Heat Loss & Immediate Needs Flashcards
what are the four mechanisms of heat loss?
Evaporation
Conduction
Radiation
Convection
what is the first mechanism of heat loss at birth and why?
Evaporation → baby comes out wet with amniotic fluid
what should the nurse do to prevent evaporation at birth?
dry the baby!
how does the baby experience heat loss through conduction?
they will transfer their heat to a cold surface
what do we do to prevent conduction heat loss at birth? (2)
- skin to skin
- warmed blankets on top of both mom & baby
how does the baby experience heat loss through radiation?
a naked baby will radiate their heat to room temp
to prevent radiation heat loss, what should always be ready for when the baby is warm?
a hat
list ways to prevent radiation heat loss at birth (3)
- hat
- cover with blankets, clothing
- radiant warmer
does clothing get put on in L&D?
no, it waits until mom is transferred to postpartum unit
how should babies be dressed?
always dressed in one more layer of clothing than adults
how do radiant warmers work?
they only warm the outside of things
should the baby be placed into blanket under the warmer?
no they should be naked only in diaper
how do we prevent convection heat loss? (4)
- keep out of drafts
- keep away from doors or fans
- perform baths away from drafty areas as well
- keep warmer away from door
what does low temp in baby equal? (3)
low glucose and ↑ risk for respiratory distress or loss of brain cells
how can heat loss lower glucose?
If baby has to use a lot of its brown fat to keep warm → will have less reserve to maintain glucose
what babies is low glucose often seen in? (3)
- preemies
- large babies
- babies born to diabetic mothers
keeping baby warm is a _____ _____ measure!
life saving
when should the warmer be checked?
prior to baby being born
90% of babies will go…?
right to skin-to-skin contact
how are warmers properly checked?
Turn it on & put hand underneath to check for heat
Make sure there is a temperature probe
what is attached to warmer? (5)
oxygen with ambu bag
suction
stethoscope
laryngoscope
meconium aspirator
when you turn on oxygen what do you need to make sure of?
you need to make sure it regulates to the proper amount of flow!!
Enough flow but not too much
what is necessary to have at delivery incase we need to clear the airway?
mechanical suction
what do we set mechanical suction to?
Set between 80-120 (usually 100)
Why is a laryngoscope necessary to have at delivery?
incase of intubation
Why is a meconium aspirator necessary to have at delivery?
incase of meconium fluid
you want to try to get baby to skin-to-skin right away, before what?
before the cord is clamped
how long should cord clamping be delayed?
at least 30 seconds, up to 5 minutes
what are the benefits of delayed cord clamping? (3)
- Increases blood volume about 33%
- Increases iron stores for up to 6 months → Lower incidence of anemia
- Increases oxygen to vital organs
when might delayed cord clamping be contraindicated? what would be done?
if neonate needs immediate resuscitation
you would clamp & cut the cord right away
what can delayed cord clamping be compared to?
it is like giving a little blood transfusion to the baby
who is delayed cord clamping very beneficial for?
preemies
how do we dry the infant & stimulate them gently?
by gently rubbing the baby dry with a warmed blanket while on mom’s chest/ abdomen
drying the baby & stimulating them gently stimulates what?
their first breath
drying the baby & stimulating them gently promotes what?
lusty cry to clear the airway → all baby needs to get started in life
most babies only need ____ _____
gentle stimulation
what should be used if secretions are blocking the baby’s airway?
- bulb suction
- mechanical suction
where is bulb suction performed?
side of mouth & nose
why should you carefully assess babies with meconium stained fluid?
some babies have their first meconium passage in utero that could block airway
if the baby is trying to breath & cry, what should you get?
bulb suction
what is considered ineffective breathing at birth?
gasping breathing or grunting cry
what should be done if the baby is not breathing or is ineffectively breathing?
ventilate with bag-valve mask
Always start with ______ ______ and go to ______ _____ if need be!!
least invasive; most invasive
