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HAIZEL RABOY
BSN 2B
PREMATURITY ● Acrocyanosis
S&S
● Thin extremities
& skin with visible veins
● Lanugo on skin & hair
● Ruddy skin
● Weak cry
● Poor suck & reflexes
● Undescended Testes
(Boys)
● Narrow labia with
enlarged clitoris (Girls)
A premature infant is defined as live-born infant born before the end of week
37 of gestation; with the weight of less than 2500 g (5 lbs. 8 oz.)
Diagnosis Complications
Risk Factors
● Previous preterm labor
● Pregnant with twins, triplets or other multiples
● Problems with the uterus, cervix, or placenta
● Smoking cigarettes, drinking alcohol or using illicit drugs
● Infections mainly in amniotic fluid & lower genital tract
● Women’s nutrition
● Multiple abortions or miscarriage
Management / Treatment
● Monitor weight, V/S, I&O, and electrolyte balance
● Test urine & blood to asess glucose, calcium, &
bilirubin levels
● Maintain warming device
● Parenteral nutrition
● I.V. fluid via continuous infusion pump
● Administer oxygen & humidification
● Neonatal Intensive Care Units (NICU)

● Impaired Gas Exchange

● Altered Nutrition
● Respiratory Distress
● Hypoglycemia
Medications
● Ineffective ● Kernicterus ● Surfactant ● Antibiotics
Thermoregulation ● Anemia of Prematurity ● Fine-mist (aerosolized) or IV medication
● Fluid volume deficit ● Patent Ductus Arterious ● Medicines that increase urine output (diuretics) to manage
● Ineffective Family Coping ● Intraventricular Hemorrhage excess fluid
● An injection of medication into the eye to stop the growth of
Sources new blood vessels that could cause retinopathy of prematurity
Premature birth - diagnosis and treatment - mayo clinic. (n.d.). Mayo Clinic. Retrieved March 21, 2021,
from https://www.mayoclinic.org/diseases-conditions/premature-birth/diagnosis-treatment/drc- ● Medicine that helps close the heart defect known as patent
20376736#:%7E:text=Depending%20on%20your%20baby’s%20condition,a%20risk%20of%20possible%2 ductus arteriosus
0infection
POST MATURITY
A post-term pregnancy is one that
extends beyond 42 weeks’ gestation.
Pathophysiology
In most cases, fetal growth continues until delivery. The placenta involutes as pregnancy
progresses and multiple infarcts, causing placental insufficiency. In these cases, the fetus
receives inadequate nutrients and oxygen from the mother, resulting in a thin (due to soft-
tissue wasting), undernourished infant with depleted glycogen stores and decreased amniotic
fluid volume. Such infants are dysmature and, depending on when placental insufficiency
develops and the severity of the condition, they may be small for gestational age. Although
placental insufficiency with dysmaturity can occur at any gestational age, it is most common in
pregnancies that progress beyond 41 to 42 weeks.

Risk Factors Complications

● Neonatal death ● Large body size ● Hypoglycemia ● Meconium stain
● Fetal dysmaturity ● Meconium aspiration ● Polycythemia ● Seizure
● Cold stress

S&S Diagnosis Management / Treatment

● Dry, cracked, peeling skin ● Hypothermia ● Determining due date accuracy
● Overgrown nails ● Altered Nutrition:< Body ● Tests: Ultrasound, Nonstress Tests, Blood Test
● Abundant scalp hair Requirements ● Provide early feeding to prevent hypoglycemia
● Visible creases on palms & soles ● Impaired Gas Exchange in the ● Maintain skin integrity
● Minimal fat deposits lungs & at the cellular level ● May need resuscitation
● Green or yellow coloring of skin ● Meconium in amniotic fluid → lethargic → tubing into
● Alertness ↑ ● Hematocrit ↑ the trachea
● Body temperature ↑ ● Meconium inhaled in the lungs → ventilator
● Cardiopulmonary monitoring
Sources: ● Provide warmth
MSD Manuals. (n.d.). Postterm and postmature infants. MSD Manual Professional Edition. ● Monitor RBC, Hgb, and Hct
Retrieved March 20, 2021, from https://www.msdmanuals.com/professional/pediatrics/perinatal-
problems/postterm-and-postmature-infants
● I.V. sugar solutions or frequent breast milk/formula
SGA (Small for Gestational Age)
Small for gestational age is a term used to describe a baby who is smaller
than the usual amount for the number of weeks of pregnancy. They usually
have birthweights below the 10th percentile for babies of the same
Etiology
● Lack of adequate nutrition
gestational age. 50 to 70% of SGA fetuses/infants are constitutionally small,
● Multiple gestations
identified by small size at all stages but growth following the centiles. No
● Substance use
patholog y is present. Contributing factors include ethnicity, sex, and
● Intrauterine infection
parental height.
● Placental abruption
S&S Diagnosis ● Placenta previa
● Inherited metabolic diseases
● Weigh, length & head ● Risk for Impaired Gas Exchange ● Genetic Syndrome
circumference ↓ ● Risk for Ineffective Thermoregulation
● Small liver → difficulty & Cold Stress Management / Treatment
regulating glucose, ● Risk for Injury to Tissues
● Altered Nutrition: < Body Requirements ● Provide adequate stimulation
protein bilirubin levels
● Risk for Altered Parenting ● Assess gestational age & identify signs of potential
● Poor skin turgor
complications
● Abdomen sunken
● Dry & yellowish umbilical Complications ● Maintain airway, body temperature
● Observe S&S of respiratory distress
cord ● Birth asphyxia ● Meconium aspiration ● Monitor for infection & initiate measures to prevent sepsis
● Hct & RBC ↑ ● Hypothermia ● Hypo-/Hyperglycemia ● Monitor blood glucose levels & for signs of hypoglycemia
● Retinopathy of ● Polycythemia ● Encourage parents to provide toys suitable for their
prematurity chronologic age
Sources: ● Need continued check up
Small for gestational age - fetal growth restriction. (2020, April 26). TeachMeObGyn. ● Polycythemia are given I.V. fluids
https://teachmeobgyn.com/pregnancy/antenatal/small-gestational-age/ ● Hypoglycemia treated with frequent feeding (tube feedings)
LGA (Large for Gestational Age) The term macrosomia is used to
describe a newborn with an
Etiology
● Large, obese, plethoric
● ↓ 5 minute APGAR Score
excessive birth weight. Fetal ● Skin: Ecchymosis, Jaundice, &
macrosomia has been defined in erythema
several different ways, including ● Fractured clavicle, Erb-Duchenne
birth weight greater than 4000 g ● Respiratory distress
or 4500 g (8 lb 13 oz or 9 lb 15 ● Capput succedaneum,
oz) or greater than 90% for ● Cephalohematoma
gestational age. ● Asymmetry anterior chest
● Dilated pupils

S&S
Management / Treatment ● Abundance of nutrition = Excessive Growth ● Beckwith Syndrome
● Congenital anomalies (Omphalocele) ● Multiparous
● Prevention & Treatment of Neonatal Hypoglycemia
● Diabetes Mellitus ● Transposition of the great vessels
● Respiratory Support
● Overproduction of growth hormone in utero
● Monitor V/S
● Monitor blood glucose levels & signs of hypoglycemia
● Initiate early feeding
Diagnosis Complications
● Monitor for infections & initiate measures to prevent sepsis ● Altered Nutrition: < Body ● Hypoglycemia
● Provide stimulation Requirements ● Hypocalcemia
● Singing or talking; stroking the back; rocking the baby ● Impaired Gas Exchange ● Excess amount of RBC
● Hypoglycemia ● Ineffective Family Coping ● Lung Problems
I.V. glucose or frequent feedings by mouth or tube into the Compromise ● ↑ Risk of Birth Injuries
stomach
Sources
● Respiratory Distress Syndrome MSD Manuals. (n.d.-a). Large-for-Gestational-Age (LGA) infant. MSD Manual Professional Edition.
Supplemental oxygen, tube placed in the nose or intense Retrieved March 21, 2021, from https://www.msdmanuals.com/professional/pediatrics/perinatal-
intervention such as respiratory support with a ventilator problems/large-for-gestational-age-lga-infant