Exam #2 Newborn

Question 1

Tonic neck reflex

Answer 1

newborn is supine and the head is turned to one side. In response, the extremities on the same side straighten, whereas on the opposite side they flex

Question 2

Moro reflex

Answer 2

newborn is startled by a loud noise or lifted slightly above the crib and then suddenly lowered In response, the newborn straightens arms and hands outward while the knees flex. Slowly the arms return to the chest, as in an embrace. The fingers spread, forming a C, and the newborn may cry.

Question 3

Suckling reflex

Answer 3

Elicited when an object is placed in the newborn’s mouth or anything touches the lips. Newborns suck even while sleeping; this is called non-nutritive sucking, and it can have a quieting effect on the baby.

Question 4

Palmar grasping reflex

Answer 4

Elicited by stimulating the newborn’s palm with a finger or object; the newborn grasps and holds the object or finger firmly enough to be lifted momentarily from the crib.

Question 5

Rooting reflex

Answer 5

Elicited when the side of the newborn’s mouth or cheek is touched. In response, the newborn turns toward that side and opens the lips to suck (if not fed recently).

Question 6

Stepping reflex

Answer 6

When held upright with one foot touching a flat surface, the newborn puts one foot in front of the other and “walks.”

Question 7

In the newborn, bilirubin levels due to physiological jaundice peak in

Answer 7

3-5 days

Question 8

Bilirubin levels in the newborn due to physiologic jaundice should not exceed

Answer 8

13-15 mg/dL

Question 9

Physiologic jaundice is caused by

Answer 9

Accelerated destruction of fetal RBC

Question 10

Breast milk jaundice occurs when? What causes it?

Answer 10

1 week after birth

Related to composition of breast milk

Question 11

Breast milk jaundice peaks at

Answer 11

2-3 weeks with a bili of 5-10mg/dL

Question 12

Breastfeeding jaundice occurs when and peaks when?

Answer 12

Occurs 24 hrs after birth, peaks at day 3 or 4

Question 13

Breastfeeding jaundice is related to

Answer 13

inadequate fluid intake; self-limiting

Question 14

Rx for breastfeeding jaundice

Answer 14

encourage more frequent feeding

Question 15

choanal atresia signs and cause

Answer 15

signs: Newborn cyanotic at rest and pink only with crying
cause: congenital blockage of the passageway between the nose and pharynx

Question 16

Crying that increases cyanosis may be a sign of

Answer 16

heart or lung issues

Question 17

A newborn that is very pale may have

Answer 17

anemia

Question 18

Acrocyanosis

Answer 18

discoloration of the hands and feet. The face and mucous membranes should be assessed for pinkness reflecting adequate oxygenation

Question 19

Mottling

Answer 19

Lacy pattern of dilated blood vessels under the skin.

May be related to chilling, prolonged apnea, sepsis or hypothyroidism

Question 20

Harlequin sign

Answer 20

A deep color developing over one side of the body while the other side remains pale. Comes from the immaturity of the hypothalamic center and results in vasomotor disturbance in which blood vessels on one side dilate while the vessels on the other side constrict. Usually clinically insignificant =>nurse should document findings

Question 21

Jaundice

Answer 21

Yellowish discoloration of the skin and mucous membranes. May be related to immature liver function, hematomas, poor feeding, blood incompatibility, oxytocin, augmentation or induction, or severe hemolysis.

Question 22

Erythema toxicum

Answer 22

an eruption of lesions in the area surrounding hair follicles that are firm, vary in size (1mm-3mm) and consist of a white or pale yellow papule or pustule with an erythematous base. No treatment necessary.

Question 23

Milia

Answer 23

exposed sebaceous glands, appear as raised white spots on the face (especially across the nose). No treatment is necessary

Question 24

Skin turgor

Answer 24

Assess to determine hydration status; usual places to assess: over the abdomen, forearm or thigh. Skin should be elastic and should return rapidly to its original shape.

Question 25

Vernix caseosa

Answer 25

A whitish cheeselike substance, covers the fetus while in utero and lubricates the skin of the newborn. The skin of the term or postterm newborn has less vernix and is frequently dry; peeling is common, especially on the hands and feet.

Question 26

Newborn head circumference

Answer 26

32-37 cm, normally 2 cm > chest

Question 27

Molding

Answer 27

asymmetry caused by the overriding of the cranial bones during labor and birth

Question 28

Molding diminishes when?

Answer 28

Within a few days; suture lines become palpable

Question 29

Fontanelles

Answer 29

anterior (jct of frontal parietal bones)

posterior (jct of parietal and occipital bones – smaller than anterior)

Question 30

Cephalohematoma—cause, when does it go away, risks

Answer 30

collection of blood resulting from ruptured blood vessels between the surface of a cranial bone (usually parietal) and the periosteal membrane. Relatively common – disappear w/in 2-3 months. May be associated with physiologic jaundice. Can lead to anemia and hypotension.

Question 31

Caput Succedaneum- what is is, when does it go away?

Answer 31

localized, easily identifiable soft are area of the scalp, generally resulting from a long and difficult labor or vacuum extraction. The caput may vary from a small area to a large area covering a severely elongated head. The fluid in the caput is reabsorbed w/in 12 hours to a few days after birth.

Question 32

normal newborn vital signs

Answer 32

Pulse- 110-160
Respirations- 30-60 resp/min
BP- 70-50/45-30
Temp- 36.5-37.5

Question 33

transient strabismus disappears when?

Answer 33

in a little over 2 months