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MIDTERMS: Maternal and Child Nursing > Care of the Newborn > Flashcards

Care of the Newborn Flashcards

by Prof Orbista

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1
Q

What are the stages of growth?

A
  1. Neonatal
  2. Infancy
  3. Toddlerhood
  4. Pre-school Age
  5. School Age
  6. Adolescent
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2
Q

Stages of Growth:

0-28 days

A

Neonatal

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3
Q

Stages of Growth:

29 days - 1 year

A

Infancy

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4
Q

Stages of Growth:

1 - 3 years

A

Toddlerhood

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5
Q

Stages of Growth:

3 - 5 years

A

Pre-school Age

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6
Q

Stages of Growth:

6 - 12 years

A

School Age

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6
Q

Stages of Growth:

12 - 18 years

A

Adolescence

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7
Q

What are the stimuli that help initiate respiration in a newborn?

A
  1. Chemical
  2. Thermal
  3. Tactile Stimulation
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8
Q

Stimuli that help initiate respiration:

Low oxygen and high CO2 levels trigger breathing.

A

Chemical

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9
Q

Stimuli that help initiate respiration:

A sudden drop in temperature prompts breathing, managed by using a bonnet and blanket.

A

Thermal

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10
Q

Stimuli that help initiate respiration:

Rubbing the back and soles of the feet helps stimulate breathing, especially in the first 24 hours.

A

Tactile stimulation

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11
Q

What are the normal cardiovascular values for a newborn?

A

> Hemoglobin (Hgb): 17-18 g/100 mL
Hematocrit (Hct): 45%-50%
Red Blood Cells (RBC): 6 million cells/mm³
White Blood Cells (WBC): 15,000 to 30,000 cells/mm³

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12
Q

What are the normal reflexes observed in a newborn?

A
  1. Blink Reflex
  2. Rooting Reflex
  3. sucking Reflex
  4. Moro Reflex (Startle Reflex)
  5. Palmar Grasp Reflex
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12
Q

Describe the characteristics of the gastrointestinal system of a newborn.

A

> The GIT is sterile at birth, and bacteria for Vitamin K synthesis are absent.
The stomach can hold 60-90 mL of milk.
First stool is meconium (passed within 24 hours), followed by transitional stool (on the 2nd-3rd day).

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13
Q

Normal Reflexes:

Protection from foreign objects.

A

Blink Reflex

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14
Q

Normal Reflexes:

In response to loud noise or sudden movement.

A

Moro Reflex (Startle Reflex)

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14
Q

Normal Reflexes:

Sucking motions when lips are touched.

A

Sucking Reflex

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15
Q

Normal Reflexes:

Turns head toward a breast when cheek is brushed.

A

Rooting Reflex

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16
Q

Normal Reflexes:

Grasps objects placed in the palm.

A

Palmar Grasp Reflex

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17
Q

What does the APGAR score assess, and what are its indicators?

A

The APGAR score assesses a newborn’s adjustment to extrauterine life, evaluated at 1 and 5 minutes after birth. The indicators include:

> Heart rate
Respiratory rate
Reflex irritability
Muscle tone
Color

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18
Q

What are the guidelines for formula feeding in newborns?

A

> Wash hands and all equipment.
Do not alter milk formula proportions.
Discard leftover milk in the bottle after feeding.
Formula should be refrigerated if not used immediately.
Calculate formula needs by adding 2 or 3 ounces to the infant’s age in months.

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19
Q

What are some characteristics of breast milk?

A

Best for babies (B)
Reduces allergic reactions (R)
Economical (E)
Always available (A)
Safe and maintains stool softness (S)
Temperature is always right (T)
Fresh (F)
Provides immunity (I)
Highly nutritious (N)
Lowers gastrointestinal disorders (G)

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20
Q

What are the types of newborn reflexes

A
  1. Swallowing Reflex
  2. Extrusion Reflex
  3. Step-in-place Reflex
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21
Q

Newborn Reflexes:

Food at the back of the tongue is swallowed automatically.

A

Swallowing Reflex

22
Q

Newborn Reflexes:

Prevents swallowing inedible substances by expelling them from the mouth.

A

Extrusion Reflex

23
Q

Newborn Reflexes:

Newborns take alternating steps when feet touch a hard surface.

A

Step-in-place Reflex

24
Q

What are the normal vital signs for a newborn?

A

> Temperature: 37.2°C
Heart Rate: 120-140 bpm (can reach up to 180 bpm)
Respiratory Rate: 30-60 breaths per minute (can reach 80 bpm)
Blood Pressure: 80/46 mmHg (can reach 100/50 mmHg by the 10th day)

25
Q

What are the key characteristics of the newborn’s immune system?

A

> Difficulty forming antibodies against antigens up to 2 months of age.
Passive immunity: The newborn receives IgG antibodies from the mother through the placenta.
Newborns are prone to infections during the first few months, so some vaccinations are delayed until the immune system matures.

26
Q

What are the sensory capabilities of a newborn?

A
  1. Touch: Well-developed at birth, most sensitive on lips, hands, and soles.
  2. Hearing: Can hear even before birth, recognizes the mother’s voice soon after birth, and calms to soothing voices.
  3. Smell: Can recognize the smell of the mother’s milk, turning towards her breast.
  4. Vision: Can see at birth, follows strong light, focuses on black-and-white objects 9-12 inches away.
  5. Taste: Prefers sweet tastes (e.g., milk) and turns away from bitter tastes.
27
Q

What is the significance of the Moro Reflex (Startle Reflex) in newborns?

A

The Moro Reflex is a defensive reaction to sudden loud noises or movement.

> It involves the newborn extending and then retracting arms in an “embracing” motion.
It is strong for the first 8 weeks and fades by the end of the fourth or fifth month.

28
Q

Normal Values of Weight for Newborn Anthropometric Measurements?

A

2,500-3,400 grams for Filipino babies; they may lose 5-10% of birth weight in the first few days, and regain it in about 7-10 days.

29
Q

Normal Values of Length for Newborn Anthropometric Measurements?

A

Average birth length is 46-54 cm.

30
Q

Normal Values of Head Circumference for Newborn Anthropometric Measurements?

A

34-35 cm (report if less than 33 cm or more than 37 cm).

31
Q

Normal Values of Chest Circumference for Newborn Anthropometric Measurements?

A

32-33 cm (normally 2 cm less than the head circumference).

32
Q

Normal Values of Abdominal Circumference for Newborn Anthropometric Measurements?

A

Measured above the umbilical cord and should be similar in size to the chest circumference.

33
Q

Describe the nursing interventions for maintaining the temperature of a newborn.

A
  1. Minimize heat loss through convection: Use a crib with solid sides to reduce airflow.
  2. Minimize heat loss through conduction: Place the newborn on padded, covered surfaces.
  3. Provide insulation: Use warmed blankets and clothes to maintain warmth.
  4. Skin-to-skin contact: This helps stabilize the baby’s temperature, especially right after birth.
34
Q

How is the APGAR score interpreted?

A

0-3 points: The infant is in serious danger and needs immediate resuscitation.

4-6 points: The infant requires close monitoring and possibly clearing of the airway or oxygen.

7-10 points: The infant is in good condition, indicating effective adaptation to extrauterine life.

35
Q

What are the nursing responsibilities for infection prevention in newborns?

A

Hand hygiene: Proper handwashing and avoiding staff contact with infections.

Eye care: Use prophylactic eye treatment against ophthalmia neonatorum (e.g., silver nitrate or erythromycin ointment).

Vitamin K administration: Administer 0.5-1 mg of Vitamin K to prevent hemorrhagic disease.

Hepatitis B vaccination: Administer the first dose within 12 hours after birth.

36
Q

What reflexes help a newborn feed properly?

A

Rooting reflex: Turns head toward the breast when cheek is brushed, helping the newborn locate food.

Sucking reflex: The baby begins sucking when the lips are touched. This helps the newborn feed effectively.

Swallowing reflex: When food reaches the back of the tongue, it is automatically swallowed.

37
Q

What steps are involved in proper umbilical cord care?

A
  1. Clean the base of the cord 3 times, alternating between betadine and alcohol.
  2. Clamp the cord 1 inch from the base.
  3. Cut 1 cm away from the clamp.
  4. Fold the diaper below the umbilicus to keep the area dry.
  5. Avoid using creams, lotions, or oils near the umbilical cord.
38
Q

What is the Newborn Screening, and why is it important?

A

Purpose: To detect congenital metabolic disorders that can lead to mental retardation or death if untreated.

How it’s done: A few drops of blood are collected from the newborn’s heel and placed on a special absorbent filter paper.

Timing: Ideally done 48-72 hours after birth, or at least after feeding has been introduced.

39
Q

What are the key nursing diagnoses for a newborn?

A
  1. Risk for ineffective airway clearance
  2. Risk for ineffective thermoregulation
  3. Risk for infection and complications
  4. Readiness for enhanced nutrition
  5. Readiness for enhanced parenting
40
Q

What are the steps to establish and maintain a patent airway in a newborn?

A
  1. the infant in a head-down or side-lying Trendelenburg position.
  2. Suctioning: Use a suction bulb (1 bulb per baby) to clear the mouth first, then the nose.
  3. Decompress the bulb before inserting into the baby’s mouth and nose.
41
Q

What are the characteristics of the newborn’s skin?

A
  1. Turgor: Good elasticity, assess hydration over the abdomen.
  2. Color: Pinkish or reddish depending on racial background.
  3. Texture: Soft, smooth, and velvety.
  4. Desquamation: Peeling of the skin, occurring during the first two weeks.
  5. Vernix caseosa: Greasy, cheese-like substance covering the skin at birth.
42
Q

What is physiological jaundice or Icterus Neonatorum?

A

> A yellowish discoloration of the newborn’s skin.
Usually appears between 3-7 days of life.
It is a normal condition resulting from the breakdown of fetal hemoglobin and immature liver function.

43
Q

What are the common birthmarks seen in newborns?

A
  1. Stork Bites
  2. Mongolian Spots
  3. Cutis Marmorata
  4. Harlequin Sign
44
Q

Common Birthmarks:

Flat, red capillary dilations usually on the eyelids, nose, upper lip, or back of the neck.

A

Stork Bites

45
Q

Common Birthmarks:

Slate-colored spots typically on the buttocks or lower back.

A

Mongolian Spots

46
Q

Common Birthmarks:

Mottling of the skin due to cold exposure.

A

Cutis Marmorata

47
Q

Common Birthmarks:

Red on the dependent side and pale on the upper side when the infant lies on one side.

A

Harlequin Sign

48
Q

What are the key characteristics of the newborn’s chest and abdomen?

A

> Chest: Anteroposterior diameter is equal, slight sternal retractions during inspiration, and some may have breast enlargement (Witch’s Milk).

> Abdomen: Cylindrical shape; umbilical cord is bluish-white at birth, becomes yellowish-brown and greenish-black after clamping, cord falls off 7-10 days after birth.

49
Q

What are the nursing interventions for preventing infection and complications in newborns?

A
  1. Eye care: Administer silver nitrate or erythromycin ointment to prevent ophthalmia neonatorum.
  2. Hand hygiene: Ensure proper hand hygiene for staff and visitors.
  3. Vitamin K: Administer 0.5-1 mg to aid in blood clotting.
  4. Hepatitis B vaccination: Give the first dose within 12 hours of birth.
50
Q

What is the correct technique for bathing a newborn?

A
  1. Bath water should be between 37-38°C.
  2. Follow the cephalocaudal technique (clean from head to toe).
  3. Involve parents in the bathing process for education.
  4. Test water temperature using the elbow or wrist.
51
Q

What is the importance of burping a newborn after feeding?

A

> Burping helps release swallowed air, which can lead to regurgitation, abdominal distention, and colic pain.

Techniques include:
1. Holding the baby over the shoulder and gently patting the back.
2. Sitting the baby on the lap, leaning forward, and patting the back.
3. Laying the baby across the lap and gently patting the back.

52
Q

What are the steps for promoting parent-infant bonding?

A
  1. Assess behaviors: Watch for signs of emotional bonding between the mother and the baby.
  2. Encourage sensitive preparation: For older children, prepare them for the arrival of a new sibling to reduce jealousy.
  3. Promote skin-to-skin contact: Encourage parents to engage in skin-to-skin time, which promotes bonding and regulates the baby’s body temperature.
53
Q

What are the steps for newborn diaper area care to prevent diaper dermatitis?

A
  1. Aerate the area: Remove the diaper periodically to allow air to the skin.
  2. Treatment: Apply talcum powder, cornstarch, or petroleum jelly.
  3. Zinc oxide ointment: Use to treat existing diaper rash.
  4. Prevent irritation: Avoid ammonia from urine by changing diapers frequently.
54
Q

How much sleep does a newborn need, and what is the recommended sleeping position?

A

> Newborns sleep an average of 16 hours per day.
They should be placed on their back to sleep to reduce the risk of Sudden Infant Death Syndrome (SIDS).
Infants cry an average of 2 hours per day and are generally fussy at predictable times.

55
Q

What immunizations should a fully vaccinated child receive in their first year?

A
  1. BCG (Bacille Calmette-Guerin) - 1 dose
  2. OPV (Oral Polio Vaccine) - 3 doses
  3. DPT (Diphtheria-Pertussis-Tetanus) - 3 doses
  4. Hepatitis B - 3 doses
  5. Measles - 1 dose

MIDTERMS: Maternal and Child Nursing (3 decks)

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