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4500 Gender & reproductive health > Class 9 newborn uncomplicated > Flashcards

Class 9 newborn uncomplicated Flashcards

1
Q

What are the 3 priority assessments for newborn?

A
  1. Are they TERM
  2. Are they CRYING
  3. Do they have good TONE
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2
Q

What are the 2 most important thing we are checking when assessing the head?

A

1.symmetrical
2.fontanels soft and level

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3
Q

Respiratory distress

A

Nasal flaring, intercostal or substernal retractions, stridor, grunting, gasping, apnea lasting 20 seconds or longer

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4
Q

What are the three most important things to watch from birth to the first 2 hours of life?

A
  1. respirations
  2. regulat temperature
  3. eliminate waste
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5
Q

What connects the umbilical vein to the inferior vena cava?

A

ductus venosus

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6
Q

what shunts blood from the pulmonary artery to the descending aorta ?

A

ductus arteriosus

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7
Q

how long do we wait to do cord clamping?

A

30 sec to 1 min

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8
Q

how do babies tend to breathe mouth or nose?

A

nose breathe

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9
Q

do we suction all babies?

A

no, we only suction if indicated

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10
Q

what is meconium aspiration syndrome?

A

resp distress in newborns
d/t meconium-stained amniotic fluid
- symptoms can’t otherwise be explained

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11
Q

What are the interventions for a baby with meconium aspiration syndrome?

A
  1. EFM
  2. Neonatal team at delivery: suction, intubate
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12
Q

What do we NEVER do with mecoinum aspiration syndrome baby?

A

DO NOT RUB BABY

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13
Q

What is the O2 % goal for each min from 1-5min and then 10 min at delivery?

A

1 min= 60-65%
2 min- 65-70
3 min = 70-75%
4 min = 75%-80%
5 min = 80-85%
10 min = 85-95%

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14
Q

what HR do we start positive pressure ventilation?

A

<100 BPM

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15
Q

at what HR do we start CPR?

A

<60 BPM

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16
Q

What does pH help us know ?

A
  1. the wellbeing of the baby
  2. Rh - birthers
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17
Q

what is the normal pH value for arterial blood?

A

7.2-7.34

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18
Q

What is normal pH for venous blood?

A

7.28-7.4

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19
Q

How do we help baby with their thermoregulation?

A
  1. skin to skin
  2. put hat on baby or replace if wet
  3. warm blankets
  4. check BG if they are still cold
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20
Q

What 3 things does neutral thermal environment help?

A
  1. minimizes oxygen and glucose consumption
  2. prevents hypothermia
  3. prevents hyperthermia
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21
Q

What can flexion be a sign of?

A

babies attempt to get thermogenesis - newborns trying to generate heat by increasing muscle activity

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22
Q

If we suspect cold stress, what two things do we check?

A

blood gas
blood glucose

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23
Q

what can cold stress lead to?

A

metabolic acidosis
respiratory acidosis
hypoglycemia

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24
Q

What can cause hypoglycemia in babies?

A
  • diabetic/gestational diabetic birther
  • cold stress
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25
Q

What are the 4 aspects of heat loss prevention?

A

Convection- temp 24C
radiation- no drafts - use radiant warmer if skin to skin not working
evaporation - dry baby off
conduction - skin to skin!

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25
Q

Why does cold cause metabolic acidosis?

A

baby burns more energy
uses glucose
less oxygen available so lactic acid builds
pH goes lower

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26
Q

What is the first intervention with a cold baby?

A

skin to skin contact

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27
Q

What is the rapid assessment of the newborn?

A

APGAR score
A- appearance (skin colour)
P- Pulse (heart rate). we want >100
G- grimace (reflex irritability )
A- activity (muscle tone) no floppy babies
R- Respirations (resp rate) crying and auscultate RR

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28
Q

When do we do APGAR?

A

min 1
min 5

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29
Q

What is severe distress for APGAR score?

A

0-3

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30
Q

What is moderate difficulty for APGAR score?

A

4-6

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31
Q

What is normal transition, little difficulty for APGAR?

A

7-10

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32
Q

If the score is <7 when do we repeat APGAR?

A

10 min
20 min

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33
Q

What is a normal temp for baby?

A

37
(36.5-37.5)

34
Q

What is a normal HR for baby?

A

110-160 BPM
(80-100 when sleeping)
(180 BPM if crying)

35
Q

What is normal RR in baby?

A

30-60 breaths per min
apnea <20 sec is normal

36
Q

what’s the last vital we should check on baby and why?

A

temp
cuz it stresses them out

37
Q

Do we assess BP in newborns?

A

NO- not routinely

38
Q

if birther is GBS pos. how often do we check temps?

A

q 4 hrs
q 8 hours until discharge home unless worried about infection, etc

39
Q

What is the priority assessment with newborn?

A
  1. observe
  2. auscultate
  3. temp & reflexes
  4. head circumference
40
Q

How do we help prevent newborn infections?

A

hand hygiene
do not visit if sick

41
Q

What is the Ballard scale used for?

A

gestational age

42
Q

where do we measure baby?

A

top of the head to heel

43
Q

where do we measure head circumference ?

A

above the ears
occipitolfrontal circumference

44
Q

what is acrocyanosis?

A

extremeties are blue. this can be normal. we want centrally pink/healthy
7-10 days

45
Q

what is vernix?

A

white all over baby.
more with preemies

46
Q

what is Lanugo hair?

A

fine hair over body

47
Q

what hair placement is not normal?

A

lower tailbone hair
could be NTD

48
Q

What skin things are normal?

A

-cracking/peeling of hands & feet
- mottling to extremities
- congenital dermal melanocytosis
- telangiectatic nevi (stork bite)
- erythema toxicum (newborn rash)
- petechiae
- sweat glands - white little pimples

49
Q

What 4 skin issues are NOT normal?

A
  1. bruising
  2. Jaundice within first 24 hours
  3. central cyanosis
  4. pallor
50
Q

what do we want the fontanals to be like?

A
  1. symmetrical
  2. soft and level
51
Q

what shape is the anterior fontanel?

A

diamond shape 5 cm

52
Q

what shape is posterior fontanel?

A

triangular 3 cm

53
Q

What is moulding?

A

cone head

54
Q

What is cephalohematoma?

A

Collection of blood between skull & bone, and its periosteum

55
Q

What is the relationship with cephalohematoma and suture lines?

A

does not cross suture lines

56
Q

What are the signs of cephalohematoma?

A

Does not cross suture lines
Does not pulsate/bulge when baby cries
Appears several hrs/day after birth
Largest on 2nd or 3rd day
Fullness resolves in 3-6 weeks

57
Q

What is subgaleal hemorrhage?

A

Bleeding into the subgaleal compartment

58
Q

What is the relationship with subgaleal hemorrhage and suture lines?

A

Crosses suture lines

59
Q

Which is most dangerous, cephalohematoma or subgaleal hemorrhage?

A

Subgaleal hemorrhage

60
Q

What are the symptoms/signs of Subgaleal hemorrhage?

A

Crosses suture lines
Potential space: loosely arranged connective tissue; blood loss in this space can be severe

61
Q

What is a normal head related issue?

A

caput succedaneum

62
Q

why are low set ears concerning?

A

could be congenital concern

63
Q

what is a normal finding of the chest that changes over time?

A

a prominent sternum

64
Q

What is normal for the respiratory system?

A

-Lungs contain approximately 20 mL of fluid/kg
-Air replaces the fluid during newborn transition
-Some lung fluid retention can be experienced
-Surfactant reduces surface tension
-Immature respiratory control
-Newborns tend to nose breathe
-Abdominal breathing is normal

65
Q

What is a signs of respiratory distress?

A

Nasal flaring,
intercostal or substernal retractions, stridor,
grunting,
gasping,
apnea lasting 20 seconds or longer

66
Q

what is TTN- transient tachypnea of the newborn?

A

parenchymal lung disorder
-pulmonary edema d/t not absorbing fetal alveolar fluid

67
Q

What is the most common cause of resp. distress in late preterm and term infants, benign, self limited?

A

TTN transient tachypnea

68
Q

when does TTN resolve?

A

within 24 hours

69
Q

how many RR max can a baby with TTN have?

A

up to 100 breaths/min

70
Q

what are the symptoms of TTN?

A

RR up to 100 breaths/min
Intermittent grunting
Nasal flaring
Mild retractions

71
Q

how do we help babies with TTN?

A

-Support with feeding
-Neutral thermal environment
-O2 supplementation may be provided to maintain O2 sats b/w 90-95%

72
Q

why do we give Vit K IM?

A

gut bacteria is nonexistent and vit K needs it. so we give vit K till they’re eating

73
Q

what are the 3 vessels o the umbilical cord?

A

2 umbilical arteries
1 umbilical vein

74
Q

are the arms of babies longer or shorter than legs?

A

longer

75
Q

which way do babies toes go with babinski?

A

toes span out

76
Q

what is the startle response called?

A

Moro

77
Q

how long do babies sleep in a day?

A

up to 17 hours

78
Q

if a baby is inconsolable what do we suspect?

A

possibly withdrawl baby

79
Q

If crying is shrill- high pitched what could that indicate?

A

neurological issues

80
Q

what is the goal of vitamin K?

A

reduce risk of bleeding - helps baby clot their blood

81
Q

what is the timing of vitamin K?

A

within 6 hours of birth

82
Q

where do we give vitamin k?

A

vastus lateralis

83
Q

what is erythromycin ointment giving for?

A

ghonorrhea and chlamydia birther for sure

we give to all babies (with birther consent) regardless of STBBI status

4500 Gender & reproductive health (11 decks)

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