CH 18 - NEWBORN 2

Question 1

Initial Newborn Assessments:

Answer 1

Signs indicating a PROBLEM

1. nasal flaring - using accessory muscles to breathe (too much fluid, need to cry, suction, percussions aka pat back)
2. chest retractions
3. grunt, labored breathing - usually just need to get fluid out
4. generalized cyanosis, flaccid posture - cyanosis of hands and feet okay BUT generalized is NOT good
5. abnormal breath sounds, rr - too fast/ too slow
6. abnormal hr, size - can heat up and go tachy

Question 2

Gestational Age Assessment tests for what:

Answer 2

1. PHYSICAL MATURITY (skin texture, lanugo, plantar creases, breast tissue, eyes and ears, genitals)
2. NEUROMUSCULAR MATURITY (posture, square window, arm recoil, popliteal angle, scarf sign, heel to ear)

Question 3

APGAR Scoring

Answer 3

A = appearance /color
P = pulse / heart rate
G = grimace / reflex irritability
A = activity / muscle tone
R = respiratory

1 min & 5 min

-score of 6 or below then we do a third score at 10 min

Question 4

Newborn VS

Answer 4

temp: 97.7 - 99.5

hr: 110 -160

respirations: 30-60 and do for a full min bc of irregular breathing

bp: don’t do

Question 5

Preterm/ Premature

Answer 5

prior to 37 weeks

Question 6

Term Baby

Answer 6

38-42 weeks

Question 7

Post term

Answer 7

after 42 weeks

Question 8

Vernix caseosa :

Answer 8

looks like cheesey white substance on skin, more for preterm babies
protects the skin

Question 9

Stork Bite:

Answer 9

at the back of the head

Question 10

Milia:

Answer 10

neonatal acne
-do not squeeze or pop these
-go way on their own, but if popped then they can get infected

Question 11

Mongolian Spots:

Answer 11

-discoloration usually by the butt crack

Question 12

Erythema Toxicum:

Answer 12

-red rash w/ white bumps
-do not pop/ squeeze
-very common on the butt

Question 13

Harlequin Sign:

Answer 13

different colors on each side of the body

Question 14

Nevus Flammeus aka Port Wine Stain:

Answer 14

red “stain”/ birthmark

Question 15

Nevus Vasculosus:

Answer 15

raised and looks like a mole, red.
does not go away

Question 16

Caput v Cephalohematoma

Answer 16

Caput - has serum

hematoma - blood, don’t drain it, want it to stop or go away on it’s own, baby can get sick.
-can have a quarter of the baby’s blood volume in there

Question 17

Microcephaly

Answer 17

usually has developmental problems
-small head
-zinka virus

Question 18

macrocephaly

Answer 18

big head

Question 19

Common Concerns During Newborn Transition (3):

Answer 19

1. transient tachypnea of newborn
2. physiologic jaundice
3. hypoglycemia

Question 20

TTN - transient tachypnea of the newborn

Answer 20

breathing fast, need to give oxygen/stimulation & it should go away

Question 21

Physiologic jaundice aka hyperbilirubinemia

Answer 21

-need phototherapy
-normal - get it at day 3/4

Question 22

Hypoglycemia

Answer 22

v common in babies, esp diabetic babies.
will get jittery when glucose goes down
-mom can breastfeed to get it back up or IV

Question 23

Screening for Newborns (4):

Answer 23

1. PKU
2. congenital hypothyroidism
3. galactosemia - can’t break it down
4. sickle cell anemia

Question 24

LATCH method for assessing breast feeding:

Answer 24

L: how well infant latches onto breast
A: amount of audible swallowing
T: nipple type
C: comfort level
H: amount of help mom needs

-done on all babies breastfeeding in the hospital