Newborn Complications
Ricci Chapter 23-24 and ATI Chapter 27
BIRTH WEIGHT VARIATIONS
Appropriate for gestational age (AGA) Low birth weight (LBW) infants born less than 2500g,
Small for gestational age (SGA) newborns below 10th regardless of gestational age
percentile for their gestational age. Very low birth weight (VLBW) infants born less than
Large for gestational age (LGA) also called 1500 g
macrosomia; newborn at or above the 90th percentile for Extremely low birth rate (ELBW) less than 1000 g
weight.
SMALL FOR GESTATIONAL AGE (SGA) infant
newborns below 10th percentile for their gestational age.
It is NOT the same as low birth weight, very low birth weight or extremely low birth
weight.
Risk factors drug abuse, smoking, HTN (blood vessels are constricted)
Symmetric IUGR (intrauterine growth restriction) the whole body is small. More
dangerous than asymmetric because there’s an overall problem with the infant –
results in in cell production = fewer cells.
Asymmetric IUGR head is bigger than the body or vice versa. Babies often occur
long and skinny.
Associated health alterations temperature regulation because they don’t have a lot of subcutaneous fat.
LARGE FOR GESTATIONAL AGE (LGA) infant (AKA: “Macrosomia”)
newborn at or above the 90th percentile for weight.
Risk factors diabetes, obesity, height of mom and dad
Assessment Sluggishness, hypotonic muscles and hypoactivity
subcutaneous fat
trauma from a difficult and/or assisted birth
shoulder dystocia from squeezing through birth Therapeutic Management
canal
care for any birth injury
hypoglycemia – when baby is getting large amount
monitor and treat hypoglycemia per protocol.
of glucose from diabetic mom, baby is making insulin
Thermoregulation also important. If they become
to balance out the sugar. When baby is born and the
hypoglycemic, it is hard for them to maintain a
cord is cut, their source of glucose is gone. This may
neutral environment.
result into hyperinsulinemia.
Parenteral nutrition and IV therapy to maintain
Jaundice
glucose levels.
Tremors from hypocalcemia
PRETERM newborn
baby born before 37 weeks
the earlier the birth, the more complications and risks
higher risk for an admission to the neonatal intensive care unit (NICU)
major concerns for hypothermia, hypoglycemia and infection.
Rev. Fall 2019
, Newborn Complications
Ricci Chapter 23-24 and ATI Chapter 27
Assessment
risk for infection Lethargy, tachycardia, and poor weight gain
Hypothermia - risk for cold stress Physical exam 31 weeks gestation video:
Impaired ability to eat – poor suck/swallow reflexes o Jitteriness present
Immature genitalia – undescended testicles, narrow o Intercostal and subcostal retractions
labia o NG tube in placed for feeds
risk for jaundice o Periodic breathing consisting of 5-10 second
Multiple integumentary issues – lanugo present, respiratory pauses, followed by 10-15
visible vasculature (more transparent ski), minimal second compensatory rapid respirations.
subcutaneous fat o Primitive reflexes may not be present
Respiratory issues – immature lungs (rooting, sucking, moro, tonic neck)
Hypotonic muscles, level of activity, weak cry for
more than 24 hours.
Therapeutic Management
Maintain airway- respiratory assistance Parenteral nutrition
Frequent vitals (frequency dependent upon Minimize newborn’s, stimulation – cluster care. Keep
newborn’s stability and orders) lighting dim and noise. Levels
Keep baby warm!!
LATE PRETERM newborn baby born before 34-36 6/7 weeks.
Assessment and Therapeutic Management same as preterm newborns.
POST-TERM newborn
baby born after 42 weeks
after 42 weeks, the placenta starts to age and eventually fails
some post term babies may not have below assessment findings
major concerns include meconium aspiration and birth injuries
Assessment
muscle and fat wasting – thing with loose skin
large baby = birth injuries
meconium passing before delivery
overgrown nails
hypoglycemia
dry and peely skin resulting from protection of vernix and
amniotic fluid.
more hair on scalp than usual
alertness similar to 2 week old.
Therapeutic Management
depends on presenting symptoms
glucose stores all used up – so fix that
assess for respiratory issues related to meconium
aspiration
Acquired Conditions
typically occur at, or soon after, birth
problems or conditions experienced by the woman during her pregnancy or at birth
Rev. Fall 2019
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller HIGHSCORE. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $15.49. You're not tied to anything after your purchase.
