Chapter 23

Question 1

Neonatal Period

Answer 1

Birth to 28 days

Question 2

Adaptions in the First 6-8 Hours

Answer 2

Maintaining respirations, adjusting to circulatory changes, regulating temperature, eliminating wastes, regulating weight

Question 3

First Period of Reactivity

Answer 3

Lasts up to 30 minutes after birth

HR increases to 160-180 BPM but decreases after 30 min

Infant is alert

Question 4

Period of Decreased Responsiveness

Answer 4

Lasts from 60-100 minutes

Newborn either sleeps or has a marked decrease in motor activity

Question 5

Second Period of Reactivity

Answer 5

Occurs 2-8 hours after birth

Lasts from 10 minutes to several hours

Tachycardia, tachypnea, increased muscle tone, improved skin color, mucous production, meconium typically passed

Question 6

Signs of Respiratory Distress

Answer 6

Nasal flaring

Intercostal or subcostal retractions

Grunting

Question 7

Acrocyanosis

Answer 7

Normal finding in the first 24 hours after birth

Question 8

Blood Pressure

Answer 8

Systolic should be 60-80

Diastolic should be 40-60

Question 9

Signs of Risk for Cardiovascular Problems

Answer 9

Persistent tachycardia

Persistent bradycardia

Skin color: pallor, cyanosis

Question 10

Hematopoietic System

Answer 10

Fetus needs additional RBCs for transport of oxygen in utero

May have low WBCs

Blood volume should be adequate

Question 11

Heat Loss Occurs by…

Answer 11

Convection (drafts coming from open doors)

Radiation (near cold surfaces)

Evaporation (moisture on the skin)

Conduction (cold objects coming into contact)

Question 12

Thermogenic System

Answer 12

Babies use brown fat to regulate their temperature

Cold stress can lead to hypothermia or hypoglycemia

Question 13

Renal System

Answer 13

Newborns pee 2-6 times for the first few days, and after day 4 they pee 6-8 times a day

98% of newborns void within 30 hours of life

Question 14

Gastrointestinal System

Answer 14

Cardiac sphincter not fully developed, can lead to regurgitation and vomiting

Audible bowel sounds within the first few hours of birth

Return to birth weight within 10-14 days

Question 15

Physiologic Jaundice

Answer 15

Caused by transient hyperbilirubinemia

Never present during the first 24 hours of life

Jaundice visible when bilirubin level is > 5 mg/dL

Occurs in 60% of term infants and 80% of preterm infants

Question 16

Nonphysiologic Jaundice

Answer 16

May occur in the first 24 hours

Caused by abnormalities causing destruction of erythrocytes

Question 17

Breastfeeding-Associated Jaundice

Answer 17

Early-onset jaundice

Lack of effective breastfeeding contributes to hyperbilirubinemia

Question 18

Breast Milk Jaundice

Answer 18

Late-onset jaundice

Bilirubin levels rise after the first 3-5 days

Treat with phototherapy; may discontinue breastfeeding

Closely monitor bilirubin levels

Question 19

Hepatic System

Answer 19

Lack of intestinal bacteria needed to synthesize vitamin K results in transient blood coagulation deficiency between the second and fifth days of life

Question 20

Immune System

Answer 20

Less effective at fighting off infections

Question 21

IgG

Answer 21

Crosses placenta and provides temporary immunity

Question 22

IgM

Answer 22

First immunoglobulin produced when exposed to an infection

Question 23

IgA

Answer 23

Receive some from colostrum and breast milk

Must be produced by the infant

Question 24

Neuromuscular System

Answer 24

Almost completely developed at birth

Normal tremors, tremors of hypoglycemia, and seizure activity must be differentiated

Question 25

Newborn Reflexes

Answer 25

Root reflex

Suck reflex

Startle (Moro) reflex

Tonic neck reflex (fencing)

Grasp reflex

Babinski reflex

Step reflex

Question 26

Most Critical Adaptation to Extrauterine Life

Answer 26

Establish effective respirations

Question 27

Jaundice is considered pathologic if…

Answer 27

It appears within the first 24 hours of life

Serum bilirubin levels increase by more than 6 mg/dL in 24 hours

Serum bilirubin exceeds 15 mg/dL at any time