Unit 2 Care of Child .Edited

UNIT 2: NURSING CARE OF THE HIGH- RISK NEWBORN TO MATURITY
Objective:
1. Define the following terms—small-for-gestational-age infant, term infant, large-for-
gestational-age infant, preterm infant, and postterm infant—and describe common
illnesses that occur in these and other high-risk newborns
2. Recognize physiologic factors that compromise the preterm infant’s health status.
3. Perform a systematic assessment of a high-risk newborn.
4. Formulate nursing diagnoses related to a high-risk newborn.
5. Identify expected outcomes for a high-risk newborn and family.
6. Plan nursing care focused on priorities to stabilize a high-risk
7. newborn’s body systems.
Nursing Diagnosis
To establish nursing diagnoses for high-risk infants, it is important to be aware of newborns' normal
assessment parameters. Nursing diagnoses generally center on the nine priority areas of care for any
newborn:
1. Ineffective airway clearance related to the presence of mucus or amniotic fluid in the airway
2. Ineffective cardiovascular tissue perfusion related to breathing difficulty
3. Risk for deficient fluid volume related to insensible water loss
4. Ineffective thermoregulation related to newborn status and stress from birth weight variation
.https://www.youtube.com/watch?v=lEhQb6rliUY
https://www.youtube.com/watch?v=SOU-JW4L-s0
Prematurity
https://www.marchofdimes.org/complications/premature-babies.aspx
https://www.youtube.com/watch?v=7H7-z-TbgQA
https://www.youtube.com/watch?v=lEhQb6rliUY
https://www.youtube.com/watch?v=ktZv5ywteKo
Most organ systems' immaturity places infants at risk for a variety of neonatal complications (e.g.,
hyperbilirubinemia, respiratory distress syndrome [RDS], intellectual and motor delays). Factors such as
poverty, maternal infections, previous preterm delivery, multiple pregnancies, pregnancy-induced
hypertension, and placental problems that interrupt the normal course of gestation before completion of fetal
development are responsible for a large number of preterm births.p.25
____________________________________________________________________________________________________________________________________________________________©2024 NUEVA
ECIJA UNIVERSITY OF SCIENCE AND TECHNOLOGY All rights reserved. No part of this publication may be reproduced, distributed, or transmitted in any
form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the
institution. Unauthorized reproduction is punishable by law.
GIRLIE DE LUNA TAYAO, MAN , RN

PEDIATRIC NURSING ( ACUTE /CHRONIC ) 2024 EDITION
d. Lack of subcutaneous fat
PRETERM NEWBORN e. Sole of the foot is smooth.
a. a neonate born before 37 weeks of gestation f. Breast buds 5mm
b. immaturity of all body systems g. Testes – undescended
c. low birth weight neonate is < 2.5 kg h. Labia majora- undeveloped
regardless of gestational age i. Rugae of scrotum- fine
d. very low birth weight neonate is below 1.5 j. Fingernails-soft
kg irrespective of gestational age k. Abdomen- relatively large
l. Thorax-relatively small
PATHOPHYSIOLOGY AND ETIOLOGY m. Head-appears disproportionately
a. factors associated with prematurity include: large
1. poor nutrition n. Muscle tone poor, possibly weak
2. diabetes reflexes
3. drug abuse 2. Obtain accurate body measurements
4. chronic disease a. HC
5. being a multigravida mother younger b. AC
than age 18/primigravida mother older c. CC
than age 40 d. Length
b. complications of pregnancy-associated with e. Shoulder to umbilicus- use to
prematurity include: calculate the proper length of the
1. PIH catheter for umbilical arterial
2. Bleeding catheter placement.
3. Placenta previa/abruptio placenta f. Wt.
4. Incompetent cervix 3. Assist with laboratory testing as
5. PROM indicated for blood gases, blood glucose,
6. Polyhydramnios/oligohydramnios CBC (hgb, Hct), electrolytes, calcium,
7. Chorioamnionitis bilirubin
c. fetal factors associated with prematurity 4. Monitor closely for respiratory or cardiac
include: complications
1. chromosomal abnormalities a. RR above 60/min indicates a
2. anatomic abnormalities such as respiratory difficulty
tracheoesophageal atresia or fistula b. Expiratory grunting, retractions,
and intestinal obstruction chest lag, or nasal flaring should be
3. fetoplacental unit dysfunction reported stat
d. systems and situations that are most likely c. Watch for cyanosis (other than
to cause problems in the premature infant acrocyanosis-coldness and cyanosis
include: of hands and feet) and other signs of
1. respiratory system respiratory distress
2. digestive system d. Increased (> 180/min) or irregular
3. thermoregulation heart rate indicates cardiac and
4. immune system circulatory difficulties
5. neurologic system e. Muscle tone and activity should be
evaluated
NURSING ASSESSMENT AND INTERVENTIONS f. Hypoglycemia may result from
1. Notice the physical characteristics of the inadequate glycogen stores,
premature neonate: respiratory distress, and cold stress
a. Hair – lanugo, fluffy g. Hypotension may be caused by
b. Poor ear cartilage hypoglycemia
c. Skin- thin, capillaries are visible 5. Institute cardiac monitoring and care for
(maybe red and wrinkled) the infant in an isolette, omit bath
____________________________________________________________________________________________________________________________________________________________
©2024 NUEVA ECIJA UNIVERSITY OF SCIENCE AND TECHNOLOGY All rights reserved. No part of this publication may be reproduced,
distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods,
without the prior written permission of the institution. Unauthorized reproduction is punishable by law.

6. Observe for any signs of jaundice and d. Note stool- abdominal distention
check maternal history for any blood and lack of stool may indicate
incompatibilities. Be aware of maternal intestinal obstruction or other
factors that can lead to additional intestinal tract anomalies. Measure
complications (drug use, diabetes, and AC.
infection) e. Note activity and behavior- look for
7. NURSERY: 24-48 h is a critical time sucking movement and hand-to-
requiring constant observation and hand maneuver-help to determine
intensive care management; observe the oral feeding initiation.
following: f. Observe for a tense and bulging
a. Note bleeding from the umbilical fontanel-indicates intracranial
cord-apply pressure hemorrhage, be alert for twitching
b. and notify AP and seizures
c. Note first voiding- occur within 36h g. Monitor and record V/S
after birth; after first voiding report
any 4-6h period when voiding does
not occur
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https://www.youtube.com/watch?v=PZ3ycIZ0pe0 Management of preterm and post term
babies
POST TERM INFANTS intrauterine deprivation. Depletion of
https://www.youtube.com/watch? subcutaneous fat gives them a thin,
v=38l3OvJcsqE physical exam of post term elongated appearance.)
baby b. Meconium stained (The little vernix
Infants born of gestation that extends beyond caseosa that remains in the skinfolds
42 weeks as calculated from the mother's last may be stained a deep yellow or
menstrual period (or by gestational age green, which is usually an indication
assessment) are considered to be post-term of meconium in the amniotic fluid.)
or postmature, regardless of birth weight. c. Hair and nails long
A fetus who remains in utero with a failing d. Dry peeling skin
placenta may die or develop postterm e. Creases cover soles
syndrome f. absence of lanugo,
Post-term Infant g. little if any vernix caseosa,
• Gestation > 42 weeks h. abundant scalp hair,
• Must determine if EDC is truly posted term i. The skin is often cracked, parchment-
• After 42 weeks placenta loses the ability to like, and desquamating
nourish the fetus Assessment
Post-term Infant Characteristics a. Assess that vernix and lanugo
a. Newborn emaciated (a wasted b. Assess skin
physical appearance that reflects c. Check fingernails and toenails
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d. Assess size
e. Observe for Hypoglycemia
f. Observe for signs of birth injury
Nursing Implementation
a. Similar to care given to preterm
infants, if premature characteristics
are observed
b. Symptoms depend on conditions at
birth.
c. Monitor for possible complication
(Asphyxia, Polycythemia)
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PROBLEMS RELATED TO GESTATIONAL WEIGHT
SMALL FOR GESTATIONAL AGE
https://www.youtube.com/watch?v=BWCdXjaJmRA
Refers to infants who are significantly undersized for gestational age—also called Intra-Uterine
Growth Retardation.
Small for gestational age (SGA) is a term used to describe a smaller baby than the usual amount for
the number of weeks of pregnancy. SGA babies usually have birthweights below the 10th percentile
for babies of the same gestational age. This means that they are smaller than 90 percent of all other
babies of the same gestational age. SGA babies may appear physically and neurologically mature
but are smaller than other babies of the same gestational age. SGA babies may be proportionately
small (equally small all over), or they may be of normal length and size but have lower weight and
body mass. SGA babies may be premature (born before 37 weeks of pregnancy), full-term (37 to 41
weeks), or post-term (after 42 weeks of pregnancy).
a. SGA weight- less than 5lb 8 oz and below the 10th% at term
b. IUGR- High-risk growth does not meet the norm and is pathologic
- Symmetric IUGR- a poor growth rate of the head, abdomen, and long bone
- Asymmetry IUGR- head long bones spared
Symmetric: Height, weight, and head circumference are about equally affected.
Asymmetric: Weight is most affected, with a relative sparing of growth of the brain,
cranium, and long bones.
Symmetric growth restriction usually results from a fetal problem early in gestation, often
during the 1st trimester. When the cause begins relatively early in gestation, the entire body
is affected, resulting in fewer cells of all types.
Causes small for gestational age (SGA)

Although some babies are small because of genetics (their parents are small), most SGA babies are
small because of fetal growth problems that occur during pregnancy. Many babies with SGA have a
condition called intrauterine growth restriction (IUGR). IUGR occurs when the fetus does not
properly receive the necessary nutrients and oxygen needed to grow and develop organs and
tissues. IUGR can begin at any time in pregnancy. Early-onset IUGR is often due to chromosomal
abnormalities, maternal disease, or severe problems with the placenta. Late-onset growth
restriction (after 32 weeks) is usually related to other problems.
Some factors that may contribute to SGA and/or IUGR include the following:
1. Maternal factors:
a. high blood pressure
b. chronic kidney disease
c. advanced diabetes
d. heart or respiratory disease
e. malnutrition, anemia
f. infection
g. substance use (alcohol, drugs)
h. cigarette smoking
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1.1 Factors involving the uterus and placenta:
a. decreased blood flow in the uterus and placenta
b. placental abruption (placenta detaches from the uterus)
c. placenta previa (placenta attaches low in the uterus)
d. infection in the tissues around the fetus
1.2 Factors related to the developing baby (fetus):
a. multiple gestations (twins, triplets, etc.)
b. infection
c. birth defects o chromosomal abnormality
Common problems at birth, including the following:
a. decreased oxygen levels
b. low Apgar scores (an assessment that helps identify babies with difficulty adapting after
delivery)
c. meconium aspiration (inhalation of the first stools passed in utero) which can lead to
difficulty breathing
d. hypoglycemia (low blood sugar)
e. difficulty maintaining normal body temperature
f. polycythemia (too many red blood cells)
Diagnosis :
Other diagnostic procedures may include the following:
ULTRASOUND
Ultrasound (a test using sound waves to create a picture of internal structures) is a more accurate
estimating fetal size method. Measurements can be taken of the fetus' head and abdomen and
compared with a growth chart to estimate fetal weight. The fetal abdominal circumference is a
helpful indicator of fetal nutrition.
DOPPLER FLOW
Another way to interpret and diagnose IUGR during pregnancy is Doppler flow, which uses sound
waves to measure blood flow. The sound of moving blood produces waveforms that reflect the
blood's speed and amount as it moves through a blood vessel.
Blood vessels in the fetal brain and the umbilical cord blood flow can be checked with Doppler flow
studies.
MOTHER'S WEIGHT GAIN
A mother's weight gain can also indicate a baby's size. Small maternal weight gains in pregnancy
may correspond with a small baby.
GESTATIONAL ASSESSMENT
Babies are weighed within the first few hours after birth. The weight is compared with the baby's
gestational age and recorded in the medical record. The birthweight must be compared to the
gestational age. Some physicians use a formula for calculating a baby's body mass to diagnose SGA.
Treatment of the SGA baby may include:

a. temperature-controlled beds or incubators
b. tube feedings (if the baby does not have a strong suck)
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Small for Gestational Age Characteristics
a. Decreased breast tissue
b. Scaphoid abdomen (sunken)
c. Wide sutures
d. Thin umbilical cord
e. Head larger than body
f. Wasted appearance to extremities
g. Reduced-fat stores
h. Little Subcutaneous tissue
i. Loose, dry, scaling skin
j. Appears thin and wasted; old for size
k. Maybe meconium staining of skin, nails
l. Sparse hair on the head
m. Active, alert, and seem hungry
n. Cord dries more rapidly
Assessment
a. Assess for Hypoglycemia or poor glucose control
b. Assess for Hypothermia
c. Assess for Asphyxia
d. Assess for Polycythemia
Nursing Implementation
a. provide care similar to Premature infants until stabilized.
b. Protect from cold stress; Keep warm; Usually in an isolette
c. Perform test for glucose
d. Weigh daily and maintain I&O
Symptoms and Signs
Despite their size, SGA infants have physical characteristics (e.g., skin appearance, ear cartilage, sole
creases) and behavior (e.g., alertness, spontaneous activity, zest for feeding) of normal-sized infants
of like gestational age. However, they may appear thin with decreased muscle mass and
subcutaneous fat tissue. Facial features may appear sunken, resembling those of an elderly person
("wizened facies"). The umbilical cord can appear thin and small. (Robert L. Stavis, 2019)
Complications
Full-term SGA infants do not have the complications related to organ system immaturity that
premature infants of similar size have. They are, however, at risk of
a. Perinatal asphyxia
b. Meconium aspiration
c. Hypoglycemia
d. Polycythemia
e. Hypothermia
Perinatal asphyxia during labor is the most serious potential complication. It is a risk of
intrauterine growth restriction. It is caused by placental insufficiency (with marginally
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adequate placental perfusion) because each uterine contraction slows or stops maternal
placental perfusion by compressing the spiral arteries. Therefore, when placental
insufficiency is suspected, the fetus should be assessed before labor, and the fetal heart rate
should be monitored during labor. If a fetal compromise is detected, rapid delivery, often by
cesarean delivery, is indicated.
Meconium aspiration may occur during perinatal asphyxia. SGA infants, especially those
who are postmature, may pass meconium into the amniotic sac and begin deep gasping
movements. The consequent aspiration is likely to result in meconium aspiration syndrome.
Meconium aspiration syndrome is often most severe in growth-restricted or postmature
infants because the meconium is contained in a smaller volume of amniotic fluid and thus
more concentrated.
Hypoglycemia often occurs in the early hours and days of life because of a lack of adequate
glycogen synthesis and decreased glycogen stores and must be treated quickly with IV
glucose.
Polycythemia may occur when SGA fetuses experience chronic mild hypoxia caused by
placental insufficiency. Erythropoietin release is increased, leading to an increased rate of
erythrocyte production. The neonate with polycythemia at birth appears ruddy and may be
tachypneic or lethargic.
Hypothermia may occur because of impaired thermoregulation, which involves multiple

factors, including increased heat loss due to the decrease in subcutaneous fat, decreased
heat production due to intrauterine stress and depletion of nutrient stores, and increased
surface to volume ratio due to small size. SGA infants should be in a thermoneutral
environment to minimize oxygen consumption.
Nursing Diagnosis:
Ineffective breathing pattern related to underdeveloped body systems at birth
Outcome Evaluation:
Newborn maintains respirations at a rate of 30 to 60 breaths per minute after resuscitation at birth.
Birth asphyxia is a common problem for SGA infants, both because they have underdeveloped chest
muscles and are at risk for developing meconium aspiration syndrome due to anoxia during labor.
Fetal hypoxia causes a reflex relaxation of the anal sphincter and increased intestinal movement.
When gasping for breath in utero, the fetus draws meconium that was discharged from the intestine
into the amniotic fluid down into the trachea and bronchi. Acting as a foreign substance, this blocks
airflow into the alveoli, leading to hypoxemia, acidosis, and hypercapnia.
For this reason, many SGA infants require resuscitation at birth. Closely observe both respiratory
rate and character in the first few hours of life. Underdeveloped chest muscles can make SGA
infants unable to sustain the rapid respiratory rate of a normal newborn.
Nursing Diagnosis:
Risk for ineffective thermoregulation related to lack of subcutaneous fat
____________________________________________________________________________________________________________________________________________________________

Outcome Evaluation:
The infant's temperature is maintained at 36.5° C (97.8° F) axillary. SGA infants are less able to
control body temperature than other newborns because they lack subcutaneous fat. A carefully
controlled environment is essential to keep the infant’s body temperature in a neutral zone.
LARGE FOR GESTATIONAL AGE

https://www.youtube.com/watch?v=bftHVPJvboE
https://www.youtube.com/watch?v=EQirzpvOkKw
https://www.youtube.com/watch?v=Qda0Z0pmQV0 – idm
Large gestational age means that a fetus or infant is larger or more developed than normal for the
baby's gestational age. Gestational age is the age of a fetus or baby that starts on the first day of the
mother's last menstrual period.
Large for gestational age (LGA) refers to a fetus or infant larger than expected for their age and
gender. It can also include infants with a birth weight above the 90th percentile.
The LGA measurement is based on the estimated gestational age of the fetus or infant. Their actual
measurements are compared with normal height, weight, head size, and development of a fetus or
infant of the same age and sex.
a. LGA weight- Larger than 9 lbs and above the 90th%
b. Large body-plump full face
c. Body size is proportionate.
d. Poor motor skills
e. Difficulty in regulating behavioral state (arouse to quiet alert state)
Common causes of the condition are:
a. Gestational diabetes
b. Obese pregnant mother
c. Excessive weight gain during pregnancy
A baby that is LGA has a higher risk of birth injury. There is also a risk for complications of low
blood sugar after delivery if the mother has diabetes.
Large for Gestational Age Common Problems
a. Birth Trauma-
b. Hypoglycemia
c. Polycythemia
d. Hyperbilirubinemia
Symptoms of large-for-gestational-age newborns are mainly related to any complications that
occur.
Kernicterus. Kernicterus is the destruction of brain cells by an indirect bilirubin invasion (Symons
& Mahoney, 2008).
Complications
Common complications, according to R. Stavis, in large-for-gestational-age newborns include the
following:
Birth injuries: Common injuries include stretching of the shoulder's nerves (brachial plexus
injuries) and fractures.
____________________________________________________________________________________________________________________________________________________________

Difficult delivery: Vaginal delivery, especially if the fetus is in a breech presentation, may be
difficult when the fetus's head is large compared to the mother's pelvis. Cesarean delivery (C-
section) is commonly done for LGA infants.
Low Apgar score: The Apgar score is a rating of the baby's condition in the first minutes of life.
LGA infants tend to have lower Apgar scores and are more likely to require assistance at birth.
Perinatal asphyxia: This complication decreases blood flow to the baby before, during, or just
after delivery. This complication may result from a problem with the placenta before or during
delivery. (Robert L. Stavis, 2019)
Meconium aspiration: LGA babies may pass meconium (dark green fecal material produced in the
fetus's intestine before birth) in the amniotic fluid and take forceful gasps that cause the meconium-
containing amniotic fluid to be breathed (aspirated) into the lungs. (Robert L. Stavis, 2019)
Low blood sugar (glucose) levels (hypoglycemia): If the fetus has been exposed to high glucose
levels because the mother's diabetes was poorly controlled during pregnancy, the fetus has a high
insulin level. At the time of delivery, the placental supply of glucose is abruptly stopped, and the
high level of insulin can rapidly drop the baby's blood sugar level, resulting in hypoglycemia.
Hypoglycemia may cause no symptoms, but some babies are lethargic and limp, and some are
jittery and very excitable. Despite their large size, newborns of mothers with diabetes often do not
feed well for the first few days. (Robert L. Stavis, 2019)
Lung problems: Lung development may be delayed in newborns whose mothers have diabetes,
and the babies are at increased risk of respiratory distress syndrome or transient tachypnea of the
newborn, even when they are not premature. (Robert L. Stavis, 2019)
Birth defects: Infants of mothers with diabetes have an increased risk of birth defects, including
those involving the brain, heart, kidneys, digestive tract, and lower part of the spine.
Excess red blood cells (polycythemia): LGA babies may have a higher blood count than usual.
Too many red blood cells may cause the blood to become too thick, which may slow blood flow.
Newborns with polycythemia have a reddish complexion and are sluggish. Polycythemia can
contribute to hypoglycemia, respiratory distress, and hyperbilirubinemia. (Robert L. Stavis, 2019)
Diagnosis
1. Before birth, measurement of the uterus and ultrasonography.
a. Ultrasonography can assess the fetus's size and estimate the fetal weight to confirm the
LGA diagnosis.
2. After birth, assessment of gestational age and size and weight of the baby
a. LGA newborns are assessed for any complications. Blood sugar is measured to detect
hypoglycemia, and doctors do a thorough examination to look for birth injuries and
structural or genetic abnormalities.
Treatment of complications
a. There is no specific treatment for large-for-gestational-age newborns, but underlying
conditions and complications are treated as needed.
b. Newborns with polycythemia are given intravenous fluids. If the polycythemia is severe,
the physician may remove some blood and replace it with plasma (partial exchange
transfusion), which dilutes the remaining red blood cells. (Robert L. Stavis, 2019)
c. Newborns with hypoglycemia are treated with frequent feedings or sometimes are
given glucose by vein.
d. Respiratory distress and meconium aspiration are treated with supplemental oxygen or
other supportive devices such as continuous positive airway pressure (CPAP—a
____________________________________________________________________________________________________________________________________________________________

technique that allows newborns to breathe independently while being given slightly
pressurized oxygen) or a mechanical ventilator, depending on the severity of the
problem.
3. During pregnancy, doctors measure the distance on the woman's abdomen from the top of the
pubic bone to the top of the uterus (fundus). This measurement, called a fundal height
measurement, corresponds roughly with the number of weeks of pregnancy. If the
measurement is high for the number of weeks, the fetus may be larger than expected.(Robert L.
Stavis, 2019)
Nursing Diagnosis: Risk for imbalanced nutrition, less than body requirements, related to
additional nutrients needed to maintain weight and prevent hypoglycemia
Outcome Evaluation: Infant’s weight follows percentile growth curve; skin turgor is good; specific
gravity of urine is 1.003 to 1.030; serum glucose is above 45 mg/dL.
As a rule, an LGA infant needs to be breastfed immediately to prevent hypoglycemia. The infant may
need supplemental formula feedings after breastfeeding to supply enough fluid and glucose for the
larger-than-normal size for the first few days. Newborns who are offered bottles often have more
difficulty than do others learning to breastfeed. Offer both the mother and baby support to
overcome this hurdle.
Post discussion activities:

1. Choose three diseases/cases from this chapter, make a diagram format illustrating
the pathophysiologic sequence of changes in your chosen diseases/cases. An outline
format is acceptable as long as the cause-and-effect sequence can be seen.
2. Make a narrative explanation of the pathophysiologic diagram of the disease.
3. Make one nursing care plan out of each pathophysiology you have made.
References
Marilyn J. Hockenberry and David Wilson (2013) WONG’S ESSENTIALS OF PEDIATRIC NURSING
ISBN: 978-0-323-08343-0 Copyright © 2013 by Mosby, an imprint of Elsevier Inc.
BIBLIOGRAPHY Muhammad Waseem, M. M. (2020, June 08). Medscape. Retrieved from

emedicine.medscape.com: https://emedicine.medscape.com/article/1009987-overview
O’Malley, G. F. (2020, April). MSD MANUAL PROFESSIONAL VERSION. Retrieved from
https://www.msdmanuals.com/: https://www.msdmanuals.com/professional/injuries-
poisoning/poisoning/hydrocarbon-poisoning
Patrici M. Nugent, RN, EdD, Judith S. Green, RN, MA, Phyllis K. Pelikan, RN, MA, Marry Ann Hellmer
Saul, RNCS, Ph.D. (2014). Mosby's Comprehensive Review of Nursing for the NCLEX-RN
Examination 20th edition. Elsevier.
Pilliteri, A. (2020). Maternal and Child Health Nursing: Care of the Child Bearing and Child Rearing
Family. 530 Walnut Street, Philadelphia: Wolters Kluwe/Lippincott Williams & Wilkins.
Robert L. Stavis, Ph.D., MD, 2019; Small-for-Gestational-Age (SGA) Infant - Pediatrics ....
https://www.merckmanuals.com/professional/pediatrics/perinatal-problems/small-for-
gestational-age-sga-infant
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Robert L. Stavis, Ph.D., MD, 2019; Large-for-Gestational-Age (LGA) Newborn - Children's ....
https://www.merckmanuals.com/home/children-s-health-issues/general-problems-in-
newborns/large-for-gestational-age-lga-newborn
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UNIT 2: NURSING CARE OF THE HIGH- RISK NEWBORN TO MATURITY

GIRLIE DE LUNA TAYAO, MAN , RN

GIRLIE DE LUNA TAYAO, MAN , RN

GIRLIE DE LUNA TAYAO, MAN , RN

GIRLIE DE LUNA TAYAO, MAN , RN

GIRLIE DE LUNA TAYAO, MAN , RN

GIRLIE DE LUNA TAYAO, MAN , RN

GIRLIE DE LUNA TAYAO, MAN , RN

GIRLIE DE LUNA TAYAO, MAN , RN

GIRLIE DE LUNA TAYAO, MAN , RN

GIRLIE DE LUNA TAYAO, MAN , RN

GIRLIE DE LUNA TAYAO, MAN , RN

GIRLIE DE LUNA TAYAO, MAN , RN

Causes small for gestational age (SGA)

GIRLIE DE LUNA TAYAO, MAN , RN

Treatment of the SGA baby may include:

GIRLIE DE LUNA TAYAO, MAN , RN

Symptoms and Signs

GIRLIE DE LUNA TAYAO, MAN , RN

Hypothermia may occur because of impaired thermoregulation, which involves multiple

GIRLIE DE LUNA TAYAO, MAN , RN

LARGE FOR GESTATIONAL AGE

GIRLIE DE LUNA TAYAO, MAN , RN

GIRLIE DE LUNA TAYAO, MAN , RN

Post discussion activities:

BIBLIOGRAPHY Muhammad Waseem, M. M. (2020, June 08). Medscape. Retrieved from

GIRLIE DE LUNA TAYAO, MAN , RN

GIRLIE DE LUNA TAYAO, MAN , RN

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