Exam 3 Flashcards
There are _________ newborn practices which all help in the transitioning of a baby from intra- to extrauterine life. Give all of these practices.
Immediate and thorough drying
Skin-to-skin contact
Properly timed cord clamping
Non-separation of mother and child
The placenta may be expelled via two mechanisms: ______________ mechanism with the rough, maternal side first or the____________ mechanism with the smooth, fetal side first.
Duncan’s
Schultze’s
A newborn is unstable for the first ___________ hours of life and this time span has two periods of reactivity.
8 hours
The first period of reactivity happens between the first _______ hours of life. At this time, a baby’s FHR is around ___________ bpm which is ___________.
120 – 180
Tachycardia
The first POR also has two distinct breathing patterns: ___________ in which there are pauses in breathing (<15 secs) due to the immaturity of a baby’s respiratory muscles and ___________ in which the child forgets how to breathe. The latter is remedied by a simple tap to the foot.
Periodic breathing
Apnea
The passage of meconium is also expected within _____________ hours of life. Should the child not pass his first stool within the first two days of birth, expect what?
4 – 8 hours
Imperforate anus
One of the best signs that the child is breathing is _____________. This may be due to many factors including hunger, pain, cold, etc.
Crying
The second period of reactivity is a lot tamer than the first though vital signs still remain high. The baby’s respiratory rate may still be high but should not exceed _________ cpm and no other adventitious sounds should be present.
60 cpm
- At this time, mucus production is acceptable though not at a point where air passageways are blocked. Should this incident occur, what should be done to the baby?
Suction
The first physiologic adaptation for babies in their transition from intra- to extrauterine life is done by their respiratory systems. There are also two essentials for a baby to breathe: the first breath (give the four stimulants) and surfactant which prevents alveolar collapse (__________).
i. Mechanical
ii. Chemical
iii. Thermal
iv. Sensory
Atelectasis
The umbilical cord has ___________ vein/s that deliver/s _____________ blood and _____________ artery/ies that deliver/s ____________ blood.
One
Oxygenated
Two
Deoxygenated
This organ of fetal circulation is responsible for the delivery of oxygenated blood to the liver which then becomes the __________ after birth.
Ductus venosus
Ligamentum venosum
This organ of fetal circulation is between the right and left atrium which serves as a bypass for pulmonary circulation. This organ allows for blood to pass to three branches which lead to the __________, _________, and ____________. After birth, this organ closes and then becomes known as the ____________.
Foramen ovale Brain Heart Upper circulation Fossa ovalis
This organ serves as a bypass for the lower part of the body and becomes the ______________ upon birth.
Ductus arteriosus
Ligamentum arteriosum
A baby is prone to develop hypothermia (_______°C) or hyperthermia (______°C) which is due to multiple reasons including superficial blood vessels, a loose epidermal layer, very low subcutaneous fat, low body surface area, and inability to shiver. These are solved by ___________ and _________.
36.5°C
37.5°C
Flexed posture
Brown adipose tissue
There are four mechanisms of heat transfer that should be looked out for when dealing with newborns. Give these four mechanisms, give their key terms, and the accompanying conditions abbreviated by HAHT.
Conduction – direct contact Convection – ambient air Radiation – relative proximity Evaporation – insensible heat loss Hypoglycemia Metabolic acidosis Hypoxemia Tachypnea
In newborns, there is a _______ amount of extracellular fluid as compared to intracellular fluid in which the former is found in the __________, __________, and __________ spaces. Expect that there be some weight loss in newborns and some weight gain later on but not composed of water.
Higher
Interstitial
Transcellular
Intravascular
Newborns are to be fed at least ___________ or __________ as a result of faster absorption by their intestines. However, babies must be fed in an upright position since their ___________ may fail and cause them to regurgitate what they just ate.
Eight times
As often as they want to
Cardiac sphincter
There are three types of stool: meconium, transitional, and milk stool. These often come out as the first stool, on the third day, and on the fourth day of life, respectively. Transitional stool may be green to yellow and is less thin than meconium. Differentiate the characteristics of stool by babies who are breast fed and those who are bottle fed in terms of color, consistency, and odor.
Breast milk – golden brown, pasty, peculiar odor
Bottle fed – pale or lighter brown, hard and firm stool, repulsive odor
The liver is the most immature organ of a baby. This leads to a baby developing jaundice after birth. Physiologic jaundice occurs when ______________________ and pathologic jaundice is when ____________.
Body starts to replace womb RBCs within 3-5 days
Body starts destroying RBCs inside the womb and is shown within 24 hours of birth
A baby’s immune system is immature at birth and thus requires special attention to prevent infections which spread easily throughout the body. In general, ____________ provides the passive immunity for infants though they are only immune to measles, rubella, diphtheria and other conditions for about __________ months – providing the need for immunizations.
Colostrum
3 – 4 months
The neurons of a newborn are already complete at birth. The sense of smell is already well developed and a child may differentiate the smell of his mother from other lactating women within ________ days. Hearing is developed as well in that once the amniotic fluid is drained, hearing may be compared to that of an adult. __________ may be substituted for a child if there is no milk. Also, the ______, ________, and _________ are most sensitive to touch.
five days sugar water face hands soles of the feet
The amount of melanin found in newborns is lower as compared to older people – as such, they are much whiter. Lanugo may be found on a baby’s skin and the sebaceous glands produce __________ which then becomes _____________ if clogged.
Vernix caseosa
Milia
There are multiple integumentary characteristics that may be observed from a newborn. Among these include lanugo (_____________), milia (____________), Mongolian spots (___________), stork bites (___________), and erythema toxicum which is normal except for when ______________.
Baby hair Clogs during the release of vernix caseosa Bluish-black pigmentation spots Telangiectatic nevi (like freckles) Presence of pus
As if for checking for the turgor of the skin, a child’s skin is tested for ____________ in which the skin is pinched ____________ and it must return to its previous state.
Hydration
Vertically
The baby’s cry must be __________ in which it is uninhibited and wild. This means that a child has good muscle tone.
Lusty
The normal respiration rate of a child is between 30 – 60cpm and is mostly __________ that is synchronized with the chest. Pauses in breathing are normal in a pattern called _______________.
Abdominal
Periodic breathing
These sites are most preferred when taking a newborn’s temperature as it is less invasive than conventional methods.
Ear temperature
Axillary temperature
The normal fetal heart rate is from ____________ and the normal blood pressure for babies is ___/___ mmHg. These values may change if a baby is crying because of stress.
120 – 160bpm
74/47 mmHg
When doing a physical examination on a newborn, treat it as though it is an adult and what’s considered abnormal for adults are commonly abnormal for newborns as well. However, a nurse must always assess the mouth for __________ as this may mean difficulty in oxygenation for the child. Respiratory red flags like _________ (inspiratory wheeze), ___________ (expiratory wheeze), __________, and ___________ should be watched out for as the last two may be suctioned.
Cyanosis stridor grunting crackles rhonchi
These two conditions are present only in the male genitals in where the urethral opening is on either the dorsal or ventral side of the penis. These conditions are known as _________ and _________, respectively.
Epispadia
Hypospadia
There are multiple conditions that may affect newborns that should be assessed by the nurse. One is a neural tube defect called _________ in which the spine is not in its cavity. Polydactly and syndactly should also be assessed where the former is _________ while the latter is _________. Newborns should also be assessed for ________ which is the absence of the proximal part of an extremity and __________ which is the absence of an extremity’s distal part.
Spina bifida Excess of fingers Merged fingers Phocomelia Hemimelia
When assessing a child’s hips, check for any loose or dislocated ball and socket joints. The ___________ maneuver is done in which the __________ maneuver flexes the child’s legs and pushes downwards while the ________ maneuver pull the legs out and upwards.
Ortolani-Barlow maneuver
Barlow maneuver
Ortolani maneuver
This rooting reflex is a reflex done by an infant elicited by __________ and responded to by ___________. This reflex disappears after _____________.
Touching the lips, cheek, or corner of mouth
Turns to stimulant and sucks
3 – 4 months
The _____________ reflex is when an infant forces its tongue outward in response to _____________ which disappears after ____________.
Extrusion
Touch or depression of tongue
4 months
The swallowing reflex is done by an infant when ______________ and its response is by ___________.
Mouth is filled by liquid / breast milk
Swallowing
The ______ and ______ reflex is done by an infant when _______________ and it responds by grabbing the object in its hand or curling its toes downwards which disappears within __________ for the former and ___________ for the latter.
Palmar and plantar grasp
An object is placed in its hands or feet
3 – 4 months
8 – 10 months
The _________________ reflex happens when a child’s head is turned quickly to one side and the extremities on which side the head was turned to extends while the extremities on the other flexes. The response should disappear within __________ but suspect ______ if the response is still persistent after __________.
Fencing reflex
3 – 4 months
Cerebral palsy
6 weeks
The ___________ reflex is elicited by __________ and the child responds by stepping its feet. This reflex usually disappears after ______________.
Walking reflex
Holding the child in an upright position and letting its feet touch the ground
3 – 4 weeks
The _______________ reflex is elicited by placing a child on its abdomen and the newborn responds by ______________. This reflex disappears by ________________.
Crawling reflex
Newborn makes crawling movements
6 weeks
The Moro reflex is elicited by _____________ and the child responds by ____________. This response usually disappears within ________.
Startling the infant / simulate dropping the infant
Extending arms and legs as if scared
6 months
The ___________ reflex emerges at 3 months and disappears on the 12th month of life. It is elicited by ____________ and the neonate’s response is by _____________.
Landau reflex
Holding the child in a suspended position
Arching its back and raising its head
The crossed extension reflex is elicited by _______________ and the baby responds by _______________.
Extending baby’s leg, pressing down on the knee and stimulating the bottom of its foot
Flexing, adducting, and extending its leg as if pushing away the agent
Babinki’s sign is elicited by stroking the child’s foot upward from the ball and horizontally from the small toe to the big toe. A positive sign is recorded when _____________ and it disappears by ____________. Adults who are positive for Babinki’s sign may have _____________.
All toes hyperextend and there is big toe dorsiflexion
1 year
Neural problems
The Galant reflex is done by _____________ and the child responds by ___________. The reflex disappears by __________.
Running a finger down a the left or right side of a baby’s body
Moving its trunk and hips toward the finger
9 months
The _______________ is done by placing an infant in a supine position and pressing on its lower extremities. The child should ___________.
Magnet reflex
Extend and go against the force of the examiner
There are four pillars of family planning: birth spacing (ideally ____________ apart), ______________, _______________, and ____________.
3 years
Informed choice
Responsible parenthood
Respect for life
There are three purposes of family planning: ____________, _________, and ____________.
Birth spacing
Birth limiting
Achieving birth
A woman is considered too young when she is _____________ old and this is accompanied by possible complications like: _____________, __________, __________, and __________.
Below 18 years old Toxemia Hemorrhage Anemia Prolonged labor
A woman is considered too old when she is ___________ and this is accompanied by complications like: ____________, _________, and __________. In addition, babies born to mothers who are old have a higher chance of having ___________.
Over 35 years old Toxemia Prolonged labor Hemorrhage Down’s syndrome
A woman who has had __________________ deliveries is considered high risk since the uterus may be thought of as like a _________.
Four or more
Rubber band
The sympto-hormonal method uses an OPK (__________________) kit in assisting to determine when ovulation will occur.
Ovulation predictor kit
The basal body temperature method is rendered unusable if: _____________, _____________, and _____________.
Unwilling to take daily body temperatures
Unwilling to abstain from sex on fertile days
Unable to take body temperature on the same time everyday (shifting work sched)
Cervical mucus method uses the mucus secreted by the cervix in determining fertility. The mucus is ____________ if infertile and ___________ if otherwise.
Sticky, dense, thick
Wet, slippery, clear, thin
The standard days method (SDM) uses beads to determine ovulatory days. This method is only applicable for _______________.
People with 26 – 32 day menstrual cycles
Hormonal contraception comes in many forms and the most famous is “the pill”. The pill comes in three types: _________, __________, and ________ which denotes the number of concentration differences for each phase. This pill is taken for ________ days every month.
Monophasic
Biphasic
Triphasic
21 days
Transdermal patches work for up to ___________ though it is not recommended for women who are _______________ since they have trouble absorbing the drug.
3 weeks
90 kilograms
The _________ is a silicone ring inserted into the vagina and may be left for up to __________ weeks. This is preferred by women who have ____________.
Vaginal ring
3 weeks
Liver disease
Rods containing etonogestrel are a popular form of contraception which lasts for _________________ and with very little side effects.
3 – 5 years
Intrauterine devices are small devices inserted into the uterus which creates a ______________ via progesterone diffusion. This can last for __________ but some brands may last up to ____________.
Sterile inflammatory field
5 – 7 years
12 years
This method of contraception is chemically based and is made effective by making the vaginal pH higher than normal. However, it does have a ___________________ failure rate.
Spermicide
20 – 60%
This mechanical method of contraception has a 6 – 16% failure rate and is mostly used along with spermicides. It must be fitted by a physician and is placed in the _________.
Diaphragm
Cervix
These are thimble shaped caps made of soft rubber with a 26 – 32% failure rate. These may remain in place longer than diaphragms but must be removed before ____________.
Cervical cap
48 hours
The most famous contraceptive method. It also has a female version
Condom
These are surgical methods where the ___________ is cut for males and _____________ for the females. These are permanent but may be reversed.
Vasectomy – vas deferens
Tubal ligation – fallopian tubes
