Ch18 Flashcards
First assessment
Performed in the birthing area immediately after delivery. Vital signs, APGAR score, length, weight, and “eyes & thighs” included
Second assessment
A complete head-to-toe assessment including vital signs, gestational age assessment, anthropometric measurements, and reflex testing. This assessment must be completed within the first 24 hours of life
Problem signs during newborn assessment
Flaccid body posture Abnormal respiratory rates Abnormal breath sounds Abnormal heart rates Abnormal newborn size Nasal flaring Chest retractions Grunting on exhalation, labored breathing Generalized cyanosis
APGAR
A = appearance (color) P = pulse (heart rate) G = grimace (reflex irritability) A = activity (muscle tone) R = respiratory (respiratory effort)
Perfect APGAR score = 10 pts
Pink trunk and extremeties >100 bpm Sneeze/cough/cry Right flexion, good resistance to extension Breaths 30-60/min
V/S: temp
97.7–99.5 degrees F axillary
Axilla is preferred site over rectal temperature
Adhesive probes should be placed over liver
V/S: Heart rate
120–160 bpm; regular rhythm
V/S: respiration
30-60 bpm
Respirations irregular, shallow, unlabored
Symmetrical chest movements
V/S: BP
50-75mm Hg systolic & 30-45mm Hg diastolic
Not part of the normal assessment
V/S: pulse ox
96-100% on room air (R hand & either foot. After 24h of age)
Eye prophylaxis
- help prevent neonatorum blindness if mom had gonorrhea or chlamydia when baby comes through birth canal. erythromycin ointment put in conjunctiva tract
Installation is to be done as soon as possible after birth & no longer than 1-2 hours after
Vitamin k
prevent clotting: Fat-soluble vitamin which promotes blood clotting by the synthesis of prothrombin by the liver
Measuring newborn lenght
Length is measured from the head of the newborn to the heel, while the newborn is in a supine position with one leg extended completely
Expected length, full term = 19-21 inches
Newborn weight
Weight is measured in grams, on a digital scale
Newborns may lose up to 10% of their birth weight
Typical weight, full term = 2,700-4,000g (6-9 lbs)
Low Birthweight (
Head and chest circumference
Average Head Circumference is 13-15 inches (32-38cm)
Average Chest Circumference is 12-14 inches (30-36cm)
Vernix caseosa
Thick white cheesy-looking substance that protects the fetus’ skin
Often found in body creases, ears, etc.
Lanugo
Hair
Grows on fetuses as a part of normal gestation
Typically found on shoulders, back, cheeks,
Begins to appear at 24 weeks gestation & is shed by 40 weeks
Its presence is typically a sign of prematurity
Milia
Unopened sebaceous glands
Most often on nose, chin, forehead
Disappear on their own, within 1-2 weeks
Erythema toxicum
Known as “Newborn Rash”
Benign, idiopathic, generalized, transient rash
70% of newborns develop
Resolves on its own within days
Nevus simplex
Also known as stork bites or salmon patches
Frequently on eyelids, forehead, upper lip & nape of the neck
Concentration of immature blood vessels
Most visible when infant cries or is upset
Usually fade within the first year
Nevus Flammeus
Also known as “Port Wine Stain”
Most often on the face
Below the dermis
Permanent
May be associated with structural malformations and certain cancers
Nevous vasculosus
Known as Strawberry Hemangioma Benign capillary hemangioma Raised, rough, sharp demarcation Often on scalp, neck, or face No treatment Usually resolves within 3 years
Mongolian spots
Concentrated area of pigmented cells Appear as blue or purple splotches Most often on buttocks Frequently on dark-skinned newborns Usually disappear within first 4 years
Seborrhoeic dermatitis
cradle cap
