High Risk Infant 2
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| Describe the cause of respiratory distress syndrome or hyaline membrane disease. | Inadequate production of surfactant which results in increased alveolar surface tension and decreased lung compliance, increases risk for developing permanent neurological damage often not seen until later in development. | |
| Name the clinical signs of respiratory distress syndrome. | Chest wall retractions, expiratory grunting, flaring nostrils, cyanosis, and tachypnea. | |
| Describe extracorporeal membrane oxygenation. | ECMO is a form of cardiopulmonary bypass that mechanically oxygenates the blood outside of the body, used in severe cases of RDS or HMD. | |
| Describe the cause and significance of bronchopulmonary dysplasia. | Iatrogenic chronic lung disease; child will always be susceptible to URI. | |
| What are the causes of seizures? | Asphyxia, intracranial hemorrhage, subarachnoid bleeding, birth trauma, IVH, infections, congenital cerebral malformations, neonatal seizures are one of the strongest predictors of later motor or intellectual deficits. | |
| Define hyperbilirubinemia. | An excess accumulation of bilirubin due to prematurity or maternal Rh factor blood incompatibility. | |
| How is hyperbilirubinemia treated? | Phototherapy with florescent lamps. | |
| Describe kernicterus. | Yellow staining of the brain due to the deposition of bilirubin in the brain especially in the basal ganglia, may lead to choreoathetosis, rigidity, hypotonia, deafness, MR. | |
| Describe necrotizing entercolitis. | Acute inflammatory disease of the bowel, leads to intestinal mucosal ulceration, hemorrhage, necrosis, requires surgery. | |
| What are the signs of NEC? | Vomiting, lethargy, abdominal distention, bloody stools. | |
| Define retinopathy of prematurity. | A condition of prematurity which results in an abnormal proliferation of blood vessels in the immature part of the retina and may form scar tissue that becomes detached leading to visual problems or blindness. | |
| What are the causes of ROP? | High levels of O2 and vitamin E deficiency, leading cause of childhood blindness. | |
| Define meconium aspiration. | O2 deficits during labor causes fetus to release first stool which is then aspirated and results in acute airway obstruction and chemical pneumonitis. | |
| Name the TORCH-S infections. | Toxoplasmosis, Other infections, Rubella, Cytomegalovirus, Herpes, and Syphilis. | |
| Discuss toxoplasmosis. | Protozoa in cat feces, uncooked meats, and eggs, may cause spontaneous abortion, premature birth, LBW, DD, MR, seizures, and hydrocephalus. | |
| Discuss the chicken pox and influenza virus (other). | Chicken pox may result in motor and sensory deficits, visual problems, the flu may cause spontaneous abortions. | |
| Discuss rubella (german measles). | Often affect child if mother contracts in 1st trimester, may result in heat anomalies, cataracts, deafness, microcephaly, and CP. | |
| Discuss cytomegalovirus. | Common herpes type virus, results in hypertonia, seizure disorder, microcephaly, vision/hearing deficits, MR, LD, or CP. | |
| Discuss herpes. | Acquired at birth through the birth canal, localized infection of mouth, eyes or skin (good prognosis), CNS involvement, meningitis/encephalitis (poor prognosis). | |
| Discuss syphilis. | 1/2 of fetuses are aborted, the rest may have dental/skeletal abnormalities, vision/hearing deficits, MR, seizure disorders. | |
| What are the orthopedic conditions associated with high risk infants. | Brachial plexus injury, congenital hip dislocation, talipes equinovarus (clubfoot), spina bifida, and torticollis. | |
| Describe Erb’s palsy. | C5/6 roots, weakness or paralysis in shoulder ER, extension, and abduction, elbow flexion, wrist extension. | |
| Describe Klumpke’s palsy. | C8/T1 roots, weakness of paralysis in wrist and hand. | |
| Describe Erb-Klumpke’s palsy. | Whole arm paralysis. | |
| What are the cardiac problems associated with high risk infants. | Patent foramen ovale, patent ductus arteriosus, atrial or ventricular septal defects, coarctation of aorta, and tetralogy of fallot. | |
| What are the normal and alarm parameters for newborn HR? | Normal: 120-160 bpm, abnormal: <100 or >200. | |
| What are the normal and alarm parameters for newborn RR? | Normal: 20-60 bpm, abnormal: no breath in 15-20 sec. | |
| What are the normal and alarm parameters for newborn O2 SAT? | Normal 90-100%, abnormal: <85%. |
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