Dressler Module 5 Neonatal Care Flashcards
Apgar scoring is done in what frequency
first minute, then every 5 minutes
In immediate care in delivery room it is important to assess and prevent
hypothermia
Average weight for newborn is
5.5-10 lbs , 7-8 avg
Nutrition is provided in immediate care orally be giving
glucose water hardly any formula
Avg head circumference for newborn
13-14 inch avg.
We give bath to newborn to remove (3)
secretions, vernix, lanugo
Describe cord care
Allow exposed to air
observe for drainage
Cord will fall out on its own in
7-10 days
In doing a screening test in immediate care we are checking for _____ and we will do this _________
PKU
after first feeding
We administer Vitamin ____ with a ______ because _____
Vitamin K with small bore needle, because baby is unable to produce because gi tract is sterile
We administer Erythromycin Ointment in the
Lower Conjunctival Sac
Me must discard formula
24 hours after opening
Baby should not go more than ___ hours w/o eating this can cause _____
4 hours
can cause failure to thrive
Avg length of newborn is
18-22 inches
Edema of the scalp cone shape is also known as _____ and will _____
Caput Succedaneum
Disappear within a few days
Accumulation of blood between the periosteum and the skull bones is known as ______ and will ________
Cephalohematoma
Disappear within a week
Diamond shaped on the head is also called _____ and will _____
Anterior Fontanel
close 12-18 months
Triangle shape on head is also called ______ and will ____
Posterior Fontanel
close 3 months
Eye color is always
Blue when born
Characteristics we look for (eye) (3)
Pupil react to light
Tears absent for a few weeks
Ophthalmia Neonatorum
Ears should be
symmetrical
Nose should be
flat
It is not considered thrush if you could
wipe it away
Neck should be
short
Chest avg size
31-35cm
In the chest the breast tissue should be
swollen
The abdomen should be
Round, Protruding
Avg wet diapers in 24 hour period should be
6-8
It is normal for female genitalia to have (2)
Labia
Blood tinged discharge
In males if a circumcision was done we can apply
A&D ointment
Undescended testicle is called
Cryptorchidism
Urethra on top surface of penis is called
Epispadias
Urethra underneath surface of penis
Hypospadias
Extremities should be
symmetrical
Baby does not see in color until
2-3 months
It is important to remove all (Respiratory)
Remove fluid and secretion
Regular Resp rate
40-60
Respirations are usually (2)
Irregular and shallow
Common med given for respiratory distress
Narcan
Reg Apical Heart Rate
110-160
Norm B/P
60-40
Thoracic pressure increases and closes the
openings in the babys heart
Anus should be
imperforated
First stool is called the
Meconium
Meconium should pass within first
24 hours
If bottle fed what color should meconium be
yellow green to brown
If breast fed Meconium should be
Soft yellow pasty 6 or more/day
Baby should void within
8-12 hours
Darkened area on buttocks and lumbar region
Mongolian Spots
Hands and feet have blueish tint
Acrocyanosis
Find downy hair is called
Lanugo
White cheesy substance
Vernix Caseosa
Tiny white spots or papules
Milia
Normal physiological jaundice usually appears on day
2-3
Normal Pathological jaundice usually appears within
first 24 hours
The higher the bilirubin level, the higher the chance for
brain damage
Anything higher than _____ mg/dl is considered high serum bilirubin levels
12’9
Highest blood type at risk for jaundice
O-
The check legs for equal length and to stretch them we can use the
Ortolanis maneuver
If baby has club foot we can use
Denis-Browne Splint
Common s&s of Congenital Hip Dysplasia (3)
Limited abduction of leg
Skin folds asymmetrical
Buttocks higher in affected side
Head of femur displaced from acetabulum is called
Congential Hip Dysplasia
Tx for Hip dysplasia
Pavlik Harness
Surfactant is given in neonatal babies to
help lungs mature
Accumulated Phenylalanine causes
damage to brain tissue
two most common birth defects are ______ and usually comes from
Cerebral bleeding and Anorexia
Prolapsed Cord
Postpartum Care begins ______ after delivery and ends _____ after delivery
4 hours - 6 weeks
Postpartum - Elevated temperature will decrease within
24 hours
Postpartum - Within one hour P, R, B/P and T should
return to levels PRE LABOR
Postpartum - Contractions after birth can last
24-72 hours
Postpartum - Contractions and after pains are more common in
Multiparas
Return of uterus to non-pregnant state is called
Involution
After delivery uterus is about how big
20 week pregnancy
The uterus ends app
7 days, 1cm/day
Uterus is hastened by (2)
Athletic moms
Nursing moms
Putting baby immediately after birth to breast helps with
contractions
Internal Os and External Os may remain
slightly open
Vaginal Rugae return will happen within
6 weeks
Ovulation will return
3-5 weeks
Menstruation will return
6-8-12 weeks
Menstruation is usually delayed in
Lactating women
Lochia goes from (3)
Rubra - Serosa - Alba
Soaking through pad in 1-2 hours is called
Profuse
Colostrum should be given for
2-3 days
Colostrum helps babies
immunity
Breast milk benefits (3)
Easily digested
Carries natural antibodies
Increase lactose / calcium
Common staph infection of breast
Mastitis
Care of breast (3)
Pat dry
Expose to air
Good support bra
Normal blood volume decreases by
4th week
Normal blood loss for vaginal delivery
300-500ml
Normal blood loss for C-section
500-1000ml
DVT is due to
Increased Fibrinogen level
In moms with DVT it is important to check for
+ Homon’s sign
3 nursing interventions for Embolism
Early ambulation
Teds stockings
Dont cross legs
For regular mom we should decrease calories by about
300
Diet for nursing mom
Increase iron/fiber/fluid
Diuresis : Postpartum patients can void up to ____ for up to ______
3000ml/24hours
6 weeks
Burning while urinating for first 24 hours is
normal
Protein in urine and ketones in urine is normal until
mom goes home
Massage uterus when it is
boggy
Moms with _____ need intervention for baby safety we are scared she might hurt the baby
Psycosis
Postpartum blues could last up to ______ if it lasts more than _____ we call it
3 months - 1 year
if more than 1 year we call it generalized depression
5 reportable symptoms
Temp change Bright red vaginal lochia Pain in calf Pain in abdomen Dysuria
We consider hemorrhage blood loss more than
500ml
If uterus is not going back 1 finger width per day it is called
Subinvolution
S&S of Hemorrhage (3)
Decreased B/P
Increased Pulse
Lochia Rubra
S&S of Uterine Atony (2)
Boggy fundus
Increased bleeding with clots
Tx for Atony
Oxytocin
Methergine
Tx for Vaginal or Cervical Laceration
D&C
Tx for late hemorrhage
D&C
S&S of Puerperal Infection (4)
Foul Smelling lochia
Pain
Tenderness
Redness
Tx for Puerperal Infection
ABT
What is reduced in premature infant that puts it as risk for pulmonary problems
Surfactant
A premature infant has a _____________ putting it as risk for malnutrition
Decreased metabolism
What can occur if jaundice is not treated
Brain Damage
Best way to treat anemia is to give
Iron supplements
Best way to treat DVT
TEDS
