Chapter 21: Care of the Normal Newborn Flashcards
The correct order for suctioning an infant’s airway with the bulb syringe is to suction the ____ first and the ____ second. Why?
The correct order for suctioning an infant’s airway with the bulb syringe is to suction the mouth first and the nose second. (only if needed)
The infant might gasp when the nose is suctioned, drawing any secretions that are in the mouth into the airway.
Why is it particularly important that the infant’s head be dried promptly?
The head makes up a large part of the newborn’s body and thus is a large surface for heat loss.
What added interventions should the nurse perform if an infant has a subnormal temperature?
Assess for and correct sources of heat loss, such as wet clothing, drafts, or exposed skin. Place the infant skin to skin wiht the mother or wrap the flexed infant snugly in warm blankets. Apply a hat and a shirt, and use another shirt with the sleeves over the legs. A radiant warmer, regulated by a skin probe, may be needed for very low temperatures. Have the mother breastfeed or feed the infant formula if it is near feeding time. Teach parents about maintaining the infant’s temperature, particularly if their actions have contributed to the low temperature.
What type of heat loss can occur in each situation?
a. Placing the newborn on a cold, unpadded surface:
b. Using a cold stethoscope to listen to breath sounds:
c. Placing the infant’s crib by a window on a snowy day:
d. Partially drying the infant’s hair after the bath:
e. Placing the infant’s crib near an air conditioner vent:
f. Forgetting to turn the radiant warmer on before placing the infant under it:
a. Placing the newborn on a cold, unpadded surface: Conduction
b. Using a cold stethoscope to listen to breath sounds: Conduction
c. Placing the infant’s crib by a window on a snowy day: Radiation
d. Partially drying the infant’s hair after the bath: Evaporation
e. Placing the infant’s crib near an air conditioner vent: Convection
f. Forgetting to turn the radiant warmer on before placing the infant under it: Conduction
Explain to parents why it is important for their jaundiced infant to eat frequently and adequately.
Infants who do not eat well will be slower in passing stools in which bilirubin is eliminated. When feces remain in the intestines, an enzyme that was important during fetal life may change the bilirubin back to a form that cannot be eliminated in the stools. The bilirubin may be absorbed back into the bloodstream and the liver will have added work in changing it back to a form in which it can be excreted.
What should the nurse teach new parents about infants?
a. Holding the baby for burping:
b. Urination:
c. Stools:
a. Holding the baby for burping: Hold the baby upright against your shoulder or in a sitting position on your lap, with the head and chest supported while you pat the back.
b. Urination: the baby will have at least one or two wet diapers per day on the first day or two, increasing to at least six wet diapers by the fourth day. Notify the physician if there are no wet diapers in 12 hours.
c. Stools: The first stools are called meconium (tarry, greenish-black, and sticky), followed by transitional stools, followed by milk stools. The stools of breastfed babies are mustard yellow, soft, and seedy and have a sweet-sour smell. Stools of formula-fed babies are pale yellow to light brown and formed. The baby is not constipated unless the stools are dry and hard like marbles. A water ring around the stool in the diaper indicates diarrhea and should be reported to the physician.
What are the three primary nursing observations after circumcision?
Bleeding, urination, and infection
What circumcision problems should parents be taught to report?
Notify the physician if there is no urinary output within 6-8 hours, bleeding more than a few drops with first diaper changes, or displacement of the Plastibell. Apply pressure if any bleeding occurs. Report signs of infection, such as redness, edema, tenderness, and discharge (a yellow exudate that dries is normal.).
List signs that suggest infection at the umbilical cord. What measures can prevent cord infection?
Signs of infection include redness or edema at the cord base and purulent drainage. Keep the cord area dry by folding the diaper below the area. Check with the health care provider regarding tub bathing before the cord has detached and the area is fully healed. Care generally includes cleaning the cord with water if necessary and allowing it to dry naturally.
What is the primary method of identifying the newborn and mother (or other support person)?
Identification is carried out by matching the electronic dvice or imprinted numbers on the adult’s wristband with those on the infant’s identification bands or device. The numbers should be matched every time the infant is reunited with the parent. The nurse should visually match the numbers or have the parent or support person read the imprinted numbers from his or her band.
What are some examples of suspicious behavior in a visitor that should cause the nurse to think about possibility of abduction?
Visitors who go from one room to another, visitors who ask many questions regarding hospital routines and floor plan, anyone carrying an infant in the hallway or taking a crib to areas where it should not be taken, anyone carrying a bag or package large enough to hide an infant.
What are some general signs of newborn infection?
a. Low temperature
b. lethargy
c. poor feeding
d. periods of apnea without obvious cause
e. any unexplained change in behavior
f. drainage from the eyes, cord, or circumcision.
Explain why these medications are typically given to newborns. Which is required by state law?
a. Vitamin K:
b. Erythromycin eye ointment:
c. Hepatitis B immunization:
a. Vitamin K: Vitamin K, which is necessary for normal blood coagulation, is given because the infants gastrointestinal tract is sterile at birth and temporarily lacks the microorganisms that will make this vitamin.
b. Erythromycin eye ointment: Required by state law to prevent gonorrhea acquired in the mother’s birth canal.
c. Hepatitis B immunization: Is given to promote the infant’s manufacture of antibodies against this viral infection of the liver.
Do infants of mothers with hepatitis B need any additional medication? Why?
Mothers who are positive for hepatitis B (carriers) may transit the organism to their infant at birth. The first dose of a series of three doses of vaccine is given within 12 hours of birth to infants of mothers who are hepatitis carriers. These infants also receive hepatitis B immune globulin within 12 hours to provide passive antibody protection until the infant manufactures his or her own active antibodies to the virus.
