4.2.3 Care of the Newborn I Flashcards
What is used to assess gestational age?
Ballard assessment
SGA and LGA risks on physical exam?
Considerations in history for care of newborn during transition period
What is the APGAR Scoring System chart?
How does baby know it is born?
Extra blood in circulation -> catecholamines released
Describe the initial urine?
Cloudy scant amounts with uric acid cystals (brick dust in diaper)
What is the organ of heat generation?
Brown fat (tons of Mito)
What measurements are taken at birth?
Weight, length, head circumference
What are the different changes during transition?
How do you distinguish tremors from seizures?
Tremors will stop when the limb is grabbed, but seizures will continue to shake. Tremors are normal
What happens to the mass to surface area ratio?
Decreases
What helps eliminate fluid from lungs?
Catecholamines
What are some causes of LGA (large for gestational age)?
Maternal diabeetus, maternal obesity
What occurs to glucose metabolism before and after birth?
What is transition?
Process of physiologic change in the newborn infant that begins in utero as the child prepares for transition from intrauterine placental support to extrauterine self-maintenance
What are the three fetal shunts?
Ductus venosus, foramen ovale, ductus ateriosus (all must close for normal circulation
Changes necessary for breathing in newborn?
What is determined by the APGAR score?
Need for resuscitation
What are some respiratory problems which exacerbate transition?
What are routine meds for newborns?
Erythromycin eye ointment (gonorrhea and chlamydia)
Aquamephyton (vit K)
First Hep B vaccine
HBIG if mother is Hep B surface Ag positive (95% effective w/ vaccine)
What three heat regulatory measures?
Generation, conservation, loss
What are the five area graded in APGAR?
Acitivity, pulse (taken by grabbing umbilicus), grimace, appearance, respiration
What is used to assess the newborn?
APGAR Score
What are some of the different mechanisms of heat loss?
Conduction, convection, radiation, and evaporation
When do the shunts typically close?
What are some of the newborn reflexes?
What some symptoms of improper glucose transition?
Should a mom breastfeed if sick?
Yes, she is passing along enough Ig to keep them healthy
What is transient tachypnea of the newborn? When is it most often seen?
After C-section
What is the initial glucose level in newborns?
40-45 normal
Symptoms of breathing problems?
Tachypnea, grunting, flaring, retractions, cyanosis
When is an APGAR score taken?
1, 2, 5, and 10 minutes after birth
What are some causes of SGA (small for gestational age)?
Fetal factors: genetic, infection, metabolic disorders
Maternal factors: smoking and drug use
Placental factors: insufficiency from HTN, drugs
