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N201 > Exam 2 NB Assessment > Flashcards

Exam 2 NB Assessment Flashcards

1
Q

Normal RR of NB

A

30-60 Irregular

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2
Q

Normal NB HR

A

110-160 bpm

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2
Q

NB head to toe assessment is preformed how frequently

A

q4-8h

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3
Q

Abnormal Respiration Triad

A

Retractions, grunting, nasal flaring

S/s of infection

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4
Q

Rooting

A

Stroke NB’s cheek near the corner of mouth
–>find food
Disappears at 4 months

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5
Q

Palmar grasp

A

Place obj in NB palm

hand curls around finger in Palm

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6
Q

Tonic Neck (fencing)

A

Arm and leg on same side head is turned extend, arm and leg on opposite side flex

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7
Q

Breast milk contains:

A 
Carbs 
protein
cholesterol (needed for brain development)
fat
ANTIBODIES
vitamins
minerals
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8
Q

Moro Reflex

A

Startle

NB symmetrically extends: adducts both arms–> ( )

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10
Q

Circumcision is contraindicated for:

A

Preterm
Genitourinary defects
Bleeding prob
Unstable NB

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11
Q

Delee

A

Deep Suctioning
(mouth to stomach)
Continuous Suction by Occluding Hole

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12
Q

Apneic Periods

A

Normal

<15seconds

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13
Q

Normal Temp

A

97.7-99.5 (Axillary)

If low recheck, still low–>notify instructor

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14
Q

Heat Regulation is….

A

Critical

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15
Q

Heat loss in infants is d/t

A

large surface area
limited subcutaneous fat
superficial blood vessels

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16
Q

4 Types of Heat Loss

A

Convection
Radiation
Evaporation
Conduction

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17
Q

Convection

A

Body to Air Current

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18
Q

Body heat lost to a cooler surface w/out contact

A

radiation

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19
Q

Heat lost to air vapor

A

Evaporation

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20
Q

Heat lost to surface with contact

A

Conduction

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21
Q

Rapid Assessment of Cardiac, Pulmonary, and Neurosensory Status

A

Apgar

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22
Q

Apgar is preformed at…

A

1 and 5 minutes

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23
Q

Apgar Score for: absent respiratory effort

A

Absent=0

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24
Q

Apgar score for NB HR <100bpm

A

Apgar HR Score of 1

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25
Q

Apgar Score NB HR>100bpm

A

Apgar HR score of 2

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26
Q

Apgar score 0-3

A

Serious Danger

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27
Q

Apgar score 4-7

A

May need suction/ oxygen

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28
Q

Apgar Score 8-10

A

Stable

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29
Q

AVA

A

Umbilical Cord

3 Vessel Check - 2 arteries 1 vein

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30
Q

Omphalitis

A

Infected Umbilical Cord

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31
Q

The Umbilical Cord falls off in…

A

7-10 days

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32
Q

HR increase per degree of fever

A

10 beats

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33
Q

mo before Advil, Motrin, and Ibuprofen

A

6 months

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34
Q

Treat Fevers

A

When they show s/s

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35
Q

Infant Enema

A

120-240cc 1 inch

no plain water enema

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36
Q

2-4 years Enema

A

240-360cc 2 inch

no plain water enema

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37
Q

4-10 years Enema

A

360-480cc 3 inch

no plain water enema

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38
Q

11 years Enema

A

480-720cc 4 inch

no plain water enema

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39
Q

Weighing Diapers

1Gm =

A

1ml Output

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40
Q

BMI=

A

[Wt (lbs)/ Ht (in)]*703

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41
Q

Stimulate the lips
NB makes sucking motion; sucks & takes food
Begins to diminish ~ 6 mo.
Disappears immediately if it is never stimulated. May observe during sleep.

A

Sucking

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42
Q

Touches the sole of the NB’S foot @ base of the toes –> toes grasp
Disappears at 8-9 mos

A

Plantar grasp

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43
Q

Learns to finger feed

A

Starting at 12 mo

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44
Q

IV Checks

A

Need to check site Q1 hr

Administer via Buritrol

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45
Q

Rectal

A

Not desired route for pediatric clients
Unpredictable absorption
Upsetting to toddlers and preschoolers

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46
Q

5th finger (Pinkie for Rectal)

A

rectal for infants and children under 3 years old

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47
Q

avoid Ophthalmic Medication when

A

child is crying

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48
Q

Otic Medication <3yo

A

Pull pinna down and back

Hold in position for a few moments

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49
Q

Otic Administration

A

Drops @ Rm Temp

Affected Ear Up

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50
Q

Nasal Medication

A

head down
20 min prior to feedings
Keep head below shoulder level for 1 – 2 mins

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51
Q

Pediatric Drug Doses Based on

A

Unit of drug per kilogram of body weight
Unit of drug per body surface area
dose should not exceed min. adult dose

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52
Q 
Reaches randomly toward mouth
Head drops or bobs
Sucks reflexively in response to tactile stimulation
Tongue may project food out of mouth
Stops taking fluids when full
A

Infants 1-3 months

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53
Q

PO Meds Infants 1-3 months

A

Best when Hungry
Control infant’s hands
Place syringe alongside tongue & give slowly to avoid choking

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54
Q

True/ False May use empty nipple to give PO Meds to Infants 1-3 mo

A

True

Regardless of method used, frequently need to retrieve medication from chin and re-feed

55
Q

True/ False May cup feed PO meds to infant 1-3 mo

A

True

Regardless of method used, frequently need to retrieve medication from chin and re-feed

56
Q

Spits deliberately

A

1 year – 2 ½ years old

57
Q

Temper tantrums

Obtains and throws objects

A

1 year – 2 ½ years old

58
Q

Shows pride in accomplishments

Does NOT know right from wrong

A

1 year – 2 ½ years old

59
Q

PO Med 1 year – 2 ½ years old

A

**Approach is important!
Option to take medication is NOT given
Do NOT hold nose, force meds, or give if crying–> danger of aspiration

60
Q

Able to follow directions
Make decisions
Shows pride in accomplishments
May view illness as punishment

A

2 ½ years - 6 years old

61
Q

Preferred IM Injection Sight for infants & toddlers

A

Vastus lateralis preferred

based on age and size

62
Q

IM Dorsogluteal

A

after child has been walking 1 year

63
Q

IM Ventrogluteal

A

3+ years`

64
Q

IM Deltoid

A

4- to 5-year-olds

65
Q

EMLA can be given

A

1 hr before injection

66
Q

IM Injection Amt

A

never more than 1mL… if more–> 2 sites

67
Q

IV meds

A 
Maximum concentrations
Assess IV site q1h
Administer via Buritrol
Smallest amount dilutent possible
Must ALWAYS calculate safe dose range
68
Q

Pain pathways and neurochemical processes are intact and functional in neonates! True or false

A

True

69
Q

of weeks Gestation where pain may be felt

A

20 Weeks Gestation

70
Q

Start to lie

A

2-3 yo

71
Q

Acrocyanosis

A

blue discoloration of hands and feet

72
Q

SGA

A

Sm For Gestational Age <10th%ile

73
Q

LGA

A

Large for Gestational Age > 90th%ile

74
Q

Normal Length Of Infant

A

19-21in

75
Q

Head Circumference of Infant

A

Above Ears
Ave 13-14 in
Molding can alter measurements

76
Q

Chest Circumference of Infant

A

Over the nipple line

12-13 in

77
Q

3 Main NB Prophylaxis

A

Vitamin K-phytonadione
Erythromycin
Hepatitis B

78
Q

Vitamin K-phytonadione

A

Pre-filled (IM) Do Not Aspirate
Prevent Hemorrhage
Admin-Lateral Aspect of Thigh (Vastus Lateralis)
1mg/ml

79
Q

Erythromycin

A

Prophylactic-gonorrheal & chlamydial conjunctivitis in lower conjunctival sac
May cause slight edema and erythema;
Do Not Remove for 1h

80
Q

Time Erythromycin Must Remain in lower conjunctival sac

A

Do not rinse or irrigate eye for at least 1h

81
Q

Hepatitis B

A

Recombivax HB-Viral Vaccine
Given w/in 48h
IM-Aspirate
Vastus Lateralis

82
Q

Head to Toe on the NB is preformed

A

q 4-8h

83
Q

At start of shift, prior to NB assessments, wash hands for….

A

1 Full Min

84
Q

Shape of Anterior Fontanelle

A

Diamond

85
Q

Shape of Posterior Fontanelle

A

Triangle

86
Q

Abnormal Fontanelles

A

firm, building, or depressed

want soft and flat

87
Q

Scalp edema CROSSES Suture lines
d/t pressure on pelvis or cervix
Resolves on own
Fluid

A

Caput Succendum

88
Q

Tx of Caput Succendum

A

Self Resolving

89
Q

Cephalohematoma

A

unilateral swelling; does NOT cross suture line
Hematoma of scalp r/t forceps,vac, prolonged labor
Resolves

90
Q

Protective white cheesy substance from sebaceous glands
Antimicrobial Properties
Do not need to get off w/ NB Bath

A

Vernix

91
Q

The earlier the delivery, the cheesier the baby

A

Vernix

92
Q

Desquamation

A

peeling of skin

post-term (>42wks)

93
Q

Erythematous

A

beefy red coloring

norm (6-12h) after birth

94
Q

Blotchy Skin on NB

A

Norm

No clear demark

95
Q

Ecchymosis

A

Bruising

May be d/t forceps

96
Q

Petechia

A

minute hemorrhages

worsens–>may be abnorm

97
Q

White papules

A

Milia

self-resolving

98
Q

Fine Hair
Heaviest on back, shoulders, forehead
Hispanics

A

Lanugo

99
Q

The earlier, the hairier

A

Lanugo

100
Q

white/ yellowish papules with redden skin

A

Erythema Toxicum

Benign/ Self-resolving

101
Q

One side of the body pale while other side is deep red; Vertical split, well demarcated

A

Harlequin Color Change

Harmless d/t vasomotor instability

102
Q

Circumoral Cyanosis

A

Blueing around mouth

Benign if transient

103
Q

If Circumoral Cyanosis persist with crying & feeding –>

A

Cardiac Problems?

104
Q

flat bluish area on lower back/buttock

A

Mongolian Spots

Dont mistake for bruising

105
Q

Mongolian Spots are most common on

A 
AA
Asian
Latin
Native Americans 
Vietnamese
106
Q

Telangietic Nevi-stork bites

A

Salmon colored hemangioma (strawberries)

fade @ ~18mo

107
Q

Tear Production in NB

A

Absent for 1st 2 mo

108
Q

Strabismus & nystagmus in NB

A

Normal

109
Q

Yellowing of Sclera

A

Late sign of Jundice

110
Q

Crackles in NB lungs

A

Normal right after birth

111
Q

Cap Refill in NB

A

<3SEC

112
Q

Abnorm Abd in NB

A

failure to meconium/ void w/in 24h

distention

113
Q

NB bath

A

temp must be stable x2 (97.7)

J&J for 1st bath, then no soap/lotion/powder x 1 wk

114
Q

Diarrhea in NB

A

Watery, green

Formula fed–> change formula

115
Q

Colostrum

A

only need small amt (think frozen oj)

116
Q

NB Caloric Need

A

110 cal/kg/day

117
Q

S/S of formula Allergy

A

diarrhea, distention, skin rash, copious amts of gas, mucus/ blood in stool; Failure to thrive

118
Q

Fast Flow Nipples

A

Pre-term

119
Q

Formula preparation is

A

a clean procedure

120
Q

Feeding a NB

A

NEVER prop a bottle/ warm in microwave
DONT over feed (.5-1oz)
Burp frequently (1/2 way & end)–Spitting up, burp more

121
Q

ABR-auditory brain response

A

@6h of age
May take up to 30 min (Warn parents)
Electrodes on head, neck, shoulder pick up electrical current– may have interference

122
Q

HMD (PKU)

A

Screens for metabolic disorders, genetic diseases, and infections
Lateral heel stick after 24h, repeated @<28d

123
Q

At Risk for PKU

A

French Canadians
Chinese
Greek Americans

124
Q

Bilirubin

A

Do NOT massage foot–> break down blood cells

125
Q

Pulse Ox of NB

A

Opposite arm and leg w/in 3% of ea. other (norm)

>95%

126
Q

Circumcision is contraindicated for:

A

Preterm
Genitourinary defects
Bleeding prob
Unstable NB

127
Q

Rn Actions of Circumcision

A

Do NOT feed prior
Witness consent/ preform timeout
Place restraint board
Bulb suction available

128
Q

Post Circumcision

A

Petroleum jelly w/ diaper changes

Assess q15

129
Q

Parent Teaching Post Circumcision

A 
AVOID soap & removing clots 
Petroleum jelly for 3-5d
gentle retraction after 3-5d
No ointments or creams
Plastibell remains in place until healed
130
Q

Phases of separation anxiety

A

protest
despair
detachment

131
Q

goal of a traumatic care

A

Prevent/ decrease separation from family
Promote a sense of control
Prevent/ minimize bodily injury and pain

132
Q

Short peripheral catheters

A

therapy lasts <6 days
pH between 5-9
osmolarity most distal UE

133
Q

Do NOT use hand veins for

A
  • vesicant medications
  • older adults who’ve lost sub-Q tissue surrounding vein
  • pts who’ll be getting in & out of bed frequently or using their hands for other activities.

N201 (21 decks)

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