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The Biophysical Profile uses Ultrasound to determine fetal well ... - PowerPoint PPT Presentation


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The Biophysical Profile uses Ultrasound to determine fetal well being. These five parameters are assessed: Amniotic Fluid Tone Respiratory Movement Body Movement Non Stress Test. Physical Assessment.

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slide1

The Biophysical Profile uses Ultrasound to determine fetal well being. These five parameters are assessed: Amniotic FluidTone Respiratory Movement Body Movement Non Stress Test

physical assessment
Physical Assessment
  • Caput Succedaneum- crosses the suture lines, can occur with a vertex delivery, hemorrhagic edema.
  • Cephalohematoma- will not cross the suture lines, due to traumatic delivery and is contained to one area.
physical assessment1
PHYSICAL ASSESSMENT
  • A FULL TERM INFANT THAT IS SGA IS AT RISK FOR POLYCYTHEMIA DUE TO CHRONIC HYPOXIA IN UTERO:

MORE RBC’S ARE PRODUCED TO COMPENSATE FOR LACK OF OXYGEN.

physical assessment2
PHYSICAL ASSESSMENT
  • ERYTHEMA TOXICUM- YELLOW OR WHITE MACULAR PAPULAR RASH. THIS IS A NORMAL NEWBORN RASH WHICH WILL RESOLVE SPONTANEOUSLY.
  • THIS RASH WOULD NEVER BE FOUND ON THE PALMS OF HANDS OR SOLES OF FEET (THIS TYPE OF RASH CAN BE INDICATIVE OF SYPHYLLIS)
alpha fetoprotein afp
Alpha-fetoprotein (AFP)
  • THE CONCENTRATION IS LOW IN DOWN SYNDROME BUT ELEVATED IN NEURAL TUBE DEFECTS.
slide6
LATE DECELERATIONS- A FALL IN HEART RATE AT THE BEGINNING OF THE UTERINE CONTRACTION, AND RETURNING TO BASELINE AFTER THE CONTRACTION HAS ENDED.
  • * ASSOCIATED WITH INCREASED INCIDENCE OF FETAL COMPROMISE.
thermoregulation
THERMOREGULATION
  • NEONATES CONSERVE HEAT THROUGH –NON-SHIVERING THERMOGENESIS, WHICH CONSISTS OF THE METABOLISM OF BROWN ADIPOSE TISSUE.
  • BROWN ADIPOSE TISSUE BEGINS FORMING AT 26-28 WEEKS GESTATION.
thermoregulation1
THERMOREGULATION
  • INSENSIBLE WATER LOSS IS WHAT IS LOST THROUGH THE SKIN AND RESPIRATORY SYSTEM, AND WE ARE UNABLE TO MEASURE.
  • THE MORE PRETERM THE NEONATE IS THE MORE WATER THEY LOSE IN THIS MANNER.
fluid and electrolytes
FLUID AND ELECTROLYTES
  • INFANTS WITH RDS AND BPD TEND TO HAVE THIRD SPACING OF FLUID WITH EDEMA DUE TO INJURY TO THE CELLS WHICH CAUSE FLUID TO LEAK.
  • THE INJURY IS DUE TO EXPOSURE TO OXYGEN AND POSITIVE PRESSURE VENTILATION.
developmental
DEVELOPMENTAL
  • SELF REGULATION IS WHEN A NEONATE ATTEMPTS TO MAINTAIN A BALANCED STABLE STATE: EXAMPLES OF SELF REGULATORY STRATEGIES INCLUDE-
  • 1. FOOT BRACING AGAINST A BOUNDARY
  • 2. GRASPING HANDS TOGETHER OR HAND TO MOUTH OR HAND TO FACE
  • 3. SUCKING
  • 4. GRASPING BLANKET OR TUBING
developmental1
DEVELOPMENTAL
  • THERE ARE TWO DIFFERENT STATES THE NEONATE CAN BE IN: SLEEP AND AWAKESTATE: THE AWAKE STATE CONSISTS OF THE INFANT BEING - ACTIVE ALERT, QUIET ALERT AND CRYING.
  • THE BEST TIME TO INTERACT WITH THE NEONATE IS WHEN THEY ARE IN THE QUIET ALERT STATE.
nutrition
NUTRITION
  • NEONATES DEVELOP THE ABILITY TO COORDINATE SUCKING, SWALLOWING AND BREATHING AT 31-34 WEEKS.
cardiac

CARDIAC

CONGENITAL HEART DEFECTS THAT HAVE AN INCREASE IN PULMONARY BLOOD FLOW ARE:

PDA

VSD

ASD

AV CANAL

cardiac1
CARDIAC
  • OBSTRUCTIVE DEFECTS THAT CAUSE PULMONARY VENOUS CONGESTION ARE:
  • COARCTATION OF THE AORTA
  • AORTIC STENOSIS
cardiac2
CARDIAC
  • MATERNAL FACTORS THAT PREDISPOSE NEONATES TO CONGENITAL HEART DEFECTS ARE:
          • LUPUS
          • MATERNAL DIABETES
          • RUBELLA
line placement
LINE PLACEMENT
  • UMBILICAL ARTERY CATHETERIZATION – IF PLACEMENT IS LOW CATHETR SHOULD BE BETWEEN THE 3RD AND 4TH LUMBAR SPACE.
  • IF PLACEMENT IS HIGH CATHETER SHOULD BE BETWEEN THE 6TH -10TH THORACIC SPACE.
x rays
X-RAYS
  • DUODENAL ATRESIA IS ASSOCIATED WITH DOWN SYNDROME.
  • CLASSIC APPEARANCE ON ABDOMINAL X-RAY WILL REVEAL A “DOUBLE BUBBLE”.
pharmacology
PHARMACOLOGY
  • TOLERANCE TO A MEDICATION IS WHEN THE INFANT REQUIRES AN INCREASE IN DOSE TO ACHIEVE THE DESIRED EFFECT.
  • DEPENDANCE TO A MEDICATION IS WHEN THE INFANT NEEDS REGULAR ADMINISTRATION OF THE MEDICATION FOR PHYSIOLOGICAL WELL BEING.
gi system
GI SYSTEM
  • OMPHALOCELE- HERNIATION THROUGH THE UMBILICUS, COVERED BY A SAC. ASSOCIATED WITH OTHER ANOMALIES SUCH AS SGA, SKELETAL OR CHROMOSOMAL.
  • GASTROSCHISIS- HERNIATION OCURS TO THE RIGHT OF THE UMBILICUS AND IS NOT USUALLY ASSOCIATED WITH OTHER ANOMALIES.
bilirubin
BILIRUBIN
  • INDIRECT BILIRUBIN ALSO KNOWN AS UNCONJUGATED IS FAT SOLUBLE AND MUST BE BROUGHT TO THE LIVER TO BE CHANGED TO WATER SOLUBLE.
  • DIRECT BILIRUBIN ALSO KNOWN AS CONJUGATED IS WATER SOLUBLE AND IS READY TO BE EXCRETED IN THE BILE AND INTO THE STOOL.
gi system1
GI SYSTEM
  • AT BIRTH THE ABDOMEN IS FLUID FILLED, WITHIN 30 MINUTES IT BEGINS TO FILL WITH AIR.
  • WITHIN 8 HOURS THE LARGE INTESTINE SHOLD BE FILLED WITH AIR, IF NOT THIS COULD INDICATE AND OBSTRUCTION.
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