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d- health alteration lp7 > exam 4-lp7 > Flashcards

exam 4-lp7 Flashcards

1
Q

Fertilization

fuses/makes
how does penetration happen
when take pregnancy test
who determines gender

Fetal Development

A

sperm fuses to ovum and makes zygote

all sperm surround ovum, only one will penetrate

women can take pregnancy test after first missed period to see HCG

males determine gender

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2
Q

fertilization-fetal development

how long is ovum fertile
how long is sperm fertile
how long for implantation

A

ovum is fertile for 24 hrs after release from fallopian tubes

sperm is viable in female tract from 48-72 hrs

takes 8-10 days for implantation

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3
Q

how are

paternal
identical

twins made

A

faternal twins are two separate ovum and 2 separate sperm

identical are one sperm and ovum that randomly divide

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4
Q

Functions of Amniotic Fluid

constantly
absorbed/back
once kidney
filled

Fetal Development

A

constantly changing as baby swallows fluid

absorbed into fetal blood stream and back into placenta into moms bloodstream

once kidneys develop urine will develop

cushy water filled sac

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5
Q

Amniotic fluid will protects from what
regulates
allows
helps w/

Functions of Amniotic Fluid

A

amniotic fluid will protect baby from pressure/blows from moms abdomen

regulate temperature

allows for movements

helps with umbilical cord

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6
Q

normal amniotic fluid–how much

hydramnios/ Polyhydramnios-how much

Oligohydramnios–how much

A

normal is 800-1200 mls of amniotic fluid

poly- over 2000 mls of amniotic fluid

oligo- less then 400 mls of amniotic fluid

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7
Q

Umbilical Cord

of arteries and veins

arteries do what

viens do what

A

AVA” 2 Arteries and 1 Vein

Arteries carry unoxygenated blood AWAY from fetus

Vein carries oxygenated blood TO fetus

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8
Q

Development and Functions of the Placenta

when start
place where
exchange, function–main functions
functions like

A

functions start at 3-4 weeks

Place where nutrient and metabolic exchange takes place.

gas exchange, nutrition, excerction and endocrine function

Functions like the fetal lungs

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9
Q

4 weeks
8 weeks
8-12 weeks
16-20 weeks
24 weeks

Important Milestones in Development

A

4 weeks: heart is formed

8 weeks: organs formed; facial features discernable

8-12 weeks: fetal heart rate heard with Doppler

16-20 weeks: fetal movements felt by mother

24 weeks: fetal respiratory movements begin;
low-end age of viability

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10
Q

Fetal Circulation

bypasses

A

most blood bypasses lungs because gas exchange occurs in placenta

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11
Q

How does fetal circulation differ

lungs in mom
lungs in birth

3 shunts

A

Fetal lungs are fluid filled while in mom

as baby is born fluid leaves lungs

3 shunts-
Ductus venosus
Foramen Ovale
Ductus Arteriosis

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12
Q

Ductus venosus

allow

A

Allows blood to bypass liver and go to inferior vena cava

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13
Q

Foramen Ovale

allows

A

Allows blood to pass from right atrium to left atrium

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14
Q

Ductus Arteriosis

allows

A

Allows blood to pass from pulmonary artery to aorta.

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15
Q

why will shunts close

allows for

A

close due to cold air

allow for start of respiratory circulation

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16
Q

-Intrauterine Factors-

fetal lung development-surfactant
surf develops/peaks
if premature

A

Fetal lung development-surfactant -helps with expansion

surfactant develops at 24 weeks/peaks 35

if premature might give surfactant shot to build up lungs

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17
Q

Respiratory Adaptations
abnormalities
shunts

Newborn Physiologic Responses

A

Respiratory Adaptations are the most important part to watch for

any abnormalities follow up on

shunts should close to stimulate breathing

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18
Q

Mechanical events
TS
comes out
pressure

Initiation of breathing
Newborn Physiologic Responses Respiratory Adaptations

A

-thoracic squeeze.

when baby comes out vaginal canal, fluid is squeezes out lungs

and pressure changes causes breath and expansion

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19
Q

Chemical stimuli

decrease
no longer

Initiation of breathing
Newborn Physiologic Responses Respiratory Adaptations

A

decrease of placental exchange

placenta will not longer breath for baby

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20
Q

Thermal stimuli

what prompts
stimulates
Initiation of breathing

Newborn Physiologic Responses Respiratory Adaptations

A

coldness prompts baby to take deep breathes

cold air stimulates crying

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21
Q

Sensory stimuli
what stimulates
what do you want

Initiation of breathing
Newborn Physiologic Responses Respiratory Adaptations

A

lights
sounds
gravity
talking
rubbing

you want baby to scream and cry

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22
Q

Newborn Breathing

adjusting
What is normal
retractions

A

baby will have trouble adjusting to real world

normal-irregular patterns-30-60 bpm

retractions may be near clavicle and her bottoms of ribs

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23
Q

Signs of Respiratory Distress

retractions
cyanosis
nasal flaring
grunting
apnea-normal/abnormal

A

Retractions-pulling in and body is sucking itself in-caving in

Cyanosis-blueish color from not enough oxygen

Nasal flaring
–Obligatory nose breathers

Grunting-audibly hear

Periodic Breathing Pattern
–Apnea
—–Less than 20 secs with no cyanosis=normal
——-Greater than 20 seconds=abnormal

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24
Q

Feeding an infant in respiratory distress

could indicate

A

could indicate that a duct didn’t close properly

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25
Q

when would you not want a baby to cry

A

if meconium or no suction

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26
Q

lung sound assessment-whatdo first

what helps calm down

A

listen to lungs first in assessment-so before crying

if baby is crying-gloved fingers or pacifiers may calm down

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27
Q

Transitional Physiology
3 closures
murmurs
go away

Birth: Physiologic Responses
Cardiovascular Adaptations

A

Closure of Foramen Ovale
Closure of Ductous Arteriosis
Closure of Ductous Venosis

murmurs may result as incomplete closure of these

murmurs should go away soon

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28
Q

acrocyanosis

what is it
why happens
can be/subsides

Birth: Physiologic Responses
Cardiovascular Adaptations

A

bluish discoloration of hands and feet

immature peripheral circulation

can be completely normal and will subside after 24 hrs

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29
Q

heart rate
normal
sleep
crying

Newborn Physiologic Responses

Cardiovascular Adaptations

A

120-140 bpm

90-110 during deep sleep is ok;

up to 180 if crying)

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30
Q

blood pressure
initially
first year
need
not indicator

Newborn Physiologic Responses
Cardiovascular Adaptations

A

Blood Pressure initially around 80/46,

then 100/50 average for the first year

Need correct cuff size

Not an accurate indicator for distress

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31
Q

screen

detects
clamping of cord-allows
clamping-helps

Newborn Physiologic Responses
Cardiovascular Adaptations

A

Newborn screen completed before leaving hospital to detect congential heart defects

clamping of umbilical cord allows cardiac changes to occur

helps close structures and first breath

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32
Q

intense distress baby

dont do

can cause

do do

A

do not feed a baby that is in intense distress

can cause aspiration

start oxygen or nebulizers or X-ray or iv to regulate nutrition/breathing

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33
Q

Blood pressure measurement using a Doppler device

A

– not always done routinely

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34
Q

Hematopoetic System

initial
once properly
inc can cause

Newborn Physiologic Responses

A

Initial decline in hemoglobin over first 2 months

once baby is properly oxygenated the need for a high RBC count diminishes

increased hemoglobin can cause jaundice because of rabbit destruction of rbc which causes elevated bilirubin

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35
Q

Leukocytosis

increases
difficult
s/s of infection

A
  • increased WBCs d/t birth and stress in the first few days of life

—Makes it difficult to assess infection

s/s of infection-dehydration, poor eating, lowtemp, lethargy

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36
Q

Temperature Regulation

decreases/thin
blood vessels
posture
make sure
normal temp-

Factors affecting stability
Birth: Physiologic Responses

A

Decreased fat and thin epidermis

Blood vessels close to skin (more sensitive to environmental temps)

Flexed posture (less surface area exposed to environment, heat loss reduced).

make sure baby is wrapped up tightly

Normal Temp
97.6 – 98.6ºF (axillary)

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37
Q

Methods of heat loss

convection -what is it

examples

A
  1. convection -flow of heat from body surface to cooler surrounding air- air conditioner /open window
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38
Q

evaportaion- what is it

examples

A

loss of hear through conversion of a liquid to a vapor

amniotic fluid evaporation when born

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39
Q

conduction-what is

example

A

-transfer of heat to solid object in contact with baby-

cold stethoscope on skin

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40
Q

radiation-what is it

examples

A

transfer of body hear to a cooler solid object not in contact with baby

heat from baby moving to an open window

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41
Q

Heat Production

NST
BAT

Newborn Physiologic Responses
Temperature Regulation

A

Nonshivering thermogenesis (NST)

Brown fat/Brown Adipose Tissue (BAT– skin detects change in template and will use brown fat to change temperature

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42
Q

Pathology altering ability to generate heat

indicator of specific problems

Newborn Physiologic ResponsesTemperature Regulation

A

decrease in temperature can be indicator of problems–

Hypoxia

Acidosis

Hypoglycemia- Blood glucose first 24 hrs can be 30// standard is 40-45

Effects of certain drugs (Demerol given to mom in labor)

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43
Q

Iron storage and RBC Production-

when destroyed
iron is stored where-why

Newborn Physiologic Responses
Hepatic Adaptations

A

as RBCs are destroyed after birth,

the iron is stored in the liver until needed for new RBC production

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44
Q

Conjugation of Bilirubin

placenta/liver
start
liver performs

Newborn Physiologic Responses
Hepatic Adaptations

A

placenta took care of RBC breakdown, now liver needs to start to do

takes a few days for liver to start functioning

liver performs breakdown of bilirubin and breakdown goes through bowel movements and gives stool its color

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45
Q

Conjugation of Bilirubin

direct
indirect
What happens if bilirubin is too high -get

Hepatic Adaptations

A

Direct-water soluble

Indirect-non excrete able and can be potentially toxic

high bilirubin can cause nuerological issues-get daily labs

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46
Q

Physiologic Jaundice
caused by(accelerated, impaired, increased)

is this normal /when

Newborn Physiologic Responses
Hepatic Adaptations

A

(caused by accelerated RBC destruction, impaired conjugation, increased bili reabsorption from intestine)

NORMAL RESPONSE BY NEWBORN
Signs after first 24 hrs

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47
Q

Physiologic Jaundice-labs-

treatment

/dangerous

light therapy when

A

treatment is when lab goes as high as 10-12

more then 20 is dangerous to infant

light therapy at 15

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48
Q

breastfeeding jaundice

breastmilk jaundice

Pathologic Jaundice

one other cause

Newborn Physiologic Responses
Hepatic Adaptations

A

Breastfeeding Jaundice- (caused by poor feeding practices)

BreastMIlK Jaundice -caused by milk composition.

Pathologic Jaundice- signs WITHIN 24hrs of life.

vacuum can cause jaundice

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49
Q

treting jaunduice

therapy
skin
want/much

A

light therapy with eye protection

as much skin exposed as possible

want baby to eat and have as much bowel movements as possible-gets rid of bilirubin

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50
Q

Blood Coagulation

what is
cannot make
needed
given when
where given

Newborn Physiologic Responses

A

Vitamin K

(cannot make vitamin K at birth due to absence of normal flora in GI system)

needed for clotting factors

given at first day of birth

im Injection into thigh

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51
Q

nutrition
—Caloric Requirements
first 10
—Weight loss

Newborn GI Adaptations

A

—Caloric Requirements–110-120 calories per kilogram per day to keep up with growth

first 10 days are toughest since digestive system is immature

—Weight loss- baby can lose up to 10% of birthweight

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52
Q

Regurgitation

what is
due to
dont
often

Newborn GI Adaptations

A

spit up of food

due to immature sphincter in stomach

dont overfeed

burp as often as possible- to expel gas so they feel less full

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53
Q

Stools-
–Meconium-
–Breast fed-
formula fed

when’s first(meconium)

Newborn GI Adaptations

A

–Meconium-thick tarry black stool-

–Breast fed-3-4 yellow stools a day dt lactic acid

formula-2-3 bright yellow stools a day

mecronium passes within 24-48 hrs-ensures gi function

54
Q

Urinary Function
1st
alert

Urinary Adaptations
Newborn Physiologic Responses

A

1st void- within 24 hr;

Alert provider if no void in 24hr

55
Q

What does first urine look like

from

but __

A

Cloudy or “dusky”

from uric acid crystals and can appear like blood in urine,

but reassure scant amt it is okay.

56
Q

Immunologic Adaptations

dont
inability
fever

Newborn Physiologic Responses

A

dont really have immune system built up

Inability to recognize, localize, and destroy bacteria –

fever is not reliable indication of infection

57
Q

More reliable signs of infection:

Newborn Physiologic ResponsesImmunologic Adaptations

A

resp distress

↓ BS

hypothermia

58
Q

Immunologic Adaptations

produce
most
what given in hospital
where do pts get antibodies from

Newborn Physiologic Responses

A

Produce antibodies around 2 months

Most immunizations start at this time

erethymyocin, vit k, and hep b(not important for right away) given in hospital

babies get antibodies from mothers milk

59
Q

Newborn Reflexes:

A

Blink
Rooting
Sucking
Swallowing
Extrusion
Palmar Grasp
Stepping/Walk-in-place
Placing
Plantar grasp
Tonic neck
Moro
Babinski
Magnet
Crossed extension
Trunk incurvation

60
Q

Hearing

recognize
womb
fluid
every
might not

Sensory
Newborn Physiologic Responses

A

recognize mom’s voice immediately is common

babies can hear in womb

fluid drains from middle ear within hours after birth, then hearing becomes acute (just trouble locating/tracking sound)

every newborn has hearing screen in hospital

may not pass right away, if fail second time may need to go to audiologist

61
Q

Vision
reflex
loses
objects
cannot
black and white

Sensory
Newborn Physiologic Responses

A

Blink/squint reflex starting in utero @26 wk gestation

Loses track of subjects/toys easily,

object needs to be close to infant

cannot track across midline

Black and white objects 9-12 inches from face for a few months

62
Q

Touch
well
do not
sleep
cry

Sensory
Newborn Physiologic Responses

A

Well developed – hold, cuddle, swaddle for security feeling

babies do not like to be out in open and like to be help tightly

sleep better when swaddled

Cry with pain

63
Q

Taste

taste
prefer
circumcision baby

Sensory
Newborn Physiologic Responses

A

Taste buds are developed

Prefer sweet

circumsise babies-use glucose pacifiers to calm baby

64
Q

Smell
present
prefers

Sensory
Newborn Physiologic Responses

A

Present after clearing nose of fluid

Prefers mother scent/breastmilk

65
Q

Newborn Assessments

done when
what’s good
under
under immediatly

0/1/2
APGAR

A

done at 1 minute at 5 minute

7-10 is considered good

under 7 might need resuscitation

under 3 needs immediate resuscitation

0/1/2 pts

Activity/absent/flexed arms/ active

Pulse-absent/below 100 bpm/ above 100 bpm

Grimace-floppy/ minimal repsonse/ prompt response to stimulation

Appearance-blue pale/ pink body, blue extremities/ pink

Respiration-absent/ slow irregular/ vigorous cry

66
Q

Physical maturity

book 446 if you need to fill out idfk

Gestational Age Assessment

A

routinely done,

do if no prenatal care for person

most accurate if done in first 12 hrs

takes about 5-10 minutes to complete

Skin

Lanugo-fine blond hair-immature

Plantar surface

Breast

Eye/ear

Genitals

67
Q

Neuromuscular maturity

Gestational Age Assessment

A

Posture

Square window

Arm recoil

Popliteal angle

Scarf sign

Heel to ear

68
Q

General Appearance

why doing
head

Nursing AssessmentPhysical Assessment and Health History

A

visualizing baby

head is approximately 2 cm larger then chest

69
Q

Weight and Measurements

plotting
looking at
do

Nursing AssessmentPhysical Assessment and Health History

A

Plotting on Growth Chart

height, weight, chest and head circumference

do % to check where baby is and were they should be

70
Q

nerbown measurements

weight

length

head

chest

A

wt- F-7lbs M7.5 lbs

length- F19.2 in M 19.6

H 12.7-14.1

chest- 0.75-1 in less then head

71
Q

Temperature
preferred
normal range
unstable
rectal

Nursing AssessmentPhysical Assessment

A

Axillary preferred

97.6-98.6 normal range

Skin Probe for unstable newborns-stickers on stomach with sensor

Rectal temp not routinely recommended due to causing problems

72
Q

Skin and Color
Acrocyanosis vs central cyanosis

are each normal/abnormal(what does it mean)

Nursing AssessmentPhysical Assessment

A

A- when Lips/ hands/Feet
are blue-normal 24-48 hrs after birth

C-cyanosis of trunk- abnormal and can indicate issues with heart and lungs

73
Q

Skin and Color
Jaundice

what caused from-large
need to
color

Nursing AssessmentPhysical Assessment

A

– hyperbilirubinemia-large amount of red cells that are broken down but cant be excepted as fast,

need to be feeding and watching bm

yellow color

74
Q

Skin and Color
what does pallor mean
might
treat

Nursing AssessmentPhysical Assessment

A

– anemia-

most aren’t, so might be issues

can treat with iron or blood transfusion

75
Q

Skin and Color-Harlequin sign

when occur
type of condition
occurs
side

Nursing AssessmentPhysical Assessment

A

-2-5 days,

benign condition,

change in colors, occurs when baby sleep on side

side baby slept on is a different color then side not slept on

76
Q

Nevus flammeus (“Port-wine stain”) or (“Stork bite”)

what type
what color
treatment
may need to remove
can be

Nursing Assessment-Hemangiomas

A

benign,

dark or light port wine stain color,

treatment -may spontaneous fade,

may need surgery to remove,

can be covered by hair

77
Q

Infantile hemangiomas (“strawberry hemangiomas”)-

what looks like
when appear
enlarged
when shrink

Nursing Assessment
Hemangiomas

A

elevated areas of immature capillaries and epithelial cells,

appear 2 weeks of birth,

enlarged after 1 year

, after a year they are absorbed and shrink in size

78
Q

Cavernous-

what is it
what type of shapes
do they dissepear
can appear where
if on organs
treatment
watch

Nursing Assessment
Hemangiomas

A

dilated vascular spaces

, irregular shapes,

does not disapeaer,

can appear on organs,

surgical removal if interfering with organs,

steroids, radiation therapy,

watch h and h

79
Q

Mongolian spots-

A

blue areas that occur over body, fade away over time,

80
Q

Vernix Caseosa-
what looks like
will
noticeable
look
indicator
if assessing…

Physical Assessment
Nursing Assessment

A

white cream cheese lubricant all over baby body- ,

will fade,

noticeable in skin folds,

look at color and areas,

indicator of immature baby if al over

wear gloves to assess

81
Q

Desquamation

what is
what do

A
  • dry skin,

usually nothing, but if so then mild lotions or baby lotions

82
Q

Lanugo-

fine
usually
keeps

A

fine hair all over,

usually falls off,

keeps baby warm

83
Q

Milia

what are they
why occur
will
do not

A

little white heads all over nose

plugged/unopened sebaceous glands

will go away on own

do not push or squeeze them-can cause infection.

84
Q

Erythema toxicum-

what are they
also called
disappears
do not

Physical Assessment
Nursing Assessment

A

pinpoint red papules,

“baby acne” ,

disappears in a few days and sometimes will go back a couple days into age-

do not poke or prode

85
Q

Forceps marks-

what is forceps
what happens
when disappear
check when

A

forceps go around cheek or head,

scrath marks around baby head from them

disappear in 1-2 days

check face during crying to look for symmetry

86
Q

Skin turgor-

should
if dehydrated

A

should have good elasticity

if dehydrated will tent

87
Q

Fontanelles

when anterior and posterior close
soft spots allow
if sunken
if bulging and not crying
best to look when

Nursing AssessmentPhysical Assessment - Head

A

anterior -Closes by 18 months-

posterior- closes by 8 weeks

soft spots-open to allow for flexibility and allow brain to grow

if looking sunken in-then look for dehydration

if bulging and not crying, then increased intracranial pressure, doctor needs to be contacted immediately.

best to do when not crying

88
Q

sutures
overide/subside

molding/subside

Physical Assessment-Head
Nursing Assessment

A

Sutures – override due to vaginal birth
(subsides in 24-48 hrs)

Molding also due to birth
(subsides in a few days

89
Q

Caput succedaneum-
what is it
suture lines
vaccume
hats

Physical Assessment-Head
Nursing Assessment

A

collection of fluid.

DOES cross suture lines.

vaccumes can cause hematoma

hats can cause headaches and can make baby crabby

90
Q

Cephalohematoma-

what is it
suture line
increases
vacuumed
hat

Physical Assessment-Head
Nursing Assessment

A

collection of blood.

Does NOT cross suture lines.

can increase chances of jaundice

vaccumes can cause hematoma

hats can cause headaches and can make baby crabby

91
Q

Physical Assessments
eyes

looking for

Nursing Assessment

A

slight edema

no tears

hemmoraghe-could have bloodshot eyes due to pressure at birth

92
Q

Physical Assessments
ears

sides
low
make sure

Nursing Assessment

A

equal on both sides

low set ears can indicate abnormality like down syndrome

make suer can hear

93
Q

Physical Assessments
Nose

usually
where in head
assess
obligatory

Nursing Assessment

A

usually short, creased with skin folds

midline in head

assess symmetry and choanal atresia- blockage of the rear of the nose by compressing one nare at a time

obligatory nose breathers

94
Q

Physical Assessments
mouth

thrush
epsteins pearls

Nursing Assessment

A

Thrush-(white patches that look like milk curds) on tongue and cheeks

Epstein Pearls (small white specks on hard palate and gum margins)

95
Q

neck
what looking for

Physical Assessments
Nursing Assessment

A

short creased

white skin folds

head lay

cant support head-support for them

96
Q

Physical Assessments
chest

Nursing Assessment

A

some children have engorged breast tissue from moms hormones

small

97
Q

Physical Assessments
cry

make sure
high pitched
looking for
easily

Nursing Assessment

A

make sure loud

high shrill cat cry may mean intracranial pressure or trauma

looking for pain

easily distinguishable from toddler

98
Q

female-Anogenital
Pseudomenstruation-

may/
subsude

Nursing AssessmentPhysical Assessments

A
  • may have blood in diaper from moms hormones,

will subsides when hormones leave the body

99
Q

Abdomen
looking for
usually
some may

Physical Assessments
Nursing Assessment

A
  • looking for bowel sounds,

usually aucaltating 1 hr after birth,

some may have bowel movement in 24-48 hrs

100
Q

Umbilical Cord-

pull-will
turns what color
leave what
when fall
should not be
if__ looking for
treat infections
dont do what

A

dont pull off-will fall off on own

, cord turn brown and dries up,

leave clamp and security tag-

6-10 days should fall off,

should not be any bleeding or wetness-

if wetness or odor looking for infection-

treat infections with antibiotic,

dont submerge baby into bath to keep uc dry

101
Q

Male-Anogenital
Hypospadias

Male-Anogenital
Nursing Physical Assessment

A
  • urinary meatus is on ventral surface of penis
102
Q

Phimosis
what is it
what needs

Male-Anogenital
Nursing Physical Assessment

A
  • foreskin cannot be pulled back over glans-

surgery Neds to be performed because of urinary retention

103
Q

Cryporchidism-
what is it

Male-Anogenital
Nursing Physical Assessment

A

failure of testes to descend-

104
Q

Hydrocele-

what is it
what look like
scortal sac

Male-Anogenital
Nursing Physical Assessment

A

fluid surrounding the testes-

very enlarged

-scrotal sc can be reddened and swelling

105
Q

Back

assess
when supine
make sure
checking

Nursing AssessmentPhysical Assessment

A

asses prone-lay on stomach

when supine- back should be flat

make sure spine bifida

checking extremities

106
Q

Extremities

paralysis
digits
clubfoor
hip dysplasia

Physical Assessment
Nursing Assessment

A

Paralysis-inability to move extremities

Digits/webbing-fingers are together-or any extra digits

Clubfoot -foot is tuned inwards-can be aligned with brace or surgery

Congenital hip dysplasia- make sure baby ball and socket aren’t out of place

107
Q

Heel stick –

after when
3 h’s
numbers
can help determine

Newborn Lab studies

A

after 1 hr to asses how baby is adapting to outside world

Hematocrit
Hemoglobin
Hypoglycemia

numbers will be lower then adults

if large or gestational diabetes, questionable infections can help determine.

108
Q

Newborn Screen

after
sent
card
can look

A

– after 24 hrs

sent to state

card with 3 dots

can look at different genetical problems

109
Q

Newborn ID and registration

what Prevents abduction-

registration Info

A

banding

Registration info given to parents – use birth certificate to obtain social security, etc..

110
Q

Erythromycin

prevents
prevention

nursing considerations
wear
babies
swelling

Newborn Needs and Care

A

-profilactive to prevent gonorrhea and chalmydia,

Prevention of Eye Infection

nursing considerations
wear gloves,

babies dont open eyes completely.

swelling does get better

111
Q

Initiation of first feeding

teaching
maintaining clear airways/vitals

Newborn Needs and CareInterventions

A

teaching parent to look for rooting and sucking reflexes

Maintain clear airway and stable vital signs:
Position
Remove mucous

112
Q

Maintain a neutral thermal environment

what per protocol
RW
will always need what
what helps
environment
babies dont

A

Skin sensor per protocol

Radiant warmer

Hat-babies will always need hat to keep warm

Baths

warm environment

babies dont eat if cold

113
Q

Newborn Needs and CareHep B

when done
can be
given

A

1st vaccination given within 12 hrs after birth

can be held off a little bit

given within 1,3,6 months

114
Q

Newborn Needs and Care\ Vitamin K

when done
prevents
done with

A

IM within first hr of life

prevent bleeding problems

done with erythromycin

115
Q

Newborn Circumcision

up to
any
usually

Current recommendations

A

up to parents to do,

any gi/gu issues may be held off for a little bit

usually 24 hrs into stay

116
Q

Newborn Circumcision
Care during-

strap
put
make sure
releive pain

A

strap baby down onto board

, put emela cream to numb area,

make sure vit k has been given

, sugar water, sucrose water, and glucose pacifier helps to relieve pain

117
Q

Newborn Circumcision
Care after

s/s infection
may have
do not
keep
use
change
if bleeding
heals in

A

s/s of infection-odor, discharge,

may have some shroud drainage at first,

do not wash right away ,

keep area clean

, use vaciliene gauze to keep moist for 3 days post circumcision,

change gauze every diaper change,

if bleeding hold pressure and if continue call doctor.

heals in 7-10 days

118
Q

Assess home environment

car seat

crying

anticipatory

Newborn Needs and CareParent Teaching

A

home- put bias aside- try to promote healthiest environment for baby

car seat- parents need car seat to leave hospital-nurse do not install

crying is how babies communicate

anticipating-need to eat, sleep, changed

119
Q

Where should baby sleep

A

on back

120
Q

Newborn nutrition

Breast Feeding

advantages
disavantages
contraindications

A

Advantages
Immunologic aspect
high Nutrition
Psychosocial-helps bonding

Disadvantages-releis a lot on mom and can be exhausting/frustrating to mom
can cause a lot of problems to mom

Contraindications- breast surgery, any specific reasons why mom cant give milk

121
Q

how long to breastfeed

when whole milk

what’s in breastmilk

baby food when

A

breastfeeding/formula up to first birthday,

baby cannot get whole milk until then-done have enzymes to break down

baby get iron from milk

at 4 months you can start adding baby foods per pshycian

122
Q

Newborn Nutrition

how often breast feeding
know if enough
how many cals per day

Caloric and fluid needs

A

breast feeding should be done 8 times in 24 hrs

know if baby is getting enough bc of weight gain

120 calories per kilogram on average per day

123
Q

Newborn Nutrition
listening for
watching
looking for

Caloric and fluid needs

A

listening for swallowing

watching amount of ounces baby ate

looking for wet diapers and stools

124
Q

lactation education

lactation is what
what if needed
hormones
sites
get baby

A
  • breastfeeding,

there is lactation consultants if needed,

prolactin is released at birth and stimulates milk production,

alternate breast sites,

get baby to latch onto

125
Q

Leaking– education

is it normal
can leak where
subside when
can leak more why

A
  • does happen

, can leak out of other side,

after month it will subside,

can leak more if there’s time in between pumps

126
Q

Breastfeeding education

establish

A

Establishing a feeding pattern

127
Q

Breastfeeding education

expressing

support

A

Expressing milk-done by hand, there’s also electric pumps,

Support-lactation consultant, family/friends, work needs to provide rooms for at work pumping,

128
Q

Storing milk education

put in what
originally put where
for how long
then where
for how long

A

-sterile container, and in bag,

put in fridge

fridge for 8 days,

then in freezer or dumped,

freezer last 3-4 months

129
Q

breastfeeding problems
pacifiers
warming
never
feed

make sure to

A

Problems-
pacifiers shouldn’t be used until breastfeeding is well established,

warm breastmilk by warm water and place bag in there,

never microwave breastmilk,

feed on demand,uslaly every 1.5-3 hrs

make sure burping and rotating sites

130
Q

Formula Feeding

just as
types
techniques
dont want formula
amounts
tempature
burping

A

just as effective

Types- cans/powder,

Techniques/ Positioning-always hold baby head higher then body, baby can hold own bottle around 6 months,

dont want formula siting out for more then an hour, dont want formula in fridge longer then 4 hrs

Amounts-1-3 ounces every 2-4 hrs. formula is more filling

Temperature-bottle is warmed with warm water, bottle warmers. make sure its safe

Burping- burp every 0.5-1 ounce, establish a feeding pattern

d- health alteration lp7 (7 decks)

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