Exam 3 - book - incomplete Flashcards
security - code pink
Tags (usually attached to babies) that alarm when taken past a point to prevent abduction; locks down hospital and nearby streets
circumcision
removal of prepuce, insufficient data to recommend by major bodies
circumcision pain relief
EMLAs, nerve blocks, acetaminophen
nonpharm = pacifiers, oral sucrose, music, low lights, intrauterine sounds, talking softly to infant
circumcision care
- Consent
- infant is stable and already had vit K
- withhold feeding for 2-4 hours
- note first urination after surgery or 6-8 hours if hasnt by discharge by mother
- yellow crust normal
Infant characteristics that lead to increased heat loss
- thin skin
- low white fat
- 3x more SA and 4x more heat loss
infant thermogenesis
by nonshivering thermogenesis using brown fat (in back, chest, neck, front). starts by thermoreceptor stim releasing norepi initiating casade.
PT infants dont have enough brown fat
hypoxia, hypogly, and acidosis limit thermogenesis
uses up glucose, RF jaundice
newborn care tasks
Admin vitamin K and erythromycin
removing secretions
bathing and cord care
assisting with feedings
positioning, protecting, and IDing the infant
preventing abduction
Admin of vitamin K and erythromycin
K: clotting factor, within the first hour bc the baby cant make it on its own
Erythromycin: prophylactically to prevent ophthalmia neonatorum if mother has gonorrhea
removing secretions
turn head to side and using a bulb suction out secretions to help the baby breath better
bathing, cleaning diaper area and cord care
bath: given to remove birth stuff, bath in 38*C or 100.4*F water, this is a good time to include teaching
diaper area: water or soap, or detergen/EtOH free wipes
Cord care: checked for bleeding or oozing, purulent drainage = infection, becomes brownish black within 2-3 days and falls off in 10-14 days
Positioning, protecting and IDing the infant
Positioning: on back not belly, firm sleep surface, tummy time
Protection: baby to the right parent, precautions for abductions, preventing or recognizing signs of infection
IDing: ID bands or cord blood in case
Infant discharge requirements and follow-up care
Discharge requirements: normal VS, 2x successful feedings, passed urine and stool, no excess bleeding, testing complete, or follow up care scheduled
Follow-up care:
preventing abduction
have everyone wear an photo ID, teach parents to prevent kidnapping, be suspicious, never leave infant alone, always match infant to parent when they take an infant
SS of hypoglycemia in infants
diaphoresis (normally uncommon in infants), jitteriness or tremors, rapid respirations, low temp, poor muscle tone
complication: RDS
Ix for IDM (infants of DM mothers)
feed early or immediately when BG <45 mg/gl (IDMs are poor feeders), IV glucose if needed, support mother, aware of RDS
consider hypocalcemia if BG normal
RDS pathology
insufficient surfactant usually in PT infants that begins production at 34-36 weeks. Surfactant decreases surface tension so the alveoli stay open each breath making lungs noncomplient (stiff)
RDS SS
TP, nasal flaring, retractions, cyanosis, grunting, decreased breath sounds
RDS Tx
surfactant replacement therapy
RDS RN considerations
be aware for at birth and early hours of life, abn in lab ABGs or acid-base
PT appearance
frail and weak, large head, thin translucent skin, (undecended testes/ labia minora > majora
PT behavior
low energy
PT respiratory problems
RF RDS, apneic spells (lack of breathing lasting >20 sec)
PT respiratory Ix
humidified O2, CPAP
place in side-lying or prone (until can breathing with proper drainage and without regurgitation)
Suctioning (5-10 sec each), proper hydration
PT thermoregulation problems
thin skin, low brown fat, less flexion (extended arms)
Abd temp: 96.8* - 97.7*
Axillary temp: 97.3* - 98.4*
