ch 7 health promotion of newborn and family Flashcards
respiratory changes in the newborn
-fetal lung fluid removal
-compression of chest through birth canal
-lymphatic vessels and capillaries
cardiac changes in the newborn
-closure of fetal shunts (foramen ovale, ductus venosus and arteriosus)
-decreased pulmonary vascular resistance
factors that predispose the newborn to excessive heat loss
-large surface area results in heat loss to environment (evaporation, radiation, conduction)
-thin layer subq fat
-can’t shiver
-brown fat metabolism used for thermogenesis
when should meconium stool be passed in newborn
24-48 hrs after birth (black and tarry appearance)
when do transitional stools occur in the newborn? when do milk stools occur in the newborn?
-transitional: day 3 of life (colostrum)
-milk: day 4 of life
factors that could contribute to low apgar score
-low tone
-reduced reflex irritability
-infection
-congenital anomalies
-maternal sedation/analgesia (+drugs)
-hypovolemia
-neuromuscular disorders
what might a weak/groaning/grunting cry at birth indicate
resp disturbance
what might a absent/weak/constant cry at birth indicate
pathology anomaly
what might a high pitched shrill cry at birth indicate
intracranial pressure
neurological issue
what is the NPI
neonatal perception inventory
mom’s perception of her baby compared with image of “average” baby
how many weeks is a term baby?
post-term?
preterm?
term: 36-42 wks
preterm: <36 wks
term: 42+ wks
when does the posterior fontanel close in a newborn?
anterior fontanel?
posterior: by 2 months
anterior: by 18 months
what is the red reflex
-direct visualization of retina to evaluate for congenital cataract
when should strabismus (eyes wander in and out) resolve by in newborn
4-6 months
potential problem from drainage of newborn’s eyes
infection (gonorrhea/syphilis)
can lead to blindness
normal findings in lungs of newborn
-30-60 breaths/min
-episodes of apnea up to 20 secs
how long can you access the veins/arteries in the umbilical cord in a newborn
almost 2 weeks
possible abnormalities in the back of a newborn
-sacral tuft: spina bifida
-pilonidal cyst/sinus
-tethered spinal cord
when are eyedrops and vitamin k (and hep b vaccine) given to newborn after birth
within 2 hrs
why can you not microwave breastmilk
destroys anti-infective properties
negates vitamin C
when can infant have cows milk
after 1 year old
what 3 factors cause a newborn to be more prone to dehydration, acidosis and overhydration
-high rate metabolism
-more acid is formed (leading to acidemia)
-immature kidneys (can’t concentrate urine to conserve body water)
APGAR score (what indicates a 2 in each category)
-Heart rate: 100+ bpm
-resp effort: good strong cry
-muscle tone: well flexed
-reflex irritability: cry, sneeze
-color: completely pink
how is thermogenesis achieved in the newborn
brown fat metabolism
