newborn final exam (dragged) 6

FAS Overview 1. A group of conditions that can occur when a mother consumes alcohol while pregnant a. No safe amount 2. Can be mild or very severe Nursing Points General 1. You may only note the physical assessment issues, kids with FAS can grow to have issues with judgement, behavior, problems hearing/seeing, or low intelligence 2. Also known as Fetal Alcohol Spectrum Disorder Assessment 1. Various craniofacial abnormalities can be noted a. Small eye openings b. Wide set eyes c. Smooth between nose and mouth (no philtrum) d. Thin upper lip e. Up turned nose 2. CNS issues a. Encephalopathy b. Increased sensitivity to stimuli c. Seizures d. Learning disabilities e. Memory trouble f. ADHD g. Impulsive 3. Growth deficiencies a. Small height b. Small weight c. Small head size Therapeutic Management 1. Low stimulation 2. Pace feedings 3. Consult developmental specialist 4. Consult for other concerns/comorbidities that require a specialist Nursing Concepts 1. Human Development 2. Health Promotion Patient Education 1. The child will have cognitive deficits for life 2. The child may experience judgment and impulse control issues 3. There is NO KNOWN safe amount of alcohol during pregnancy HIV Overview 1. Close monitoring of HIV+ pregnant women is essential 2. Current recommendations are for HIV+ mothers to not breastfeed because of transmission risk Nursing Points General 1. Ongoing assessment of the newborn up to 18 month after birth is necessary, as mother’s antibodies persist that long a. Lab tests 2. Modes of transmission a. Across the placenta during pregnancy b. During childbirth c. Through breastmilk Assessment 1. Asymptomatic at birth 2. Immunodeficiencies 3. CBC with differential (CD4 count) 4. Blood test for HIV Therapeutic Management 1. Interventions a. Antiretrovirals i. AZT (zidovudine) b. Watch for signs of immunocompromise (enlarged liver or spleen) c. Immediate bath d. Lab tests i. HIV testing 1. Unreliable until around 18 months because of maternal antibodies Nursing Concepts 1. Immunity 2. Infection control 3. Lab values Patient Education 1. Guidelines for breastfeeding 2. Guidelines for vaccinations a. No live vaccines until it is confirmed that there is no HIV 3. Importance of follow-up and testing