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NRSG 206: OB > [Exam 2] Chapter 18 – Nursing Management of the Newborn > Flashcards

[Exam 2] Chapter 18 – Nursing Management of the Newborn Flashcards

1
Q

Nursing Management Immediate Newborn Period - Assessment: What is an easy, rapid newborn assessment tool?

A

RARP. Respiratory, Activity, Perfusion, and Position

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2
Q

Nursing Management Immediate Newborn Period - Assessment: When would a second assessment be performed?

A

Within the first 2-4 hours, when admitted to nursery, or labor and birth room

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3
Q

Nursing Management Immediate Newborn Period - Assessment: When is a third assessment completed?

A

BEfore discharge

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4
Q

Nursing Management Immediate Newborn Period - Assessment: What problems may you look for in the initial assessment?

A

Nasal Flaring, Chest Retractions

Grunting on exhalation

Generalized Cyanosis

Abnroaml breath sounds/respiratory rates

Pallor and abnormal size/heart rates

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5
Q

Nursing Management Immediate Newborn Period - Assessment - Apgar Scoring: When is this performed?

A

At 1 minute and 5 minutes after birth . Additional one done at 10 minutes if score less than 7

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6
Q

Nursing Management Immediate Newborn Period - Assessment - Apgar Scoring: What are the five parameters of this?

A 
Appearance (Color)
Pulse (Reflex Irritability)
Grimace (Reflex Irritability)
Activity (Muscle Tone)
Respiratory ( Respiratory Effort)
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7
Q

Nursing Management Immediate Newborn Period - Assessment - Apgar Scoring: What should the normal score be?

A

Between 8-10

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8
Q

Nursing Management Immediate Newborn Period - Assessment - Apgar Scoring: What do scorees of 4-7 and 0-3 represent?

A

Signify moderate difficulty

0-3 points to severe distress

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9
Q

Nursing Management Immediate Newborn Period - Assessment - Length and Weight: Expected length of a newborn?

A

44 to 55 cm (17-22 cm)

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10
Q

Nursing Management Immediate Newborn Period - Assessment - Apgar Scoring: Heart Rate scoring for 0, 1, 2?

A

0 = Absent

1= SLow <100 bpm

2= >100 bpm

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11
Q

Nursing Management Immediate Newborn Period - Assessment - Apgar Scoring: RR scoring for 0, 1, 2?

A

0 = Apneic

1 = Slow, irregular, shallow

2 = Regular respirations

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12
Q

Nursing Management Immediate Newborn Period - Assessment - Apgar Scoring: Muscle tone scoring for 0,1,2?

A

0 = Limp, Flaccid

1 = Some flexion, limited resistance to extension

2 = Tight flexion, good resistance to extension with quick return to flexed positiona fter extension

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13
Q

Nursing Management Immediate Newborn Period - Assessment - Apgar Scoring: Reflex Irritability (flicking soles of feet) for 0, 1,2?

A

0 = No response

1 = Grimace or frown when irritated

2 = Sneeze, cough, or vigorous cry

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14
Q

Nursing Management Immediate Newborn Period - Assessment - Apgar Scoring: Skin Color scoring for 0,1,2?

A

0 = Cyanotic or Pale

1 = Appropriate body color, blue extremities

2 = Completely approrpiate color (pink on both trunk and extremities)

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15
Q

Nursing Management Immediate Newborn Period - Assessment - Length and Weight: Typical weight of a newborn?

A

2500 - 4000 g (5 lb 8 oz to 8 lb 14 oz

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16
Q

Nursing Management Immediate Newborn Period - Assessment - Length and Weight: How much weight can infants lost after birth?

A

10% by 3-4 days due to loss of meconium, ECF, and limited food intake

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17
Q

Nursing Management Immediate Newborn Period - Assessment - Length and Weight: What is a low birth weight baby

A

> 2500 g ( > 5.5 lb)

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18
Q

Nursing Management Immediate Newborn Period - Assessment - Length and Weight: Very low birth weight range?

A

> 1500 g ( > 3.5 lb)

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19
Q

Nursing Management Immediate Newborn Period - Assessment - Length and Weight: Extremely low birth weight ?

A

> 1000 g ( >2.5 lb)

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20
Q

Nursing Management Immediate Newborn Period - Assessment - VS: How is this obtained, and normal range?

A

Apical pulse for 1 minute, and typically 110 to 160

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21
Q

Nursing Management Immediate Newborn Period - Assessment - VS: RR for infant?

A

30/60 breaths / min

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22
Q

Nursing Management Immediate Newborn Period - Assessment - VS: How often are heart and RR assessed?

A

Every 30 mins until stable for 2 hours after birth

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23
Q

Nursing Management Immediate Newborn Period - Assessment - VS: HR and RR checks how often once stable?

A

Every 8 hours

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24
Q

Nursing Management Immediate Newborn Period - Assessment - VS: When are VS assessed?

A

Within 1-4 hours after birth

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25
Q

Nursing Management Immediate Newborn Period - Assessment - VS: Normal axillary temperature?

A

97.7 to 99.5

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26
Q

Nursing Management Immediate Newborn Period - Assessment - VS: Typical BP if assessed?

A

50-75/30-45 mm Hg

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27
Q

Nursing Management Immediate Newborn Period - Gestational Age Assessment: How is this determined?

A

Ballard gestational age assessment or Ballard scale. Determines gestational age between 20-44 weeks

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28
Q

Nursing Management Immediate Newborn Period - Gestational Age Assessment: Range of Ballard Scale?

A

Low score of -1 or -2 points for extreme immaturity to 4-5 points for postmaturity

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29
Q

Nursing Management Immediate Newborn Period - Gestational Age Assessment: When is the physical maturity section of the exam done?

A

During the first 2 hours after birth

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30
Q

Nursing Management Immediate Newborn Period - Gestational Age Assessment: Areas assessed on the physical maturity exam?

A 
Skin Texture
Lanugo
Plantar Creases
Breast Tissue
Eyes/Ears
Genitals
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31
Q

Nursing Management Immediate Newborn Period - Gestational Age Assessment: What is assessed in skin texture?

A

Sticky and transparent to smooth, with varying degrees of peeling and crackking, or leathery with significant cracking and wrinkling

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32
Q

Nursing Management Immediate Newborn Period - Gestational Age Assessment: What is assessed with lanugo?

A

Soft downy hair on newborn body, which is absent in preterm. Disappears with postmaturity

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33
Q

Nursing Management Immediate Newborn Period - Gestational Age Assessment: What is assessed with plantar creases?

A

Creases on the soles of the feet , which range from absent to covering the entire foot, depending on maturity

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34
Q

Nursing Management Immediate Newborn Period - Gestational Age Assessment: What is assessed with breast tissue?

A

Thickness and size of breast tissue and areola. Range from imperceptible to full and budding

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35
Q

Nursing Management Immediate Newborn Period - Gestational Age Assessment: What to assess with eyes and ears

A

Eyes can be fused or open and ear cartilage and stiffness. Greater the stiffness, greater the maturity

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36
Q

Nursing Management Immediate Newborn Period - Gestational Age Assessment: What to assess with genitals?

A

Testicular descent and appearance of scrotum.

Females, appearance and size of clitoris and labia

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37
Q

Nursing Management Immediate Newborn Period - Gestational Age Assessment: When is neuromuscular maturity completeled?

A

Within 24 hours of birth

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38
Q

Nursing Management Immediate Newborn Period - Gestational Age Assessment: What are the six parts of neuromsucular assessment?

A

Posture

Square Window
Arm Recoil
Popliteeal Angle 
Scarf Sign
Heel to Ear
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39
Q

Nursing Management Immediate Newborn Period - Gestational Age Assessment: What is assessed with posture?

A

How do they hold extremities in relation to trunk. Greater the degree of flexion, greater the maturity.

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40
Q

Nursing Management Immediate Newborn Period - Gestational Age Assessment: Example of posture assessment?

A

Extension of arms and legs score as 0, full flexion of arms and legs is scored for 4 points

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41
Q

Nursing Management Immediate Newborn Period - Gestational Age Assessment: Example of square window?

A

How far newborns hands flexed toward wrist. Angle more than 90 degrees is 1, and angle of 0 degrees is 4 points

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42
Q

Nursing Management Immediate Newborn Period - Gestational Age Assessment: Example of Arm recoil?

A

How far do arms spring back to flexed position?

Recoil less than 90 degree angle is scored as 4 points

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43
Q

Nursing Management Immediate Newborn Period - Gestational Age Assessment: Example of popliteal angle?

A

How far will knees extend? Angle less than 90 indicates maturity. 180 degrees is one point. less than 90 is 5 points

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44
Q

Nursing Management Immediate Newborn Period - Gestational Age Assessment: Example of scarf sign?

A

How far can elbows be moved across chest?

If elbow reaches or enars the opposite shoulder , 1 point . if elbow does not cross axillary line, 4 points

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45
Q

Nursing Management Immediate Newborn Period - Gestational Age Assessment: Example of heel to ear?

A

Scored the same way as scarf sign

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46
Q

Nursing Management Immediate Newborn Period - Gestational Age Assessment: What are preterm infants classified as?

A

Born prior to 37 weeks

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47
Q

Nursing Management Immediate Newborn Period - Gestational Age Assessment: Term babies are born when

A

38-42 weeks

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48
Q

Nursing Management Immediate Newborn Period - Gestational Age Assessment: Postterm babies born when

A

After 42 weeks

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49
Q

Nursing Management Immediate Newborn Period - Gestational Age Assessment: Postmature baby born when

A

AFter 42 weeks and showing signs of placental aging

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50
Q

Nursing Management Immediate Newborn Period - Gestational Age Assessment: Size for small for gestation age?

A

> 5.5 lb

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51
Q

Nursing Management Immediate Newborn Period - Gestational Age Assessment: Large for gestational age normal size?

A

> 9 lb

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52
Q

Nursing Mx Immediate Newborn Period - Intervention and Maintaining Airway: What happens right after birth?

A

Newborn is suctioned to remove fluids and mucus from the mouth and nose. First with bulb syringe to remove debris and then nose suctioned

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53
Q

Nursing Mx Immediate Newborn Period - Intervention and Maintaining Airway: What to know about bulb syringe before suctioning?

A

Compress the bulb before placing into oral or nasal cavity.

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54
Q

Nursing Mx Immediate Newborn Period - Admin Prescribed Meds: What two meds are commonly ordered?

A

Vitamin K and Eye Prophylaxis with either Erythromycin or tetracycline opthalmic ointment

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55
Q

Nursing Mx Immediate Newborn Period - Admin Prescribed Meds, Vit K: What does this promote?

A

Blood clotting by increasing the synthesis of prothrombin by hte liveer

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56
Q

Nursing Mx Immediate Newborn Period - Admin Prescribed Meds, Vit K: What does deficiency of Vit K cause?

A

Delays clotting and might lead to hemorrhage

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57
Q

Nursing Mx Immediate Newborn Period - Admin Prescribed Meds, Vit K: Why does an infant need Vit K?

A

Vit K is not produced in the intestine until after microorganisms hae been introduced, such as first feeding. Usually takes a week to produce enough Vi K

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58
Q

Nursing Mx Immediate Newborn Period - Admin Prescribed Meds, Vit K: How often are oral doses given?

A

Three doses needed over 1 month period

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59
Q

Nursing Mx Immediate Newborn Period - Admin Prescribed Meds, Eye Prophylaxis: What does this prevent?

A

Ophthalmia neonatorum (which can cause neonatal blindness)

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60
Q

Nursing Mx Immediate Newborn Period - Admin Prescribed Meds, Eye Prophylaxis: What is opthalmia neonatorum?

A

Hyperacute purulent conjunctivitis occuring during first 10 days of life. usually contracted during birth

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61
Q

Nursing Mx Immediate Newborn Period - Maintaining Thermoregulation: SHould be taken how often?

A

Every 30 mins for first 2 hours, then every 8 hours until discharge

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62
Q

Nursing Mx Immediate Newborn Period - Maintaining Thermoregulation: Ways to maintain body temperature?

A

Dry newborn after birth

Wrap in warm blankets

USed a warmed cover on scale

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63
Q

Nursing Mx Early Newborn - Assess, Perinatal Hx: Historical information includes what?

A

Mothers name, maternal tests, antiobiotic therapy, rf blood group incompatibility, social history

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64
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam: When is this performed?

A

Within 24 hours.

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65
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam: What do you begin this exam with?

A

Auscultation of ehart and lungs. And then move to areas that would irritate the newborn.

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66
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Length: Average length?

A

20 inches, but can range from 17 to 22 inches.

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67
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Weight: Average weight?

A

7.5 lbs, but can range from 5 lb 8 oz to 8 lb 13 oz

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68
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Head Circumference: Average circumference?

A

13 to 15 inches

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69
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Head Circumference: This should be what length?

A

1/4 of the newborns length or haalf of infants body plus 10 cm

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70
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Head Circumference: Small head might indicate what?

A

Microcephaly caused by rubella, taxoplasmosis, or SGA

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71
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Head Circumference: Enlaged head might indicate what?

A

Hydrocephalus or increased intracrial pressure

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72
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Chest Circumference: Average here?

A

30 - 36 cm (12-14 inches). usually 3 cm less than head

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73
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and VS: How often is this taken?

A

On admission
Once every 30 mins until stable for 2 hours

Then once every 4-8 hours until discharge

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74
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Skin Cond/Color: How do you check for tugor?

A

By pinching a small area of skin over the chest or abdomen and now how quickly it returns . If tented, indicates dehydration

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75
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Skin Cond/Color: Lanugo may be seen where?

A

Over the shoulders and on the sides of thef ace and upper back

76
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Skin Cond/Color: What is acrocyanosis?

A

Persistent cyanosis of fingers, hands, toes, and feet with mottled blue or red discoloration and coldness. Is normal for first few week s

77
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Skin Variations: Common skin variations include what?

A 
Vernix Caseosa
Stork Bites
Milia
Mongolian Spots
Erythema Toxicum
Harlequim Sign
Nervus Flammeus
Nervus Vasculous
78
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Skin Variations: What is Vernix Caseosa?

A

Thick white susbtance that protects the skin of fetus. Fored by secretions from the fetus’s oil gland. Will be absorbed into skin

79
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Skin Variations: What are stork bites?

A

Superficial vascular areas found on the nape of the deck, on eyelids, and between eyes and upper lip. Caused by concentration of immature blood vessels. Disappear within first year

80
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Skin Variations: What is Milia?

A

Multiple pearly-white or pale yellow unopened sebaceous glands found on nose. Form oil glands and disappear within 2-4 weeks.

81
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Skin Variations: What are Epstein Pearls?

A

When Milia occurs in the mouth and gums.

82
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Skin Variations: What are Mongolian Spots?

A

Benign blue or purple splotches that appear solitary on the lower back and buttocks of newborns. Caused by concentration of pigmented cells. Disappear within 4 years

83
Q

What is Erythema Toxium? (Newborn Rash)

A

Benign, idiopathic, generalized, transient rash that occurs in 70%. Consists of smal papules or pustules on the skin resembling flea bites. Disappears within few days

84
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Skin Variations: What is Harlequin Sign?

A

Dilation of blood cells on one side of body, gives sappearance of waearing a clown suit. Gives midline demarcation. Results from immature autoregulation of blood flow. Lasts 20 mins

85
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Skin Variations: What is Nevus Flammeus?

A

Port-wine stain, found on face or other body areas.

86
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Skin Variations: What is Nevus Vasculosus?

A

Strawberry mark. It is raised, rough, dark red, and sharply demarcated. Commonly found on head region. Come sin the first few months of life.

87
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Head: What is molding?

A

Elongated shaping of the fetal head to accommodate passage through the birth canal. Occurs with vaginal birth froma vertex position. Resolves within a week

88
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Head: What is Caput succedaneum?

A

Describes localized edema on the scalp tha toccurs form pressure of the birth process. Usually seen in prolonged labor. Swelling leaves in 3 days

89
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Head: What is cephalhematomais?

A

Subperiosteal collection of blood of the skull confined to one cranial bone. Due to pressure on head.

90
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Head: Clinical features of cephalhematomais?

A

Well-demarcated, often fluctuant swelling with no overlying skin discoloration.

91
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Head: What is microcephaly?

A

Head circumference more than 2 standard deviations, caused by failure of brain development.

92
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Head: What is macrocephaly?

A

Head circumference more than 90% of normal, related to hydrocephalus

93
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Head: What is Large Fontanels?

A

More than 6 cm in the anterior diameter bone to bone . .Possibly associated with malnutrition

94
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Face: When is paralysis observed?

A

First or second day of lie. Will demonstrate asymmetry of the face with inability to close the eye or more the lips

95
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Mouth: Variations in mouth include what?

A

Epstein pearls (small, white epidermal cysts on the gums and hard palate

Erupted Nasal Teeth

Thursh (white plaque inside the mouth)

96
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Genitalia: Whatis hypospadiais?

A

When the meatus is on the ventral surface of the penis

97
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Genitalia: What is epispadias?

A

When the meatus is on the dorsal surface on the penis

98
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Genitalia: What is cryptochidism?

A

Undescended testes

99
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Extremities: What is polydactlyl?

A

Any extra digits

100
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Extremities: What is syndactyly?

A

Fusing of two or more digits

101
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Extremities: What is Erb Palsy?

A

Injury resulting from damage to the upper plexus and palsies associated with the lower bracial plexus termed klumpke palsies

102
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Neurological Status: How to assess for muscle tone?

A

Support the newborn with one hand under the chest. Observe how the neck muscles hold the head

103
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Reflex: What is the sucking reflex?

A

Elicited by gently stimulating the newborns lips by touching them

104
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Reflex: What is the Moro Reflex?

A

When the neonatle startle. Place them on their back. Supprt the upper body wight of supine newborn by the arms, using lifting otion, then release the arms suddenly. Will throw the arm outward and flex the knees

105
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Reflex: What is the stepping reflex?

A

Hold the newborn upright and inclines forward with the soles of the feet touching a flat surface. Baby should make stepping motion

106
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Reflex: What is the tonic neck reflex?

A

Lie on back. Turn head to one side. The arm toward which baby facing should extend straight away from the face if flexed and the fist is clenched tightly

107
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Reflex: What is the rooting reflex?

A

Stroking the newborn cheek. Newborn should turn toward it

108
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Reflex: What is the Babinski reflex?

A

Should be present at birth and disappears at 1 year. Elicited by stroking the lateral sole of the newborns foot from the heel toward ball of the foot. Toes should fan out

109
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Reflex: How to elicit the palmar grasp?

A

By placing a finger in newborns open palm

110
Q

Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Reflex: What is the truncal incurvation reflex?

A

Disappears at 4 weeks. Prone position, apply firm pressure and run finger down spine. Will cause the pelvis to flex toward stimulated side

111
Q

Nursing Mx Early Newborn - Intervention, Bathing and Hygiene, Elim. and Diaper Area Care: How often is a diaper soaked daily?

112
Q

Nursing Mx Early Newborn - Intervention, Bathing and Hygiene, Elim. and Diaper Area Care: How does meconium appear for first 48 hours?

A

thick, tarry, sticky, and dark green

113
Q

Nursing Mx Early Newborn - Intervention, Bathing and Hygiene, Elim. and Diaper Area Care: When do transitional stools appear?

A

By 3 days after initiation of feeding.

114
Q

Nursing Mx Early Newborn - Intervention, Bathing and Hygiene, Cord Care: When does this usually fall off?

A

Within 7-10 days

115
Q

Nursing Mx Early Newborn - Intervention, Bathing and Hygiene, Cord Care: What to know for baths?

A

Avoid tub baths

116
Q

Nursing Mx Early Newborn - Intervention, Bathing and Hygiene, Circumscision: What are the three common methods?

A

Gomco clamp, Hollister Plastibell DEvice, and Mogen Clamp

117
Q

Nursing Mx Early Newborn - Intervention, Bathing and Hygiene, Circumscision: Preopertion preparation includes what?

A

Infant at least 12 hours or older

Has received Vit K

Voided normally at least once an hour prior

118
Q

Nursing Mx Early Newborn - Intervention, Sleep: How to reduce risk of SIDS?

A

Always place babby on back

Room share, keep in same room where you sleep

Use a firm, sleep surface

119
Q

Nursing Mx Early Newborn - Intervention, Assisting w/ screening tests - genetic and newborn: Most common ones?

A

PKU, Hypothyroidism, galactosemia, and sickle cell disease

120
Q

Nursing Mx Early Newborn - Intervention, Assisting w/ screening tests - genetic and newborn: How to treat jaundice?

A

Hydration.

If not successful, Phototherapy has been useful, along with fiberoptic pads that wrap around the newborn

121
Q

Nursing Mx Early Newborn - Intervention, Common Concerns and Hypoglycemia: How are glucose levels during first 24-48 hours?

A

Typically lower than later in life. Defined as left then 30 mg/dL or plasma concentration of less than 40 mg/dL during first 72 hours

122
Q

Nursing Mx Early Newborn - Intervention, Common Concerns and Hypoglycemia: What infants are at greater risk for this?

A

Moms with diabetes, preterm newborns, and newborns with intrauterine growth restriction, hypothermia,

123
Q

Nursing Mx Early Newborn - Intervention, Common Concerns and Hypoglycemia: Symptoms of this?

A

Jiteriness, lethargy, cyanosis, apnea, seizures, highpitched/weak cry, hypothermia and poor feeding

124
Q

Nursing Mx Early Newborn - Intervention, Common Concerns and Hypoglycemia: Treatment for this?

A

Rapid-acting source of glucose. Such as sugar/water mixture or early formula feeding.

125
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition: Emptying time of stomach?

A

Short. Only 2-3 hours. Peristalsis is also rapid.

126
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition: Why should you not introduce solid foods prior to six months?

A

Baby is at high risk for food allergies.

127
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition: What to know about pancreatic enzymes?

A

Pancreatic enzymes and bile to digest fat limited until 3-6 months.

128
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Newborn Nutrtional Needs: Newborns caloric needs?

A

110 - 120 cal / kg body weight.

129
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Newborn Nutrtional Needs: Calories in breast milk and formulas?

130
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Newborn Nutrtional Needs: Fluid requirements for newborns?

A

100 to 150 mL/kg daily

131
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Newborn Nutrtional Needs: Why should babies be given iron?

A

Iron levels are low in all types of formula mil. Be sure to give iron-fortified formula from birth

132
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Newborn Nutrtional Needs: What to know for Vitamin D?

A

Give 400 IU within first few days to prevent rickets and Vit D deficiency

133
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Newborn Nutrtional Needs: What to know for iodine?

A

Take supplement of 150 mcg of iodine daily. Deficiency can afect fetal and early childhood neurocognitive development

134
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Newborn Nutrtional Needs: How often should they be fed?

A

Every 2-4 hours during day and only when newborn awakens at night

135
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Newborn Nutrtional Needs: Most breast fed infants need to be fed how often?

A

Every 2-3 hours, nursing for 10-20 mins on each breast

136
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Newborn Nutrtional Needs: Formula-fed newborns fed how often?

A

Every 3-4 hours, finishing bottle in 30 mins or less.

137
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Newborn Nutrtional Needs: Daily formula intake for infant?

A

!.5 to 2oz / lb

138
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Brest-Feeding: How long should infant be breast-fed for?

A

For the first 6 months of life

139
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Brest-Feeding: What is colostrum?

A

Thick, yellowish susbtance secreted during first few days after birth

140
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Brest-Feeding: What is mature milk?

A

Appears blueish, and not as thick as colostrum. Provides 20 cal/oz.

141
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Brest-Feeding: What happens to mother as infant is placed on abdemon and scoots toward the nipple?

A

Produces high level of oxytocin, which contracts the uterus and minimizes bleeding.

142
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Brest-Feeding: Keys for breast feeding?

A

Initiating breast-feeding within first hour of life.

Place newborn on mother’s chest

Follow newborns feeding schedule

Offering no supplement

Have lactation consultant observe

143
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Brest-Feeding: What are some indicators of sufficient intake from infant?

A

6-10 wet diapers daily

WEaking up hungry 8-12 times in 24 hours.

Acting content and falling asleep after sleeping

144
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Brest-Feeding: What is the LATCH scoring tool?

A

Breast-feeding charting system that provides a systematic method for gathering information about individual breast-feeding sessions

145
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Brest-Feeding: What does LATCH stand for?

A

Scores from 0-2. L is how well infant latches. A is amount of audible swallowing
T is mothers nipple type
C is mothers comfort
H is amount of help mother needs

146
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Brest-Feeding Positions: What is the football hold?

A

Mother holds infant back and shoulders in her palm and tucks the infant under her arm. Supports breast with hands and brings infants lips to latch on. Allows her to see infants mouth

147
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Brest-Feeding Positions: What is the cradling position?

A

Most common. Holds baby in crook of her arm with infant facing the mother.

148
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Brest-Feeding Positions: What is the across-the-lap position?

A

Mother places a pillow across her lap, with infant facing the mother. Supports infants back

149
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Brest-Feeding Positions: What is the side-lying position?

A

Mother lies on her with a pillow supporting her back and another pillow supporting the newborn in the front

150
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Brest-Feeding Positions: How to promote latching-on?

A

Instruct the mother to make a C or a V with her fingers.

151
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Brest-Feeding Positions: How is the C hold performed?

A

Mother places her thumb well above the areola and other four fingers below the areola and under the breast

152
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Brest-Feeding Positions: How is the V hold performed?

A

Mother places her index finger above the areola and her other three fingers below the areola and under the breast

153
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Breast Milk Storage/Expression: How soon must you use chilled and stored milk?

A

Within 24 hours

154
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Breast Milk Storage/Expression: Use any frozen expressed milk within what time?

155
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Breast Milk Storage/Expression: What should you not do with chilled milk?

A

Use microwave oven to warm

156
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Breast Milk Storage/Expression: What do you do with used milk?

A

Discard it. Never refreeze it.

157
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Breast Milk Storage/Expression: What should you do with milk before using it?

A

Thaw the milk in warm water

158
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Breast Feeding Concerns: Sore nipples are usually caused why?

A

By proper infant attachment.

159
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Breast Feeding Concerns: How do you prevent improper infant attachment?

A

Use only warm water to prevent dryness

Express some milk before feeding

Apply few drops of breast milk to nipples after feeding

Allow nipples to air dry after feeding

160
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Breast Feeding Concerns: When may engorgement occur?

A

AS milk comes in around day 3 or 4 after birth

161
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Breast Feeding Concerns: How to relieve engorgement?

A

Take warm to hot showers

Express some milk before breast-feeding

Feed newborn in vriety of positions

Increase frequency of feedings

162
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Breast Feeding Concerns: What does Mastitis cause?

A

It’s inflammation of the breast. Causes flu-like symptoms, chills, fever, and malaise. Occurs when one breast milk duct becomes blocked.

163
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Breast Feeding Concerns: Tx for Masitis?

A

Rest, warm compress, antibiotics, breast support and continued breast-feeding

164
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Formula Feeding: How fast should the botle drip per second?

A

A drop per second

165
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Formula Feeding: What should you do with well water?

A

Should boil for 1-2 mins and then cool to room temperature before use

166
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Formula Feeding: Opened cans of readymade or concentraded formula should be covered and refrigerated for how long?

167
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Weaning/Solid Foods: Weaning usually occurs when?

A

Between 6 months and 1 year of age

168
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Weaning/Solid Foods: How do you begin weaning?

A

Sub breast-feeding wiht a cup or bottle.

169
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Solid Foods: When should solid foods be introduced?

A

When infants double their birth weight and weigh at least 13 lbs

170
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Solid Foods: Readines ccues for solid foods?

A

Consumption of 32 oz of formula

Ability to sit up with minimal support

Reduction in protrustion reflex

171
Q

Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Solid Foods: New foods should be introduced how frequently?

A

Every 3 to 5 days to help identify allergies if they were to occur

172
Q

Nursing Mx Early Newborn - Intervention, Follow Up Care: When is the first appointment scheduled?

A

Within 2-4 dys after discharge

173
Q

Nursing Mx Early Newborn - Intervention, Follow Up Care: Typical schedule for visits?

A

2-4 Weeks
2,4,6 Month Checkup and Vaccine

9 Month

12 Month plus TB

15-18 Mon for Vaccines

2 Years

174
Q

Nursing Mx Early Newborn - Intervention, Follow Up Care: Warning signs of illness?

A

Temperatures of 101

Forceful, persistent vomiting

Refusal to take feedings

Abdominal distention

175
Q

Nursing Mx Early Newborn - Intervention, Providing Immunization Information: How is passive immunity used?

A

Protection transferred via already formed antibodies from one person to another. Such as from mother to newborn

176
Q

Nursing Mx Early Newborn - Intervention, Providing Immunization Information: What is active immunity?

A

Protection produced by an individuals own immune system. Can be obtained by having the actual disease or receiving a vaccine

177
Q

Nursing Mx Early Newborn - Intervention, Providing Immunization Information: First immunization received?

A

Hep B. After birth or by 2 months of age

178
Q

At birth, a newborn’s assessment reveals the following: heart rate of 140 bpm, loud crying, some flexion of extremities, crying when bulb syringe is introduced into the nares, and a pink body with blue extremities. The nurse would document the newborn’s Apgar score as:

5 points
6 points
7 points
8 points
179
Q

The nurse is explaining phototherapy to the parents of a newborn. The nurse would include which of the following as the purpose?

Increase surfactant levels
Stabilize the newborn’s temperature
Destroy Rh-negative antibodies
Oxidize bilirubin on the skin
A

Oxidize bilirubin on the skin

180
Q

The nurse administers a single dose of vitamin K intramuscularly to a newborn after birth to promote:

Conjugation of bilirubin
Blood clotting
Foreman ovale closure
Digestion of complex proteins
A

Blood clotting

181
Q

A prophylactic agent is instilled in both eyes of all newborns to prevent which of the following conditions?

Gonorrhea and chlamydia
Thrush and enterobacter
Staphylococcus and syphilis
Hepatitis B and herpes
A

Gonorrhea and Chlamydia

182
Q

The AAP recommends that all newborns be placed on their backs to sleep to reduce the risk of:

Respiratory distress syndrome
Bottle mouth syndrome
Sudden infant death syndrome
GI regurgitation syndrome
A

Suden infant death syndrome

183
Q

Which one of the following immunizations is most commonly received by newborns before hospital discharge?

Pneumococcus
Varicella
Hepatitis A
Hepatitis B
184
Q

Which condition would be missed if a newborn were screened before he had tolerated protein feedings for at least 48 hours?

Hypothyroidism
Cystic fibrosis
Phenylketonuria
Sickle cell disease
185
Q

Which of the following findings in a newborn would the nurse document as abnormal when assessing the newborn head?

Two soft spots palpated between the cranial bones
A spongy area of edema outlined on the head
Head circumference 32 cm, chest 34 cm
Asymmetry of the head with overriding bones
A

Head circumference 32 cm, chest 34 cm

186
Q

Which of the following findings in a newborn would be considered normal?

Passage of meconium within the first 24 hours
Respiratory rate of 80 breaths per minute
Yellow skin tones at 10 hours after birth
Bleeding from the umbilicus area
A

Passage of meconium within the first 24 hours

NRSG 206: OB (42 decks)

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