Chapter 23 Flashcards
What is the first stage of the transition period and how long does it last?
First Period of Reactivity. Lasts up to 30 minutes after birth.
How long does the period of decreased responsiveness last?
60-100 minutes.
The second period of reactivity
occurs between 2-8 hours after birth and lasts from 10 minutes to several hours.
Clamping the umbilical cord causes a rise in ___ which increases what?
BP. Circulation and Lung perfusion.
The alveoli of the term infant’s lungs are lined with __________, a protein manufactured in type II lung cells.
surfactant
What happens with decreased or absent surfactant?
more pressure must be generated for inspiration, which can quickly tire a preterm or sick term infant.
Normal breath sounds for the first few hours?
should be clear and equal bilaterally but fine rales are not unusual
What is a normal respiratory rate for baby?
30-60. Anything below 30 or above 60 needs to be evaluated.
What is Acrocyanosis?
the bluish discoloration of hands and feet. this is a normal finding in the first 24 hours after birth.
When does TTNB usually resolve?
within 24-48 hours.
What is the normal heart rate for a term newborn?
110-160
Where can you palpate the heart rate immediately after birth?
at the base of the umbilical cord
Where is the apical pulse on the newborn located?
at the fourth intercostal space and to the left of the midclavicular line
Sinus Dysrhythmia
Is common in the newborn
What is the average systolic and diastolic BP for the term newborn?
Systolic: 60-80
Diastolic: 40-50
The MAP should be equivalent to the what?
weeks of gestation
blood volume in the newborn averages
85 ml/kg
What are benefits of delayed cord clamping?
improves hematocrit and iron status and decreases anemia, reduces the risk of intraventricular hemmorhage; benefits can last up to 6 months.
what is thermoregulation?
the maintenance of balance between heat loss and heat production.
heat loss in the newborn occurs by what four modes?
- convection
- radiation
- evaporation
- conduction
Convection
the flow of heat from the body surface to cooler ambient air
Radiation
the loss of heat from the body surface to a cooler solid surface not in direct contact but in relative proximity. (crib to window)
Evaporation
the loss of heat that occurs when a liquid is converted to vapor
Conduction
the loss of heat from the body surface to cooler surfaces in direct contact
what is thermogenesis?
in response to cold the neonate attempts to generate heat by increasing muscle activity
Brown Fat
newborns metabolize brown fat to produce heat; this is rapidly depleted by cold stress.
a stool that is very soft with a high water content with a distinct water ring around the stool on the diaper can be indicative of what?
the infant is allergic to or unable to digest a formula
Within the first week the newborns blood glucose level should be approximately what?
60-80 mg/dl
When does physiologic jaundice appear in the newborn?
after 24 hours of age
when does pathologic jaundice appear in the newborn?
within 24 hours of birth.
define kernicterus
refers to the irreversible long term consequences of bilirubin toxicity such as hypotonia, delayed motor skills, hearing loss, cerebral palsy, and gaze abnormalities.
breastfeeding associated jaundice begins when?
at 2-5 days old
breast milk jaundice appears when?
5-10 days old
what is the greatest risk factor for neonatal infection?
prematurity
what is the cheeselike whitish substance found on the epidermis after 35 weeks gestation?
vernix caseosa
what are Mongolian spots?
bluish black areas of pigmentation that can appear over any part of the body.
Nevus simplex
stork bites
petechiae can be normal if it disappears within 48 hours but if not….
should be report to the pcp as this can indicate underlying problems
what is hydrocele?
accumulation of fluid around the testes
what is caput succedaneum?
generalized edematous area of the scalp found on the occiput. Usually disappears within 3-4 days.
what is cephalhematoma?
a collection of blood between a skull bone and it’s periosteum. Usually resolves in 2-8 weeks.
what is subgaleal hemorrhage?
bleeding into the subgaleal compartment.
What are signs of developmental dysplasia of the hips?
asymmetric gluteal and thigh skinfolds, uneven knee levels, a positive Ortolani test, and a positive Barlow test.
Moro Reflex
allowing head to fall backward with support or performing a sharp hand clap; infant should extend arms and fingers out like they’re startled
Babinski Reflex
stroking the heel of the foot up and across the ball of the foot; infant should hyperextend toes.
newborns can see objects as far away as __ cm but their clearest visual distance is __ to __ cm away.
- 17-20
by the _____ day of life babies can recognize their mother’s smell.
fifth
what can a high pitched cry be a sign of?
a neurological disorder
what is habituation?
a protective mechanism that allows the infant to become accustomed to environmental stimuli.
