maternal child nursing

CONDITION ETIOLOGY / RISK FACTORS S/S DIAGNOSIS MANAGEMENT / NSG CONS
1. RESPIRATORY DISTRESS
SYNDROME
1. Prematurity
2. Meconium aspiration
syndrome
3. Pneumonia
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Expiratory grunting
- Most definitive
sign
Nasal flaring; see-saw
breathing
- Initial sign
- Rise of chest,
lowering of
abdomen
Central cyanosis in room
air
Tachypnea
Sternal & subcostal
retractions
- Subcostal = in
betw ribs
1. X-ray
2. ABG
●
Determine blood pH
1. Surfactant
- Given directly to lungs
2. Oxygen
3. Airway management
4. Extracorporeal Membrane Oxygenation
(ECMO)
- Oxygenates blood, removes CO2
- For cardiopulmonary disorders
5. Prevention
2. MECONIUM ASPIRATION
SYNDROME
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Low APGAR score
Retractions
Barrel chest
X-ray = bilateral course
infiltrates
1. Amnioinfusion
2. CS
3. Pharmacologic
4. Chest [physiotherapy
5. ECMO
3. SUDDEN DEATH SYNDROME unknown 1. Supine position, ​x prone
2. No pillows, place infant on hard surface; crib
● Induces flexion
4. ABO/RH INCOMPATIBILITY
●
ABO is less threatening,
compared to Rh
incompatibility
1. Incompatible RH and ABO ❏ Coomb’s Test
❏ Enlarged liver & spleen
❏ Hydrops fetalis
❏ Pathologic jaundice
❏ Hypoglycemia
❏ Green stool, dark urine
● Post
phototherapy
effects
(sun/bililight)
1. Coomb’s Test
a. Direct
●
b. Indirect
●
Detect antibodies
on bb’s RBC
Detect antibodies
on mom’s serum
1. RHOGAM - DOC
● Given 3x:
○ 28 wks AOG
○ 37wks AOG
○ 72h postpartum
- Prevent production of antibodies
2. Quartz halogen, Cool white daylight/blue
fluorescent light
- @ 12-30 inches above the bassinet
- Cover eyes, genitalia
- BF from time to time
- Stimulation
3. Early breastfeeding
4. Phototherapy
5. Exchange transfusion
● transfer blood one 1 side, then
withdraw from the other

NURSING CONSIDERATIONS
1. Protect eyes and genitalia
2. Frequently feed
3. Promote mother-child interaction
4. Thermoregulation
5. ACQUIRED MATERNAL
INFECTION
6. INFANT OF THE DRUG
DEPENDENT MOTHER
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Hypothermia
Hypotonia
Tachypnea
Pallor
1. Blood culture 1. Prophylaxis
2. Standard & contact infection precautions
3. Eye irrigation
4. Bathe baby immediately
5. Antenatal prevention
i. GROUP B-BETA
HEMOLYSIS
ii.
OPTHALMIA
NEONATORUM
iii.
HEPATITIS B
iv.
GENERALIZED
HERPES VIRUS
1. Acyclovir
v. HIV INFECTION
7. INFANT OF THE DRUG
DEPENDENT MOTHER
Symptoms will depend on
drug taken
1. Remove excess stimuli
2. Avoid BF with narcotic use mothers

Neonatal Abstinence syndrome (NAS)
- Occurs 24-48h up to 2 weeks
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Uppers - ecstasy
Downers - analgesics,
sedatives
8. INFANT WITH FETAL
ALCOHOLIC SYNDROME
Fetal Alcohol Spectrum Disorder
(FASD)