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RNSG 1251 UNIT 1 > ch. 23: physiologic and behavioral adaptations of the newborn > Flashcards

ch. 23: physiologic and behavioral adaptations of the newborn Flashcards

1
Q

What is the BALLARD ASSESSMENT?

A

estimation of gestational age by neuromuscular and physical maturity

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2
Q

Is PERIODIC BREATHING normal in newborns?

A

yes it is a normal variation of breathing

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3
Q

What is the NORMAL BREATHS/MIN for newborns?

A

30 to 60 breaths/min

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4
Q

When should APNEIC PERIODS be evaluated?

A

when they last > 20 seconds

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5
Q

Are MOIST LUNG SOUNDS normal in newborns?

A

yes it is common, especially in c-section babies

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6
Q

What is ACROCYANOSIS?

A

bluish discoloration of HANDS and FEET due to immature circulation

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7
Q

Is ACROCYANOSIS normal?

A

It is normal in first 24 hrs of birth

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8
Q

What are some signs of RESPIRATORY DISTRESS?

A
  • nasal flaring, intercostal or subcostal retractions
  • grunting
  • RR < 30 or > 60
  • central cyanosis
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9
Q

What is CENTRAL CYANOSIS?

A
  • a LATE sign of RESPIRATORY DISTRESS
  • LIPS & MUCOSA are BLUE
  • signifies HYPOXEMIA
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10
Q

What is the normal range for FHR?

A

110 to 160 bpm

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11
Q

What is the average FHR when SLEEPING?

A

80 to 100 bpm

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12
Q

What is the average FHR when CRYING?

A

up to 180 bpm

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13
Q

Where is the PMI on newborns?

A

4th ICS left of the midclavicular line

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14
Q

What is the normal range for NEWBORN BP?

A
  • systolic: 60-80 mmHg

- diastolic: 40-50 mmHg

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15
Q

What is PERSISTENT TACHYCARDIA (>160 BPM) associated w?

A

anemia, hypovolemia, hyperthermia, sepsis

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16
Q

What is PERSISTENT BRADYCARDIA (<100bpm) associated w?

A

hypoxemia or congenital abnormalities

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17
Q

What is CONVECTION?

A

loss of heat from the warm body surface to the COOLER AIR CURRENTS
-keep infant away from open doors, wrap them and place cap on head

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18
Q

What is RADIATION?

A

loss of heat when body heat RISES TO COOLER SURFACES and objects NOT IN DIRECT CONTACT w/ body
-keep infant away from cold objects and outside windows

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19
Q

What is EVAPORATION?

A

loss of heat when WATER is converted into VAPOR

-dry infant after birth and place skin to skin

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20
Q

What is CONDUCTION?

A

loss of heat to cooler surface by DIRECT CONTACT

-place protective covering on scale, prewarm bed

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21
Q

What are signs of HYPOTHERMIA and COLD STRESS?

A
  • pale, mottled, and skin cool to touch
  • flexed position to conserve heat
  • increased RR
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22
Q

What are some INTERVENTIONS for COLD STRESS?

A

1) cap on head
2) skin to skin w/ warm blanket
3) swaddle
4) radiate warmer (set to 36.5 C)
5) assess VS every 5 min when rewarming until 37 C
6) check hydration and provide fluids
7) monitor q4 hrs
8) obtain heel stick BS

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23
Q

What are signs of HYPERTHERMIA?

A

-infant appears FLUSHED, hands and feet WARM to touch, EXTENDED POSITION

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24
Q

What are some interventions for HYPERTHERMIA?

A

1) physical assessment
2) maintain neutral thermal environment
3) assess axillary temp

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25
Q

What is the normal BODY TEMP for newborns?

A

36.5 to 37.5 C (97.7 to 100 F)

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26
Q

What percentile is LGA?

A

> 90%

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27
Q

What percentile is AGA?

A

10-90 %

28
Q

What percentile is SGA?

A

< 10%

29
Q

What could a PILONIDAL DIMPLE OR SINUS mean?

A

spina bifida

30
Q

How can you check if an infant has NORMAL TREMORS?

A

as you touch the body part or place mild restraint, the TREMORS SHOULD CEASE

31
Q

Why do NORMAL TREMORS OCCUR?

A

because of slight immaturity

32
Q

How long do NORMAL TREMORS LAST?

A

first month

33
Q

What are SIGNS of HYPOGLYCEMIA?

A

-lethargy, poor feeding, jitteriness, abnormal cry, hypotonia, temp instability

34
Q

How do you check for SEIZURE ACTIVITY?

A
  • tremor DOES NOT cease w/ general restraint

- involves ocular and autonomic (apnea, tachycardia, pupil changes, salivation)

35
Q

What is MOLDING?

A

overlapping of the cranial bones as the baby comes through the birth canal

36
Q

What is CAPUT SUCCEDANEUM?

A

generalized area of EDEMA on the scalp and CROSSES SUTURE LINES
-subsides in 3 to 4 days

37
Q

What is CEPHALOHEMATOMA?

A

collection of BLOOD btwn the SKULL BONE and its PERIOSTEUM and DOES NOT CROSS SUTURE LINES

38
Q

What is SUBGALEAL HEMORRHAGE?

A
  • usually from trauma during birthing process such as a vacuum
  • vessels are broken and BLEEDING happens into subgaleal space
39
Q

What are SIGNS of SUBGALEAL HEMORRHAGE?

A
  • boggy scalp
  • pallor
  • tachycardia
  • increased head circ
  • decrease in HCT
  • increase in bilirubin
40
Q

What is VERNIX CASEOSIA?

A

WHITE CHEESY substance that acts as PROTECTION layer on skin and has ANTIMICROBIAL properties
-also prevents fluid loss

41
Q

What is DESQUAMATION?

A

PEELING of skin

42
Q

What is NEVI?

A
  • stork bite
  • small FLAT and PINK areas
  • on upper eyelids, nose, upper lip, nape of neck
  • fades in 1 to 2 yrs
43
Q

What is MILA?

A

small distended WHITE SEBACEOUS glands on face

44
Q

What are MONGOLIAN SPOTS?

A
  • BLUISH/BLACKISH areas
  • usually noted at BACK OF BUTTOCKS
  • most common in: HISPANICS, ASIAN, AFRICAN AMERICANS
45
Q

What is ERYTHEMA TOXICUM?

A
  • aka NEWBORN RASH
  • looks like SMALL FLEA BITES
  • appears during 224-72 hrs
  • lasts up to 3 weeks
46
Q

When should INFANTS VOID?

A

within 24 hrs

47
Q

What is MECONIUM?

A
  • first stools passed
  • black tarry stools composed of amniotic fluid & elements
  • should pass within 24 hrs
48
Q

What are some HUNGER CUES?

A
  • random hand to mouth movement

- sucking on fingers

49
Q

Is it common for newborn FEMALES to have a WHITE MUCOUSY VAGINAL DISCHARGE?

A

yes its bc of the increased estrogen during pregnancy

50
Q

Is it normal for GENITALIA to be more pigmented than the rest of the body?

A

yes

51
Q

Is it common for BREAST TISSUE to me SWOLLEN?

A

yes it is caused by HYPERESTROGENISM

  • subsides in a few days
  • may also notice thin discharge from nipples (Witch’s Milk)
52
Q

How long does the IRON STORAGE last in newborns?

A

4 to 6 months

53
Q

What is the normal GLUCOSE LEVELS for newborns?

A

50-60 mg/dl

54
Q

What glucose level is TOO LOW and requires INTERVENTION?

A

< 40 mg/dl

55
Q

What is JAUNDICE?

A

yellowing of skin, sclera, lethargy, irritability

-build-up of bilirubin (from broken down RBCs)

56
Q

Do newborns have a Vit. K DEFICIENCY?

A

yes bc of the lack of intestinal bacteria needed to synthesize Vit. K

57
Q

What is PHYSIOLOGIC JAUNDICE?

A
  • appears AFTER 24 hrs

- NO TREATMENT needed

58
Q

What is PATHOLOGIC JAUNDICE?

A
  • appears WITHIN 24 hrs

- DANGEROUS bc unconjugated bilirubin will pass the BBB and cause irreversible brain damage and neurologic delays

59
Q

What is BREASTFEEDING-ASSOCIATED JAUNDICE?

A
  • early onset (2-5 days)

- caused by LACK of effective breastfeeding

60
Q

What is BREAST MILK JAUNDICE?

A
  • late onset (5-10 days)

- may be due to factors in BREAST MILK that inhibit conjugation or decrease excretion in bilirubin

61
Q

What ANTIBODY makes up most of the circulating antibodies in newborns?

A

IgG

62
Q

At what distance do newborns have the CLEAREST VISION?

A

8 to 12 inches

63
Q

What is TEMPERAMENT?

A

individual characteristics that affect how infant responds to stimuli

64
Q

What is HABITUATION?

A

ability to ADAPT to and DECREASE RESPONSE to REPETITIVE STIMULI

65
Q

What is CONSOLABILITY?

A

can the newborn console themselves or does the caregiver need to do something like HOLDING or ROCKING?

66
Q

What is CUDDLINESS?

A

the degree to which the newborn will RELAX and MOLD to caregiver

67
Q

What is IRRITABILITY?

A

sensory threshold

does the child get upset easily?

RNSG 1251 UNIT 1 (8 decks)

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