Chapter 23 Flashcards
What is the transition from intrauterine to extreuterine life occur during the first what hours after birth?
6-8 hours
What is occurring in this 6-8 hours?(3)
Elimination of placental circulation
Lung expansion & increase blood flow
Closeure of the foramen ovale
Since babies are not able to regulate their temperature what do we have to do as nurses and parents?
Maintain it!!
Between the heat loss and heat production
So pat them dry fast
What is GI function of a newborn?
And how does this help?
They can swallow, digest and metabolism and absorption of simple proteins and carbohydrates
Now that their GI is being stimulated usually helps with mom breast milk they can pass their first poop
Meconium
Reproductive system of a newborn
Females vs males
What’s the difference
Females usually will have discharge or even small bloody spotting which is normal because of the increased estrogen in pregnancy and then suddenly drop
Males usually have small white lesion called epithelial pearls at the top
At what weeks of gestation are the tested palpable ?
36-40 weeks
What are the 3 stages of transition period of a newborn?
First period of reactivity
Period of decreased response
2nd period of reactivity
What is in the first period of reactivity in a newborn? (6)
Heart rate is increased to 160-180 beats and then decrease after 30mins
Respirations are irregular
60-80breaths/min
Fine crackles are heard on auscultation
Audible grunting,nasal flaring, restriction of the chest
- normal for the first hour and should cease
Infant is alert and crying
Head side to side movement
Bowel sounds are audible and Meconium may be passed
What is the period of decreased response? (3)
60-100mins
Infant is pink and respiratory are rapid and shallow but not unlabored
Bowel sounds are audible and peristalic waves may be noted
What is the 2nd period of reactivity? (3)
2-8 hours after birth and lasts 10mins to several hours
Tachycardia and Tachypnea
Increase tone and skin color and mucus production
Meconium is usually passed
What does thermoregulsruon mean?
Maintaince of balance bwteeen heat loss and heat production
Hypothermia from excessive heat loss is a common but?
Serious problem
How are 4 ways heat loss can be lost?
Convection
Radiation
Evaporation
Conduction
How does convection heat loss work?
Newborn is an open bassinet without being wrapped
How does radiation heat loss work?
Placing the baby under an open vent or window
How does evaporation heat loss work?
Not drying the baby birth
How does conduction heat loss work?
Placing a naked infant on a cold surface like the scale
How does the neonate attempt to generate heat?
Also called thermogenesis?
By increasing muscle activity
Cold infants may cry and appear restless. Because of the vasoconstriction happening how can the baby look like?
Pale and mottled
How do newborns produce heat?
No shivering thermogenesis
Notes
When an infant is stressed by cold, oxygen consumption increase and plants and peripheral vasoconstriction occur. Thereby decreasing oxygen uptake by the lungs and oxygen to the tissues ; anaerobic glycolysis increase and there is a decreased in PO2 and PH, leading to metabolic acidosis
Newborn reflexes
Rooting & sucking ?
Swallowing?
Palmar grasps ?
Plantar grasps?
Extrusion?
Glabellar (Myerson)?
Tonic neck or fencing ?
Moro?
Stepping or walking ?
Crawling ?
Deep tendon?
Crossed extension?
Touch infant lip and they open mouth
Sucking and obtaining fluids
Hand grasps
Feet grasps
Touch or depress tip of tongue
( newborn forced tongue outward )
Newborn blinks for forth four or five taps on their forehead
Facing left side, arm and leg will extend and the opposite arm and leg flex
Kinda scare the baby and they extend everything and fan out fingers
They will stimulate walk when you hold under arms
Place newborn on abdomen and they will do crawl motions
Percussion on their arm or leg and they will move it, a jerk
Supine position and press down on knee or leg to extend it, the other leg should flex it
Babinski planter ?
Pull to sit?
Truncal incurvation
Magnet?
All goes hyperextend and flex of big toe
Stroke their foot
Pull infant by wrist in supine position and infant head should not move but body does
Baby is in prone position and run finger on back
Truck is flex and pelvis is swung toward
Please fingers on their toes and they should pressure against the fingers with their toes
Newborns baby can see as far as ?
50cm (2.5 feet )
The clearest vision distance is ?
17-20cm ( 8-12 inches )
This 8-12inches of best vision usually is the approximate distance of?
Mom and infant face between breast feeding
When doing this vision test how will the baby show they can see ?
They will do facial expression and stick out tongue
How does a baby hear?
Move or turn towards the sound
And able to recognize mom voice
Smell is super high in newborns, they can even smell their mom and regonize other breast milk at what day?
Day 5
What is their touch most sensitive?
Like what part of their body?
Mouth
Hands
Face
Feet soles
Can babies distinguish among taste?
Duh
That’s why they so picky!
Identify signs of neonate risk of problems and infection
What’s the 3 first signs?
Persistent crying
Irritability
Fever
Respiratory sick?
Cardio sick?
Gi sick?
Renal sick?
Hepatic sick?
Integumentary sick ?
Reproductive sick?
Skeletal sick?
Nasal flaring
Subcostal retractions
Tachy or Brady
Absent, bounding pulse
Cyanosis
Lack of urination
Enlarged masses like kidneys
Poor appetite
No Meconium
Abdominal distention
Diarrhea/vomiting
Jaundice, hypoglycemia
Pale
Purplish color
Jaundice
Females /fecal discharge in vagina
Hymnal tags - absence means vaginal agnesis
Males : enlarged testicles, undestended
Inguinal hernia when they cry^
Fracture of clavicle to pass through
