >5
4.Seizures, hypotonia, coma
5.Evidence of multi-organ system dysfunction in the immediate neonatal period. Arterial-
reflects fetal status, venous- reflects placental status. SOGC recommends that blood gases
should be obtained following births.
Neonatal Respiratory Distress Initiation and maintenance of resp effort is essential for the
neonates transition to extrauterine life. Any infant is at risk of resp distress, however there are
some factors that put a neonate at higher risk:
•Meconium Aspiration: If there was meconium passed in the intrapartum period or during
delivery, neonate could be at risk.
•Cold Stress: There is a direct relationship between hypothermia, blood glucose and resp
status.
•Low Blood Glucose: Neonates that are SGA, LGA or born to diabetic mothers may be at risk for
low blood glucose. Cold stress can cause this as well.
•Transient Tachypnea of Newborn (TTN): Will be discussed later.
•Resp Distress Syndrome (RDS), Indicators- •Tachypnea
•Apnea
•Cyanosis: Perioral, facial, central
•Grunting
•Nasal Flaring
•Retractions: Intercostal, xyphoid, tracheal
•Poor feeding
, Abdominal breathing - blood cultures, oxygen, antibiotics, PICU admission
transient tachypnea of the newborn Wet Lung Syndrome"
•Excess fluid or delayed reabsorption
•Present around 4-6hrs post birth
•Self limiting within 12-72hrs
TTN will cause impaired gas exchange which may present as follows: •Tachypnea
•Tachycardia
•Cyanosis (perioral or central)
•Grunting
•Nasal flaring
•Use of resp accessory muscles
•Crackles or diminished breath sounds on auscultation
This newborn should be moved to an observation unit or Neonatal Intensive care for diagnostic
work-up and oxygen, intravenous and antibiotic therapy!! Diagnostics may include:
•Chest xray (Screen for presence of fluid, pneumonia or other differentials being considered)
•CBC, blood cultures (rule out sepsis)
•ABG (Insight into oxygen, carbon dioxide and pH levels- may dictate acuity and guide
treatment)
•Echo (Rule out congenital heart defects)
Presentation of TTN may mimic infection or shock, therefore antibiotics may be appropriate.
True or False: A newborn with TTN may present with perioral cyanosis True: Due to
impaired gas exchange the newborn may have perioral cyanosis. If the TTN is not identified and
treated facial and central cyanosis may occur.
