Immature Kidney Effects-Postterm

IMMATURE KIDNEY EFFECT | JAUNDICE |PRE-TERM VS FULL-TERM|POST-TERM
CAUMBAN & NOGRA
ST . A L E X I U S C O L L E G E
www.stalexiuscollege.edu.ph
IMMATURE KIDNEY EFFECT
Immature kidney
Refers to a kidney that has not fully developed or matured. This can be a
condition present at birth or can refer to a kidney that hasn't reached its full
functional capacity.
Will results in improper elimination of the body’s wastes contributes to

electrolyte imbalance and disturbed acid-base relationships
Immature kidney
Etiologic factors
Genetic factors
Premature birth
Intrauterine growth restriction (IUGR)
Immature kidney
May cause:
Dehydration can occur easily.

Limited tolerance to salt.
Susceptibility to edema
Impaired growth and development
Chronic kidney disease (CKD)
JAUNDICE
JAUNDICE
Hyperbilirubinemia is caused by the accumulation of excess bilirubin in blood

serum. In the average newborn, the skin and sclera of the eyes begin to appear
noticeably yellow on the second or third day of life as a result of a breakdown of
fetal red blood cells(called physiologic jaundice). This occurs because, as the high
red blood cell count built up in utero is being reduced, heme and globin are
released.
JAUNDICE
Physiological jaundice is the most common type of newborn

hyperbilirubinemia. This unconjugated hyperbilirubinemia presents in
newborns after 24 hours of life and can last up to the first week. NO
treatment is required
Pathological jaundice is defined as the appearance of jaundice in the

first 24 hours of life due to an increase in serum bilirubin levels greater
than 5 mg/dl/day, conjugated bilirubin levels ≥ 20% of total serum
bilirubin, peak levels higher than the normal range, and the presence
of clinical jaundice greater than two weeks. Treatment is required
PRE-TERM VS FULL TERM
RESTING POSTURE
WRIST FLEXION
SCARF SIGN
HEEL TO EAR
SOLE (PLANTAR) CREASES
BREAST TISSUE
MALE GENITALIA
FEMALE GENITALIA
RESTING POSTURE
PRE-TERM
The premature infant is characterized by very little, if any, flexion in the upper
extremities and only partial flexion of the lower extremities. Premature infants have a
lack of body tone and are quite ‘floppy’ in comparison. This increases their risk of
becoming cold after birth.
FULL-TERM
The full-term infant exhibits flexion in all four extremities.

babies tend to adopt a frog-like, fully flexed posture. This posture also helps them to
keep warm.
RESTING POSTURE
WRIST FLEXION
PRE-TERM
The premature infant at 28-32 weeks gestation will exhibit a 90-degree angle
FULL-TERM
With the full-term infant, it is possible to flex hand onto the arm
WRIST FLEXION
THE SCARF SIGN
Score according to location of the elbow:
• elbow reaches opposite anterior axillary line 0;
• elbow between opposite anterior axillary line and midline of the thorax 1;
• elbow at midline of thorax 2
• elbow does not reach midline of thorax 3;
• elbow at proximal axillary line 4.
PRE-TERM
In the premature infant, the elbow will reach near or across the midline
FULL-TERM
In the full term infant, the elbow will not reach the midline
THE SCARF SIGN
HEEL TO EAR
With the baby supine, draw the baby’s foot as near to the ear (no forcing)
PRE-TERM
In the premature infant, Very little resistance will be met.
FULL-TERM
In the full-term infant there will be marked resistance; it will be impossible to

draw the baby’s foot to the ear
HEEL TO EAR
PRE-TERM
The sole of the premature infant has very few or no creases.
FULL-TERM
The full-term baby has creases involving the heel.
BREAST TISSUE
PRE-TERM
In infants < 34 weeks’ gestation, the areola and nipple are barely visible. Also, an
infant < 36 weeks’ gestation has no breast tissue.
FULL-TERM
An infant of 39–40 weeks will have 5–6 mm of breast tissue, and this
amount will increase with age
MALE GENITALIA
PRE-TERM
In the premature male the testes are very high in the inguinal canal and there are
very few rugae on the scrotum.
FULL-TERM
The full-term infant’s testes are lower in the scrotum and many rugae have
developed
MALE GENITALIA
FEMALE GENITALIA
PRE-TERM
A premature female has very prominent clitoris and the labia majora are very small
and widely separated.
FULL-TERM
The full-term infant, the labia minora and the clitoris are covered by the labia majora
FEMALE GENITALIA
Why do we need to distinguish the physical
difference between PRE-TERM and FULL-TERM
infants?
POST TERM
POST TERM
• Post-term infants are those who are born after the 42nd week of
gestation.
• Some post-term fetuses grow to more than 4000g (8 lb, 13 oz),
placing them at risk for birth injuries or CS.
• Placental functioning decreases when pregnancy is prolonged.
• Post maturity syndrome – results in hypoxia and
malnourishment of the fetus
POST TERM
• The cause of post-term pregnancy is usually unknown
• Inaccurate pregnancy dating based on the last menstrual period (LMP)
is the most common cause of post-term pregnancy. Some factors
place an individual at increased risk.
• The incidence is higher in first pregnancies and in individuals who have
had a previous post-term pregnancy.
• Genetic factors seem to also play a role. One study showed an
increased risk of post-term pregnancy in pregnant individuals who
were, themselves, born post-term.
POST TERM
The following problems associated with postmaturity:
• Asphyxia – caused by chronic hypoxia because of deteriorated

placenta.
• Meconium aspiration – hypoxia and distress cause relaxation of the
anal sphincter
• Poor nutritional status – depleted glycogen reserves cause
hypoglycemia.
POST-TERM PREGNANCY PREVENTION AND TREATMENT
• Antenatal fetal monitoring – The health care provider will recommend tests on the
fetus if the pregnancy extends beyond the due date.
• Nonstress testing - Nonstress testing is done by monitoring the baby's heart rate
with a small device that is placed on the mother's abdomen.
• Biophysical profile - The biophysical profile (BPP) score is calculated to assess
fetal health. measurement of four fetal parameters: body movements, breathing
movements, tone (flexion and extension of an arm, leg, or the spine), and amniotic
fluid volume.
• Cervical Ripening - In some cases, if the cervix is not yet favorable for induction,
cervical ripening methods may be used to soften and dilate the cervix before initiating
labor induction. Methods for cervical ripening include mechanical methods or the
administration of medications like prostaglandins.
POST TERM
Characteristics:
• Long and thin and looks as though weight has been lost.
• Skin is loose (thighs and buttocks)
• Skin is dry, cracked, almost leather-like skin (lack of fluid)
• Little lanugo or vernix caseosa
• Nails are long stained with meconium.
• The infant has a thick head of hair and looks alert
• Elevated Hct; lowered polycythemia and DHN lowered the circulating volume
REFERENCES
R.N, P. M., BSN. (2016, September 29). 4 Hyperbilirubinemia (Jaundice) Nursing Care Plans.
Nurseslabs. https://nurseslabs.com/hyperbilirubinemia-nursing-care-
plans/#:~:text=The%20newborn
Seely, J. C. (2017). A brief review of kidney development, maturation, developmental abnormalities,

and drug toxicity: juvenile animal relevancy. Journal of Toxicologic Pathology, 30(2), 125–133.
https://doi.org/10.1293/tox.2017-0006
Prem vs term? (n.d.). FutureLearn. Retrieved April 19, 2024, from

https://www.futurelearn.com/info/courses/neonatal-
assessment/0/steps/51130#:~:text=Term%20babies%20tend%20to%20adopt
UpToDate. (n.d.). Www.uptodate.com. Retrieved April 19, 2024, from

https://www.uptodate.com/contents/postterm-pregnancy-beyond-the-
basics#:~:text=Inaccurate%20pregnancy%20dating%20based%20on

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IMMATURE KIDNEY EFFECT | JAUNDICE |PRE-TERM VS FULL-TERM|POST-TERM

CAUMBAN & NOGRA

Will results in improper elimination of the body’s wastes contributes to

Intrauterine growth restriction (IUGR)

Dehydration can occur easily.

Hyperbilirubinemia is caused by the accumulation of excess bilirubin in blood

Physiological jaundice is the most common type of newborn

Pathological jaundice is defined as the appearance of jaundice in the

The full-term infant exhibits flexion in all four extremities.

In the premature infant, Very little resistance will be met.

In the full-term infant there will be marked resistance; it will be impossible to

The sole of the premature infant has very few or no creases.

The full-term baby has creases involving the heel.

• Asphyxia – caused by chronic hypoxia because of deteriorated

Seely, J. C. (2017). A brief review of kidney development, maturation, developmental abnormalities,

Prem vs term? (n.d.). FutureLearn. Retrieved April 19, 2024, from

UpToDate. (n.d.). Www.uptodate.com. Retrieved April 19, 2024, from

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