Give an example of each abnormality: structure, function, and metabolism. How can they cause disabilities and/or death?
Describe each classification. Review one or two of each type of defect and discuss nursing assessment/interventions needed for each.
What is the main purpose of the March of Dimes? Audience Response Question #1 Active and efficient participation in prenatal care can significantly decrease the risk of congenital anomalies. 1. True 2. False
How are neural tube defects treated?
Refer to Figures 14-1 and 14-2 on page 323. Discuss hydrocephalus.
Discuss the pathophysiology regarding each cause of hydrocephalus.
Audience Response Question #2 Complete the analogy. Communicating hydrocephalus : inadequate absorption of CSF as non-communicating hydrocephalus : ____________________. 1. increased ICP 2. brain tumor 3. obstruction of CSF 4. shunting of CSF
How are classic signs related?
Describe each procedure listed.
Discuss the pathophysiology regarding each symptom listed.
Discuss Figure 14-3 on page 324.
Discuss the proper procedure to measure head circumference. What methods protect the infant from infection? How is pain measured in an infant?
Discuss Figure 14-4 on page 325.
How are the two types of spina bifida different?
Discuss the pathophysiology regarding an increased incidence of hydrocephalus with meningomyelocele spina bifida.
In what form is folic acid taken?
Discuss the term habilitation and the nurse’s role in the treatment process.
What methods assist the child during the habilitation process? Discuss methods to assist the parents and child in developing a healthy personality.
Discuss methods to prevent infection and injury to the sac. Which nursing interventions prevent contractures? What is the nurse’s role in providing education for the parents of a child with spina bifida?
How would you document assessment of the sac, head circumference, and fontanels?
Discuss the pathophysiology regarding each complication in relation to the disorder.
Refer to Figure 14-7 on page 327. Discuss cleft lip.
Discuss the rationale for preventing sucking and crying. Describe a Logan’s bow.
What is the difference between a cleft lip and a cleft palate? Discuss potential life-threatening complications associated with cleft palate.
What can each member of the team contribute to the therapy of a child with cleft palate?
Discuss the nurse’s role in assisting the family and child with each factor listed.
Describe talipes equinovarus.
Refer to Figure 14-8 on page 329. Discuss clubfoot.
What are passive stretching exercises?
Give examples of the nurse providing cast care instructions and emotional support to the parents.
Refer to Figure 14-9 on page 331. Discuss the pathophysiology of hip dysplasia.
Describe the gait of a child in which hip dysplasia is suspected.
Audience Response Question #3 Complete the analogy. Barlow's test : feeling as Ortolani's sign : _____________. 1. seeing 2. hearing 3. auscultating 4. palpating
Refer to Figure 14-10 on page 331. Discuss the Pavlik harness.
See Figure 14-10 on page 331 and Figure 14-11 on page 332.
Describe neurovascular assessment of the affected extremity.
Give an example of a toy that might fit inside the cast.
Give an example of an assessment of an infant with a suspected metabolic defect.
Discuss the pathophysiology regarding the manifestations listed.
Does your state require early screening for PKU?
What are some dietary restrictions for the infant or child with PKU?
What foods need to be restricted in the infant’s or child’s diet? Most meats, dairy products, and diet drinks.
What is acidosis?
Discuss the pathophysiology of the sweat characteristics and ketoacidosis.
If this defect is left untreated, what can occur? Cirrhosis of the liver, cataracts, and mental retardation.
In what ways can you provide parental support and education?
Discuss the pathophysiology regarding the parent’s age and this disorder. Occurs in 9 of 10,000 live births and may increase to 1 in 365 live births in mothers older than 35. Paternal age is also a factor, especially if he is older than 55.
What is nondisjunction? The failure of a chromosome to follow the normal separation process into daughter cells.
Discuss AFP, HCG, inhibin-A, and unconjugated estriol levels and confirmation of Down syndrome by amniocentesis.
Refer to Figure 14-12 on page 336. Discuss the manifestations of Down syndrome.
In what ways can the nurse assist the parents of a child with Down syndrome?
Compare a normal child’s development to the development of a child with Down syndrome. Refer to Table 14-1 on page 337.
Compare the normal child to the child with Down syndrome regarding feeding, toileting, and dressing. Refer to Table 14-2 on page 337.
Review terms related to this condition in Box 14-2 on page 338.
Discuss the maternal sensitization process in the newborn. Refer to Figure 14-13 on page 338. What is anasarca?
Discuss the maternal health history and erythroblastosis fetalis. Describe the indirect Coombs’ test.
Discuss the pathophysiology of early induction of labor and/or intrauterine fetal transfusions.
Why is RhoGAM used in treatment?
Discuss the life-threatening condition of kernicterus.
Describe phototherapy and exchange transfusions.
Although phototherapy may prevent an increase in the level of bilirubin, it has no effect on the underlying cause of the jaundice.
Discuss the Biliblanket shown in Figure 14-16 on page 343.
Discuss the possible signs and symptoms of intracranial hemorrhage: Poor muscle tone Lethargy Poor sucking reflex Respiratory distress Cyanosis Twitching Forceful vomiting High-pitched cry Convulsions
Discuss the rationale for each question listed.
What nursing and medical care should be provided for a newborn with TTN?
How does amnioinfusion prevent meconium aspiration syndrome?
Discuss the rationale for the treatments listed.
What are some long-term effects an infant could experience who is born to a drug-addicted mother?
Discuss the pathophysiology of the symptoms listed. What is the rationale for each treatment listed?
Define macrosomia . Refer to Figure 14-17 on page 344.
How would you describe the Cushingoid appearance of the newborn? Give an example of a morning assessment of the newborn.
Chapter 14The Newborn with a Perinatal Injury or Congenital Malformation