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MCN > Care Of The Newborn > Flashcards

Care Of The Newborn Flashcards

1
Q

NEWBORN CARE

Two broad goals of nursing care during this period:

A

1.to promote the physical well-being of the newborn

2.to enhance the establishment of a well-functioning
family unit.

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2
Q

Initiation of Admission Procedures

A
  1. Condition of the newborn
    2.Labor and birth record
    3.Antepartal history
    4.Parent-newborn interaction information
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3
Q

NEWBORN CARE (UNANG YAKAP)
4 STEPS

A

1.) Immediate drying

2.) Skin to Skin Contact

3.) Proper clamping and cutting

4.) Non separation of baby from mother and breastfeeding initiation

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4
Q

THE FIRST 90 MINUTES:
TIME BAND
At perineal bulging, with
presenting part visible

ACTION:

A

•Ensure that delivery area is draft- free and between 25-28 degree celsius using a room thermometer.

•Wash hands with clean water and soap.

•Double glove just before delivery.

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5
Q

IMMEDIATE NB CARE:

TIME BAND: Within the 1st 30 secs
Call out the time of birth

INTERVENTION: Dry and provide warmth.

ACTION:_______

A

•Use a clean, dry cloth to thoroughly dry
the baby by wiping the eyes, face, head,
front and back, arms and legs.

•Remove the wet cloth.

•Do quick check of newborn’s breathing
while drying.

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6
Q

IMMEIDIATE NB CARE:

TIME BAND: If after 30 secs of thorough drying, newborn is not breathing or is gasping

ACTION:
Clamp & cut cord
•Call for help.
•Transfer to a warm, firm surface.
•Inform the mother that the newborn has difficulty breathing
and that you will help the baby to breathe.
•Start resuscitation protocol.

A

INTERVENTION: Re-position, suction and
Ventilate

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7
Q

IMMEDIATE NB CARE

TIME BAND: If after 30 seconds of thorough drying, newborn is breathing or crying

INTERVENTION: DO SKIN TO SKIN CONTACT

ACTION?

A

•If baby is crying and breathing normally, avoid any
manipulation, such as routine suctioning, that may cause
trauma or introduce infection.

•Place the newborn prone on the mother’s
abdomen or chest skin-to-skin

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8
Q

Rationale for covering the newborns back with blanket and head with a bonnet?

A

Keeping temperature at optimal range of 36.4 to 37.2 C to avoid metabolic acidosis, hypoxia and shock

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9
Q

Time band: 1-3 minutes

Intervention: Do non immediate or appropriate timed cord clamping

Action???

A

•Remove the first set of gloves immediately
prior to touching or handling the cord.

•Clamp and cut the cord after cord pulsations
have stopped(typically at 1 to 3 minutes)

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10
Q

Time band: 1-3 minutes

Intervention: Do non-immediate or appropriately times cord clamping

Action part 2???

A

•Apply sterile plastic clamp or tie at 2cm and the second
clamp at 5cm from the umbilical base.

•Cut close to the first clamp with sterile scissors.

•Observe for oozing blood. It should have 2 arteries & 1 vein

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11
Q

TIME BAND: Within 90 minutes of age

Intervention: Provide support for initiation of breastfeeding

Action???

A

•Leave the newborn on mother’s chest in
skin-to-skin contact.

•Observe newborn for feeding cues

•Counsel on positioning and attachment. Look
for signs of good attachment and suckling.

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12
Q

Time Band: Within 90 minutes of age

Intervention for Small baby or twins:
For a visibly small newborn or a newborn
born> 1 month early

Action???

A

•Skin-to-skin contact with her as much as
possible.

•Provide extra blankets to keep the baby
warm

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13
Q

•If mother cannot provide skin-to-
skin contact, use warm_______ or
________

A

Blankets

Radiant Warmer

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14
Q

•Do not bathe the small baby. Ensure hygiene
by wiping with a damp cloth but only after ________

A

6 Hours

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15
Q

Intervention: Do eye care

Action???

A

•Administer erythromycin or tetracycline
oitment or 2.5% providone- iodine drops to
both eyes after newborn has located breast.
(Rationale: for treatment of gonorrheal
conjunctivitis)

•Do not wash away the eye antimicrobial.

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16
Q

Time Band: 90mins to 6 Hours

Interventions: Rooming in

Action????

A

• Check for birth injuries, malformations or defects.
• Weigh the newborn.

• Get the head, chest, abdominal circumference and length.

• Give Vit K prophylaxis (AquaMEPHYTON), middle third vastus lateralis or rectus femoris to prevent hemorrhagic disease; 0.5 – 1mg single dose

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17
Q

Time Band: 90 minutes to 6 hours

Interventions: Rooming in

Action Part 2?

A

• Inject hepa B & BCG vaccine
• Get the vital signs
• Perform cord care
• Dress the newborn

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18
Q

Time Band: After the 90 minutes of age, but prior to discharge

Interventions:???

A

Support unrestricted per demand breastfeeding, day and night

Ensure warmth the baby washing and bathing

Sleeping

Look for signs if illness, jaunduce or infection

Discharge instructions

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19
Q

Signs of neonatal distress:

A

–Changes in color or activity
–Grunting or “sighing sounds”
–Rapid breathing with chest retractions
–Facial grimacing

20
Q

Monitoring of Output:

Voiding -

Passage of foods -

A

Within 24 hours

Within 48 hours

21
Q

Weighing of the NB

A

Same time of the day

10% of weight loss is normal in the 1st week

Regained within 2 weeks

22
Q
  • Milk produced by
    the mother
    provides primary
    source of nutrition for
    the baby before they
    are able to eat &
    digest
A

Breastmilk

23
Q
  • yellowish or creamy fluid
  • thicker than mature milk
  • contains more protein,
    fat-soluble vitamins &
    minerals
  • high level of IgA
  • replaced by transitional
    milk within 2-4 days after
    birth
A

Colostrum

24
Q

produced from the
end of colostrums & production until
approximately 2 weeks postpartum.

  • contains lactose, water-soluble vitamins,
    elevated levels of fats, & more calories than
    colostrum.
A

Transitional Milk

25
Q

10% solids (carbohydrates,
proteins, fats) for energy & growth; rest is
water, which is vital in maintaining hydration.

A

Mature Milk

26
Q

When can a baby typically eat solid foods?

A

6 months and above

27
Q

Beginning, high in water and contains vitamins and proteins -

Released after the initial letdown; has higher FAT concetration -

A

Foremilk

Hindmilk

28
Q

Physiology of BM production

A

1.) Estrogen & progesterone levels (after delivery of the placenta)

2.) Stimulates adenohypophysis to produce prolactin

3.) Act on acinar cells to produce milk

4.) Stored in collecting tubules

29
Q

Milk Secretion reflex pathway

A

1.) When infant sucks

2.) Stimulates posterior gland to produce oxytocin

3.) Causes contraction of smooth muscles of collecting tubules

4.)Breast milk is released

30
Q

7 surprising superpowers of breastmilk

A
  1. Breastmilk can potentially cure cancer.
  2. Breastmilk can ‘sense’ when your baby is sick.
  3. On hot days, your breastmilk automatically
    becomes more ‘watery’.
  4. Breastmilk can fight bacteria.
  5. Breastmilk cures acne.
  6. It’s a natural pain-relief medication.
  7. It’s the perfect pre-term baby milk.
31
Q

Preparation of Breast:

A

Avoid use of soaps on nipples

Use of creams is not advisable

Women with flat or inverted nipples may find breast shells useful

32
Q

Assisting with flat feeding:

A

~Within the first hour of birth

~Baby and Mother are stable

~Position mother & baby

~Assess infants response to feeding

33
Q

Feeding Techniques Positions

A

~Cradle

~Football Hold

~Cross cradle hold

~Side lying postion

34
Q

Latching on techniques

Signs of good attachment

A

~Chin touching breast

~Mouth wide open

~Lower lip turned outward

~More areola visible above than below the mouth

35
Q

Removal from the breast

A

~insert finger into corner of infants between mouth between gums

Indent the breast tissue with a finger near the infant’s mouth and remove infant when suction is released

36
Q

Slow deep sucks and sometimes pausing -

10 mins and then increase the time of feeding in each breast -

Average 1 quart but some women are producing more milk -

Begin on the last breast for even stimulation and emptying of the breast -

A

~Suckling Effectively

~ Duration

~ volume of breast milk

~Next breastfeeding

37
Q

whole grains, dark green leafy vegetables, (spinach, broccoli, malunggay, camote tops), garlic, nuts/seeds
(almonds, fennel), ginger, papaya, mussels,
spices (cumin, anise, turmeric)
• warm compress
• lactation massage
• good attachment
• frequent BF

A

Galactogogues

38
Q

Temporary swelling or fullness of the breast when milk begins to “come in” or change from colostrums to transitional breast milk.

• Usually occurs on the 2nd or 3rd day after birth.

• Result of accumulation of milk, enlarged lymph glands & increased blood flow.

• May also be caused by milk retention if feedings are delayed, too short, or infrequent

A

Engorgement

39
Q

Engorgement therapeutics

A

– application of heat
& cold

– massage & proper
breastfeeding
techniques

– a well-fitting bra
may be worn both
day & night to help
support breasts.

40
Q

• Pain for a minute or less

• Usually peaks at the 3rd to 6th day & resolves
soon afterward.

A

Nipple painq

41
Q

• sustained pain

• appear red, cracked, blistered, or bleeding

• Tx includes proper positioning, rotating used
nipples, application of small amount of BM in
affected nipples.

A

Nipple Trauma

42
Q

• localized edema &
tenderness is present, & a
hard area may be palpated

• tiny, white area may be
present on the nipple

A

Plugged Ducts

43
Q

• Inflammation of breast tissue

• caused by blocked milk ducts or milk
excess

• Onset of flu-like symptoms: fever,
chills, body aches & headache.

• Localized breast pain,
tenderness, a hot reddened area on
breast; usually on upper outer
quadrant

A

Mastitis

44
Q

Mastitis Therapeutics

A

•antibiotics
•Analgesics
•Antipyretics
•Rest
•Warm compress
•Adequate fluid intake & balanced diet

45
Q

• Unable to nurse for medical or
employment reasons

• Manual or breast pump

• Breasts need frequent
stimulation

A

Expression of Milk

46
Q

EXECUTIVE ORDER NO.51

A

Philippine code of marketing of breastmilk substitutes

47
Q

REPUBLIC ACT NO. 7600

A

The rooming in & breastfeeding act of 1992

MCN (4 decks)

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