1229 Exam 3: Newborn Care/Skills Flashcards
Conversions
Fahrenheit: Celsius x 9/5 + 32
Celsius: Fahrenheit - 32 x 5/9
Weight: Convert lbs to grams, 1000g=1kg=2.2 lbs, G=#of lbs/2.2x1000
Length: Convert cm or in, 2.54cm/1in, Cm=2.54 x #of in, In= #of cm/2.54
Transitional Period
Newborns undergo phases of relative instability during first 6 to 8 hours
First Period of Reactivity
Birth to 30 min, normal HR up to 180, alert, bond and breast feed, sleep 1-1 1/2 hour
Second Period of Reactivity
4-8 hrs after birth, may have tachycardia, tachypnea, increase muscle tone, color improve, may be when first bowl is passed
Respiratory
Chemical-first breath is stimulated by hypoxia, surfactant in lungs can expand, first breath takes a lot of effort, may hear rales because of fluid in the first 6-8 hrs, inadequate lung inhale can cause tachycardia, crying helps clear the lungs
Sensory-noises, lights, touching, and cool air
Thermal-environmental temp drops
Apnea-normal in the neonatal period, 10-15 sec, <20 sec something is going on, can be caused by high or low temp
Cardiovascular
Blood volum-85-100ml/kg, placental function, placental loss at birth, PMI-fourth intercostal space, BP-normal, P-100-160, BP increases 10 days after birth
Blood coagulation-give vit K
Labs
Hemoglobin: 14-24 g/dl
Hematocrit: 44%-64%
Glucose: 45-65 mg/dl
Leukocytes: 9,000-30,000/mm
Bilirubin, total serum: <2.0 mg/dl
Arterial: pH 7.32-7.48
PCO2 26-42 mm Hg
PO2 60-70 mm Hg
Base excess: -10 to -2 mEq/L (whole blood)
Bicarbonate, serum: 21-28 mmol/L (arterial)
Anion gap: 7-16 mEq/L
Venous: pH 7.31-7.41
PCO2 40-50 mm Hg
PO2 40-50 mm Hg
**These values may change significantly in the first week of life.Nutrition, Fluid, Electrolytes
Weight- 5% weight loss in the first week, limited intake and fluid loss, two weeks should gain weight back
Calorie requirements- 117cal/kg/day
Blood sugar- Glyco is a major energy source at birth and 90% is used in first 3 hrs
Iron- storage at birth and enought for about 6 months
Capacity- 90mL and emptying time of stomach is 24 hrs, cardiac sphincter casue them to aspirate if they are fed too much or too fast, 2nd week more gas and colic
Numbers
Temp- 37C(98.6F) ax, Range: 36.5-37.2C (97.7-98.96F) HR: 100-160 R: 30-60 BP: 60-90/40-50 Head circumference: 33-35 cm Chest circumference: 30-33 cm Neutral Thermal Environment: 31.5-35 C
Temperature
BSA: sweat glands are ineffective first month, cannot lower their own temp
Brown fat: at nape of neck and scapula, blood warms as it circulates through fat
Nonshivering thermogenesis: the inability to shiver
Heat loss: convection, conduction, evaporation, radiation
Bowels
Meconium: the first bowel movement after birth
Transitional: days 3&4 greenish brown, 4&5 more yellow
Milk stool: breast fed will have yellow and a sour milk odor, bottle fed more brown
5-6 stools a day in the first two weeks of life
Bladder
Renal system: kidneys take over elimination and filtration, is immature, increased risk for dehydration, acidosis, and high potassium esp during times of stress, capacity 40 mL, urinate by first 24 hrs of life, 6-10 times a day for first few weeks, excrete uric acid will look like brick dust stain on the diaper
Neurological
Reflexes assessed in the quiet alert state, occer during infancy, some disappear, replaced by purposeful activity, head to toe mature, fontanels are important assessment, anterior closes at 18 mo, posterior closes 2-5 mo, bulging could indicate hydrocephalus, depressed will indicate dehydration
Muscle activity and rest
develop individually, each will do differently, develop individualized sleep patterns
Endocrine and Reproductive
maternal hormones affects the appearance of the breast and genitalia, milky substance and enlarged breast, vaginal discharge and bleeding due to mothers hormones, blood glucose, metabolic abnormalities can make blood sugar drop
