Chapter 23 - 3 Flashcards
Psychosocial Adaptation
Periods of reactivity
Behavioral states
Brazelton Neonatal Behavioral Assessment Scale (BNBAS) assesses response to 28 hours
First Period of Reactivity
Intense activity first 30min alternating with quietness
Tachypnea, retractions, grunting
Tachycardia, transit murmur, acrocyanosis
(baby trying to figure out how to breathe)
Period of decreased responsiveness
Quietness or sleeping
No intense reactions
Respirations and heart rate return to baseline
Duration: 60-100 min
Second Period of Reactivity
Hyperresponsive Varied skin color changes VS depend on activity Airway may become compromised 2-8 hours after birth, lasts 10 min to several hours
sleep-wake states
deep sleep, light sleep, drowsy, quiet alert, active alert, crying, state modulation
deep sleep -
Eyes closed, no REM, may startle w/o stimulus
light sleep -
Irregular respirations, sucking, little movement, may startle w/stimulus
drowsy -
Eyes open, closed, or flutter; slow movement
quiet alert -
Follows objects, some motor activity
active alert -
Reacts to stimuli, rapid movement
State modulation-
ability to smoothly transition (babies have trouble going from state to state)
Physical Assessment of the Newborn (start with head)
Respiratory Thermoregulation Blood glucose Bilirubin Neurologic Skin color, vernix caseosa, lanugo, milia, erythema toxicum, birthmarks, delivery trauma
Newborn Assessment
Inspection, auscultation, palpation, percussion
Assessment at delivery:
Apgar (in 1-5 minutes)
Nursery assessment
General appearance (Color, position, tone)
Cry (Lusty, weak/shrill, grunting)
Respiratory effort (Retractions, gasping, nasal flaring)
VS
Physical exam
Apgar Scoring:
Assessment of: Appearance: Color Pulse: Heart rate Grimace: Reflex response Activity: Muscle tone Respirations: Respiratory effort
Graded 0-10 at 1 min and 5 min after birth, q5min if <7 at 5 min up to 20min
temp of newborn
36.5 to 37.5 degrees C (97.7 to 99.5 degrees F) axillary, 36.5 to 37.6 degrees C (97.7 to 99.7 degrees F) rectal
apical pulse of newborn
120 to 160 bpm (100 sleeping, 180 crying)
respirations of newborn
30 to 60/min
Newborns: Head-to-Toe
Skin Head Ears Face Eyes Nose Mouth Feeding Neck/clavicles Chest Abdomen Genitals Extremities Back Reflexes
Telangiectatic nevi-stork bites-
pink easily blanched-upper eyelids, nose, uper lip, lower occipital area, nape of neck
Usually fade by 2 years
Nevus vasculosus-
strawberry hemangioma-75 % on head
Nevus flammeus-
port wine stain
Erythema toxicum-
erythema neonatorum, newborn rash, flea bite dermatitis
First 3 weeks of life
No tx-goes away
