NURS 421 Peds Class 1 - Prematurity and Associated
Conditions Children with Special Needs
1) Poor Thermal Regulation Correct Answers inability to
regulate temp of self; cardiovascular system under the control of
the CNS is restricting/dilating to allow blood to perfuse.
Adipose tissue also acts as heater, muscular system is making
micromovements to heat yourself up
2) Immature CNS (apnea & bradycardia) Correct Answers
ability to take first breath is controlled by CNS; premature
infants don't have the stimulus to take breaths
-the slower the respirations, the slower the heart rate
-myocardium is not getting oxygen, less cardiac output, less
perfusion/less nutrients to cells
3 C's of Esophageal Atresia Correct Answers Baby starts to
Cough, Choke, Cyanosis
3 episodes of aspiration = Correct Answers candidate for NG
tube
3) Immature immunity (infection) Correct Answers very
vulnerable to infection; septic shock
4) IVH (trauma, asphyxia) Correct Answers Intraventricular
Hemorrhage
5) Immature cardiopulmonary system Correct Answers walls
of ventricles of brain are very fragile and don't firm up until the
,last weeks of gestation. Lots of pressure put in walls of brain
when pushing results in bleeding of brain
6) Immature GI system (NEC) Correct Answers GI tracts
forms late in gestation b/c heart/brain gets priority; fetus doesn't
eat
7) Jaundice Correct Answers visible on mucous membranes
and sclera; RBCs in immature baby have very short lifespan and
breakdown at a much faster rate; Liver breaks down bilirubin
but is immature liver can't do it's job; high levels of bilirubin is
toxic to brain, demilates the gray & white mater of the brain
8) Glucose instability Correct Answers Pancreas can't regulate
glucose very well and overshoots. Glucose levels bottom up (eg.
20). Nothing will fuel the metabolic processes
ALL kids withs spina bifida has Latex Allergy Correct Answers
-Can be local reaction
-Can be severe, anaphylactic reaction: life-threatening especially
in children with myelomenigocele.
Bile is made in small intestine and sent to gallbladder then large
intestine Correct Answers if infant is vomiting bile (green) - it's
going back to stomach and indicates GI obstruction; will kill pt
Birth Asphyxia Correct Answers (not breathing at birth) Eg.
cord around neck
*do lighter bagging (don't want to damage alveoli/brain vessels)
, Cerebral Palsy Correct Answers A non-progressive
(permanent) disorder of the developing brain
-brain wants to stop muscle movements (flexor engaging but
extensor is disengaging = stiff)
-May present at birth or evident in infancy/early childhood
CH Presentation Correct Answers -Low T4, TSHu
-"Quiet good" baby
-Prolonged jaundice
-Lethargy, poor appetite, VS changes, macroglossia
Cleft Lip and Palate
*upper lip did not form and/or palate did not close (we all close
laterally to centrally - didn't close) Correct Answers -May or
may not be diagnosed prenatally.
-Genetics, teratogens, folate deficiency, or isolated incident
-Surgery
Cleft lip and palate pts = At risk for hearing loss. Correct
Answers EARLY screening with AABR (Automated Auditory
Brainstem Response)
by the 3rd month, 6th month, 9th month
Cleft Lip and Palate Surgery Correct Answers -Cleft lip repair
usually 2to 3 months
(rule of tens...weeks, pounds, hemoglobin)
-Cleft palate repair completed before 12
months, sometimes in stages.
-Associated Problems:Orthodontic, speech, hearing, OM.
Conditions Children with Special Needs
1) Poor Thermal Regulation Correct Answers inability to
regulate temp of self; cardiovascular system under the control of
the CNS is restricting/dilating to allow blood to perfuse.
Adipose tissue also acts as heater, muscular system is making
micromovements to heat yourself up
2) Immature CNS (apnea & bradycardia) Correct Answers
ability to take first breath is controlled by CNS; premature
infants don't have the stimulus to take breaths
-the slower the respirations, the slower the heart rate
-myocardium is not getting oxygen, less cardiac output, less
perfusion/less nutrients to cells
3 C's of Esophageal Atresia Correct Answers Baby starts to
Cough, Choke, Cyanosis
3 episodes of aspiration = Correct Answers candidate for NG
tube
3) Immature immunity (infection) Correct Answers very
vulnerable to infection; septic shock
4) IVH (trauma, asphyxia) Correct Answers Intraventricular
Hemorrhage
5) Immature cardiopulmonary system Correct Answers walls
of ventricles of brain are very fragile and don't firm up until the
,last weeks of gestation. Lots of pressure put in walls of brain
when pushing results in bleeding of brain
6) Immature GI system (NEC) Correct Answers GI tracts
forms late in gestation b/c heart/brain gets priority; fetus doesn't
eat
7) Jaundice Correct Answers visible on mucous membranes
and sclera; RBCs in immature baby have very short lifespan and
breakdown at a much faster rate; Liver breaks down bilirubin
but is immature liver can't do it's job; high levels of bilirubin is
toxic to brain, demilates the gray & white mater of the brain
8) Glucose instability Correct Answers Pancreas can't regulate
glucose very well and overshoots. Glucose levels bottom up (eg.
20). Nothing will fuel the metabolic processes
ALL kids withs spina bifida has Latex Allergy Correct Answers
-Can be local reaction
-Can be severe, anaphylactic reaction: life-threatening especially
in children with myelomenigocele.
Bile is made in small intestine and sent to gallbladder then large
intestine Correct Answers if infant is vomiting bile (green) - it's
going back to stomach and indicates GI obstruction; will kill pt
Birth Asphyxia Correct Answers (not breathing at birth) Eg.
cord around neck
*do lighter bagging (don't want to damage alveoli/brain vessels)
, Cerebral Palsy Correct Answers A non-progressive
(permanent) disorder of the developing brain
-brain wants to stop muscle movements (flexor engaging but
extensor is disengaging = stiff)
-May present at birth or evident in infancy/early childhood
CH Presentation Correct Answers -Low T4, TSHu
-"Quiet good" baby
-Prolonged jaundice
-Lethargy, poor appetite, VS changes, macroglossia
Cleft Lip and Palate
*upper lip did not form and/or palate did not close (we all close
laterally to centrally - didn't close) Correct Answers -May or
may not be diagnosed prenatally.
-Genetics, teratogens, folate deficiency, or isolated incident
-Surgery
Cleft lip and palate pts = At risk for hearing loss. Correct
Answers EARLY screening with AABR (Automated Auditory
Brainstem Response)
by the 3rd month, 6th month, 9th month
Cleft Lip and Palate Surgery Correct Answers -Cleft lip repair
usually 2to 3 months
(rule of tens...weeks, pounds, hemoglobin)
-Cleft palate repair completed before 12
months, sometimes in stages.
-Associated Problems:Orthodontic, speech, hearing, OM.
