Guided Lecture Notes, Chapter 20, The Newborn at Risk: Gestational and Acquired
Disorders
Learning Objective 1. Define the classifications used to describe newborns based on their size,
gestational age, or weight.
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Explore gestational size classifications, delineating what is included in each
classification. (Refer to PowerPoint slide(s) 04.)
Identify newborn weight-based classifications. (Refer to PowerPoint slide(s) 05.)
Outline newborn gestational age classifications. (Refer to PowerPoint slide(s) 06.)
Learning Objective 2. Explain the various components of the gestational age assessment.
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Identify six categories used to determine newborn physical maturity. (Refer to
PowerPoint slide(s) 07 and 09, Figure 20-1, and Table 20-1.)
Explore six categories of neuromuscular maturity. (Refer to PowerPoint slide(s) 07 and
08.)
Explain how to determine gestational age.
Learning Objective 3. Describe the most common underlying condition that causes a newborn
to be small for gestational age (SGA), and explain the reason this condition occurs.
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Describe characteristics of and contributing factors for SGA newborns, indicating
potential complications. (Refer to PowerPoint slide(s) 12 to 14 and Box 20-1.)
Discuss mechanism for condition occurrence.
Learning Objective 4. Differentiate symmetric and asymmetric growth restriction in infants.
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Describe the appearance of a symmetrically growth-restricted newborn, exploring the
connection to hypoxia. (Refer to PowerPoint slide(s) 13.)
Describe the appearance of an asymmetrically growth-restricted newborn. (Refer to
PowerPoint slide(s) 14.)
Outline potential neurologic complications of IUGR. (Refer to PowerPoint slide(s) 15.)
Learning Objective 5. List factors that contribute to a newborn being large for gestational age
(LGA).
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Describe characteristics of and contributing factors for an LGA newborn. (Refer to
PowerPoint slide(s) 18 and 19.)
Identify potential complications for an LGA infant. (Refer to PowerPoint slide(s) 20.)
Learning Objective 6. List possible contributing factors for preterm birth.
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Describe the physical characteristics of a preterm newborn. (Refer to PowerPoint
slide(s) 26 and 27 and Figure 20-2.)
Identify factors contributing to preterm birth. (Refer to PowerPoint slide(s) 25.)
Learning Objective 7. Compare characteristics of the preterm newborn with those of the term
newborn.
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Comparecontrast physical characteristics of the preterm and term newborns. (Refer to
Figure 20-2.)
Learning Objective 8. Identify complications commonly associated with preterm newborns.
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Identify respiratory problems of the preterm newborn, especially respiratory distress
syndrome. (Refer to PowerPoint slide(s) 28.)
Describe intraventricular hemorrhage, including its causes, signs, and prevention. (Refer
to PowerPoint slide(s) 28.)
Outline causes of retinopathy of prematurity, outlining its potential complications,
treatment, and prevention. (Refer to PowerPoint slide(s) 28.)
Explore necrotizing enterocolitis, describing its precipitating factors, clinical
manifestations, and treatment. (Refer to PowerPoint slide(s) 28.)
Discuss preterm newborn thermoregulation difficulties, explaining cold stress. (Refer to
PowerPoint slide(s) 29.)
Indicate other possible complications, discussing implementations for prevention or care.
(Refer to PowerPoint slide(s) 30 and 31.)
Learning Objective 9. Describe the goals of care for the preterm newborn.
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Discuss the goals of care for the preterm newborn. (Refer to PowerPoint slide(s) 29.)
Learning Objective 10. Describe major aspects of nursing care for the post-term newborn.
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Describe physical characteristics of post-term newborns. (Refer to PowerPoint slide(s)
35.)
Outline potential complications of and appropriate nursing care needed by post-term
newborns. (Refer to PowerPoint slide(s) 36.)
Learning Objective 11. Give details of care for three acquired respiratory disorders associated
with newborns.
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Identify respiratory disorders for which newborns are at risk. (Refer to PowerPoint
slide(s) 37 and 38.)
Describe clinical manifestations of and appropriate nursing care for each acquired
respiratory disorder listed.
Learning Objective 12. Describe hemolytic disease of the newborn.
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Outline causes and clinical manifestations of newborn hemolytic disease, describing
treatment and appropriate nursing care. (Refer to PowerPoint slide(s) 39.)
Learning Objective 13. Explain important features of treatment, clinical manifestations, and
nursing considerations for the newborn of a diabetic mother.
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Describe physical characteristics of a newborn whose mother has poorly-controlled DM,
contrasting type 1 and type 2 characteristics. (Refer to PowerPoint slide(s) 40.)
Discuss complications associated with a newborn of a diabetic mother. (Refer to
PowerPoint slide(s) 40.)
Learning Objective 14. Discuss the clinical manifestations of and nursing care for a newborn of
a chemically dependent mother.
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Describe clinical manifestations of and nursing care for an infant born with fetal alcohol
syndrome. (Refer to PowerPoint slide(s) 41.)
Discuss problems in the newborn caused by chemical dependence in the mother,
including clinical manifestations of withdrawal. (Refer to PowerPoint slide(s) 41 and
Figure 20-9.)
Describe the physical and emotional support needed by the newborn with withdrawal
symptoms, outlining medications to ease withdrawal and prevent seizures. (Refer to
PowerPoint slide(s) 41.)
Learning Objective 15. Differentiate causes of and care for newborns with congenitally
acquired infections.
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Explore congenitally acquired infections in the newborn, describing clinical
manifestations. Outline strategies regarding their treatment. (Refer to PowerPoint
slide(s) 42 and Table 20-2.)