Exam II

Question 1

This type of jaundice typically appears after 24 hours of age and resolves without treatment. Bilirubin is gradually increased to 5 to 6 mg/dL by 72 to 96 hours of life and decrease to 2 to 3 mg/dL by day 5 of life.

Answer 1

Physiologic jaundice

Caused by increased levels of unconjugated bilirubin

Question 2

When should maconium pass in your newborn

Answer 2

24-48 hours

Question 3

This edematous area of the scalp appears at the suture lines of the occiput and disappears within 3-4 days. Typically seen with vacuum extraction delivery.

Answer 3

Caput Succedaneum

Question 4

A collection of blood between the skull bone and the periosteum and does not cross suture lines. It shows prominently on the second or third day after birth and resolves in 3-6 weeks.

Answer 4

Cephalhematoma

Question 5

Bleeding occurs in the subgaleal compartment due to torn vessels as a result of difficult vaginal birth, especially vacuum extraction. Can cause hypovolemic shock, disseminated intravascular coagulation, and death.

Answer 5

Subgaleal hemorrhage

Question 6

What is the head circumference for a term neonate

Answer 6

32-36.8 cm (12.6-14.5 in)

Question 7

What is the head-to-heel length for term neonates

Answer 7

45-55 cm (17.7-21.7 in)

Question 8

What is normal newborn temperature?

Answer 8

36.5-37.5 C (97.7-100 F)

Question 9

What are normal respirations for newborn?

Answer 9

30-60 bpm

Question 10

What is the weight for an average newborn?

Answer 10

2500-4000 g (5.5-8.8 lbs)

10% loss in first 3-5 days is acceptable

Question 11

What is the normal apical pulse for a newborn?

Answer 11

80-100 bpm sleeping

120-160 bpm awake

Question 12

How many breaths per minute are considered bradypnea in newborn and what are the causes?

Question 13

How many breaths per minute are considered tachypnea in newborn and what are the causes?

Answer 13

> 60/min

Caused by RDS, transient tachypnea of the newborn, genital diaphragmatic hernia

Question 14

What is the normal chest circumference for a newborn?

Answer 14

30-33 cm (11.8-13 in)

2-3 cm less than head circumference

Question 15

What are normal findings for the breasts of a newborn?

Answer 15

Prominent nipples, well formed, symmetrically placed, nodule measures 3-10 mm in term infant

Question 16

What is the normal voiding pattern for a newborn?

Answer 16

2-6 times per day for first 1-2 days,

6-10 times per day by day 4-5

Question 17

What is the normal finding for the soles of the feet of a newborn?

Answer 17

The soul should be well aligned (or winkled) over two thirds of the foot in term infants

Few creases = preterm
Covered with creases = post mature

Question 18

A baby born before completion of 37 weeks of gestation, regardless of birth weight is considered _______?

Answer 18

Preterm or premature

Question 19

Baby born between 34 and 37 weeks gestation is considered ________?

Answer 19

Late preterm

Question 20

A baby born between the beginning of week 37 and the end of week 42 of gestation is considered _____?

Answer 20

Term

Question 21

A baby born after completion of 42 weeks gestation is considered _____?

Answer 21

Post term/Post date

Question 22

A baby born after completion of 42 weeks gestation and showing the effects of progressive placental insufficiency is considered ____?

Answer 22

Post mature

Question 23

How should vitamin K be administered to a newborn?

Answer 23

0.5-1 mg via IM injection soon after birth to prevent hemorrhagic disease

Vitamin K should never be administered via IV and should never be administered via rapid bolus as this can cause cardiac arrest

Question 24

How often should a newborn be assessed for jaundice?

Answer 24

Every 8-12 hours

Question 25

A TcB screening result >_____ requires a follow-up with a serum bilirubin test

Answer 25

12 mg/dL

Question 26

What is the normal glucose level for a newborn?

Answer 26

40-45 mg/dL

During the first 1 to 2 hours after birth, glucose levels may be as low as 30 mg/dL

Question 27

What is the normal hemoglobin level for a newborn?

Answer 27

14.5-22.5 g/dL

Question 28

What is the normal hematocrit level for a newborn?

Answer 28

48-69%

Three times the hemoglobin level

Question 29

Where is the normal red blood cell count for a newborn?

Answer 29

4.8 -7.1/mcL

Question 30

What is the normal platelet count for a newborn?

Answer 30

150,000 to 300,000

Question 31

What is the normal white blood cell count for a newborn?

Answer 31

9,000 to 30,000

Question 32

What is normal bilirubin level for a newborn?

Question 33

What is considered an elevated PKU result in a newborn?

Answer 33

> 20 mg/dL

Question 34

An infant whose rate of interuterine growth was slowed and whose birth weight falls below the 10th percentile on the intrauterine growth curves is considered _____?

Answer 34

Small for gestational age (SGA)

Question 35

An infant whose birth weight falls above the 90th percentile on the intrauterine growth chart is considered _____?

Answer 35

Large for gestational age (LGA)

Question 36

What are the clinical manifestations of infants of diabetic mothers?

Answer 36

Large for gestational age
Abundant vernix caseosa
Listless and lethargic
Hypotonia
Plump and fullfaced

Question 37

What are causes of respiratory distress syndrome in newborns?

Answer 37

Preterm birth,
Sepsis,
Cardiac defects,
Exposure to cold,
Airway obstruction,
Hypoglycemia,
Metabolic acidosis,
Acute blood loss,
Drugs

Question 38

What are the nursing interventions for respiratory distress?

Answer 38

Monitor oxygenation by pulseox symmetry and provide supplemental oxygen

Question 39

Newborn pulse ox should be placed on the _____ hand and _____. Rates should be from ____ to _____%.

Answer 39

Right hand & foot,
90-95%

Variance >3% should be rechecked in 1 hour

Question 40

This type of jaundice occurs within 24 hours. The serum bilirubin level exceeds 15 mg/dL or increases by more than 6 mg/dL within 24 hours

Answer 40

Pathologic Jaundice

Also called hyperbilirubinemia