Chapter 21

Question 1

What lines the alveoli of the lungs and reduces surface tension to keep the alveoli open?

Answer 1

Surfactant

Question 2

When does fetal lung fluid move into the interstitial space?

Answer 2

before, during and after birth

Question 3

What two systems absorb lung fluid after birth?

Answer 3

Lymphatic and vascular systems

Question 4

What 4 factors combine to stimulate the respiratory center in the brain and initiate respirations at birth?

Answer 4

Chemical, Mechanical, Thermal, and Sensory

Question 5

What are the 4 cardiovascular adaptions that occur after birth in the transition from fetal to neonatal circulation?

Answer 5

1. Increases in blood O2 levels
2. Shifts in pressure in the heart and lung
3. Closing of the umbilical vessels
4. closing of the ductus arteriosus, foramen ovale, and the ductus venosis,

Question 6

What 3 newborn characteristics lead to heat loss?

Answer 6

1. Skin with little subcutaneous fat
2. Blood vessels close to the surface
3. Large skin surface

Question 7

What are the 4 methods of heat loss in a newborn?

Answer 7

Evaporation, conduction, convection, radiation

Question 8

What is the difference between conduction and convection?

Answer 8

conduction is the transfer of temperature by direct contact

convection is the transfer of temperature by circulating air

Question 9

What 5 methods in the neonate produce heat?

Answer 9

Increased activity, flexion, metabolism vasoconstriction, nonshivering therogenesis (brown fat)

Question 10

What negative effects can the methods of heat production in a neonate cause?

Answer 10

increase oxygen and glucose consumption, respiratory distress, hypoglycemia, and jaundice

Question 11

What 6 effects can “Cold Stress” place on the body of the neonate?

Answer 11

Increased oxygen need, decreased surfactant production, respiratiory destress, hypoglycemia, Metabolic acidosis, Jaundice

Question 12

What is a major difference in neonate erythrocytes vs. the erythrocytes of an older child?

Answer 12

Shorter lifespan

Question 13

What does the nurse give a new born to help increase its clotting factors?

Answer 13

Vitamin K

Question 14

What are the blood glucose levels of a newborn on day one?

Answer 14

40-60

Question 15

What are the blood glucose levels of a newborn after day one?

Answer 15

50-100

Question 16

What are the characteristics of the stools from a breast feed infant?

Answer 16

Frequent, seedy and mustard- colored

Question 17

What percentage of a newborn is composed of water?

Answer 17

75%

Question 18

What is the only Ig to cross the placenta?

Answer 18

IgG

Question 19

What Ig protects a neonate from gram negative bacteria?

Answer 19

IgM

Question 20

What Ig is passed from the mother to the new born through breast milk?

Answer 20

IgA

Question 21

What is the R/R of a new born?

Answer 21

30-60

Question 22

What is the pulse of the new born?

Answer 22

120-160

Question 23

What is the average systolic of a new born?

Answer 23

65-95

Question 24

What is the average diastolic of a new born?

Answer 24

30-60

Question 25

What condition can occur after the first 24 hours of life as a result of hemolysis of red blood cells and immaturity of the liver?

Answer 25

Physiologic Jaundice

Question 26

What condition begins in the first 24 hours and may require treatment with phototherapy?

Answer 26

Pathologic Jaundice

Question 27

What can cause Breast Milk Jaundice?

Answer 27

lack of sufficient intake

Question 28

After birth how soon should the neonates first void be?

Answer 28

within 24 hours

Question 29

How soon should you first assess a neonate after birth?

Answer 29

immediately

Question 30

What 5 characteristics should the nurse assess for in the shape of the neonate head?

Answer 30

Molding, Fontanels, Caput, Cephalhematoma, Facial Symmetry

Question 31

What 5 characteristics are measured in the neonate?

Answer 31

Weight, Length, Head and Chest circumference, Eyes and ears, Reflexes

Question 32

What are signs of Hypoglycemia in the new born?

Answer 32

Jitteriness, tremors, poor muscle tone, sweating, tachypena, grunting, cyanosis, apnea, diaphoresis, low temperature, poor suck reflex, high-pitched cry, lethargy, irritability, seizures, coma

Question 33

What are the characteristics of the new born female genitalia?

Answer 33

Labia majora should be large and completely cover the clitoris and labia minora, Genitalia may be darker than the surrounding skin, a small amount of vaginal discharge is normal

Question 34

What are the characteristics of the new born male genitalia?

Answer 34

The scrotum should be pendulous, genitalia may be dark brown, palpation of the scrotum determines if the testes have descended

Question 35

What is the cheesy substance found on the skin of the new born?

Answer 35

Vernix

Question 36

What is the fine hair that covers the body of the new born?

Answer 36

Lanugo

Question 37

What are the white spots seen on a new born that look like acne?

Answer 37

Millia

Question 38

What is the normal sound of a new born cry?

Answer 38

Lusty, Strong

Question 39

How does the nurse perform the Barlow Test?

Answer 39

Adduct the hips, and apply gentle pressure down and back with the thumbs. In hip dysplasia, the examiner can feel the femoral head move out of the acetabulum

Question 40

How does the nurse perform the Babinski Reflex test?

Answer 40

By stroking the lateral sole of the infant's foot from the heel forward and across the ball of the foot. This causes the toes to flare outward and the big toe to dorsiflex.

Question 41

What is the Moro Reflex?

Answer 41

It is a flaring action that occurs when the infants head and trunk are allowed to drop back 30 degrees.

Question 42

What is the Palmar grasp reflex?

Answer 42

The hand closes into a tight fist when the infant's palm is touched near the base of the fingers.

Question 43

What is the Plantar grasp reflex?

Answer 43

When the infant's foot is touched below the toes, the toes will curl over the nurses fingers.

Question 44

What is the Rooting reflex?

Answer 44

When the infants cheek is touched near the mouth, its head will turn toward that side.

Question 45

What is the Sucking reflex?

Answer 45

When the mouth or palate is touched the infant begins to suck

Question 46

What is the Tonic Neck Reflex?

Answer 46

The infants extend the arms and leg on the side to which the head is turned and flexes the extremities on the other side.

Question 47

What is the Stepping Reflex?

Answer 47

When held upright with just the feet touching a surface the infant will lift one foot and then the other.