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Nonreassuring fetal heart rate pattern Difficult birth Fetal scalp/capillary blood sample-acidosis pH<7.20 Meconium in amniotic fluid Prematurity Macrosomia or SGA Male infant Significant intrapartum bleeding Structural lung abnormality or oligohydramnios Congenital heart disease Maternal infection Narcotic use in labor
Cold Stress
Increase in oxygen requirements
Increase in utilization of glucose Acids are released in the bloodstream Surfactant production decrease
Hypoglycemia Symptoms
Lethargy or jitteriness
Poor feeding and sucking Vomiting Hypothermia and pallor Hypotonia, tremors Seizure activity, high pitched cry, exaggerated moro
reflex
Physiologic Hyperbilirubinemia
Appears after first 24 hours of life
Disappears within 14 days Due to an increase in red cell mass
Pathologic Hyperbilirubinemia
Appears within first 24 hours of life
Serum bilirubin concentration rises by more than 0.2
mg/dL per hour Bilirubin concentrations exceed the 95th percentile Conjugated bilirubin concentrations are greater than 2 mg/dL Clinical jaundice persists for more than 2 weeks in a term newborn
erythrocytes Increasing serum albumin levels Reducing serum bilirubin levels Minimizing the consequences of hyperbilirubinemia
Anemia
Hemoglobin of less than 14 mg/dL (term)
Hemoglobin of less than 13 mg/dL (preterm) Nursing management Observe for symptoms Initiate interventions for shock
Polycythemia
Increase in blood volume and hematocrit
Nursing management: Assessment of hematocrit Monitor for signs of distress Assist with exchange transfusion
Gonorrhea
Clinical Manifestations Conjunctivitis Corneal ulcerations Nursing management Administration of ophthalmic antibiotic ointment Referral for follow-up
Chlamydia
Clinical Manifestations Pneumonia Conjunctivitis Nursing management Administration of ophthalmic antibiotic ointment Referral for follow-up
and needs Adapting to the infants hospital environment Assuming primary caretaking role Assuming total responsibility for the infant upon discharge Possibly coping with the death of the infant if it occurs