Initial Assessment of the Newborn Flashcards
Normal Weight Range:
2.5 – 4.7 kg (5.5-10 lbs)
Average kg Female
3.4 kg
Average kg Male
3.5 kg
First few days, newborns lose about ___________________ of birth weight
5 % to 10% (6 to 10 oz)
Breastfed newborns recapture birth wt within
10 days
Formula fed newborns recapture birth wt within
7 days
Normal Weight Range
Doubles at 5 months, Triples at 12 months and Quadruples at 2 to 2.5 years of age (based on weight at birth).
Normal Length Range:
46-54 cm (18-22 inches )
Normal Length Range:
Average (50th Percentile)
49 cm (19.2 in.) for females and 50 cm (19.6 in.) for males
Second important determinant in relation to weight in confirming a healthy newborn
Length
Normal Head Circumference Range:
34-35 cm (13.5 to 14 in.)
Normal Chest Circumference Range:
32-33 cm (12.6 to 13 in.)
Usually 2 to 3 cm smaller than the head
Chest Circumference
Normal Abdominal Circumference Range:
32-33 cm (12.6 to 13 in.)
Blood Pressure
Approximately 80/46 mmHg at birth and rises to about 100/50 mm Hg by the 10th day.
Not routinely measured unless a cardiac anomaly is suspected.
Blood Pressure
For an accurate reading, the cuff width used ___________________________________________________________________________________
must be no more than two thirds the length of the upper arm or thigh
TEMPERATURE:
36.5 °C– 37 °C (97.7 °F- 98.6°F)
PULSE
110-160 beats per minute
Slightly irregular due to immaturity of the cardiac regulatory center in the medulla.
PULSE
_____________________ may result from the incomplete closure of fetal circulation shunts.
Transient murmurs
Transient murmurs may result from the
incomplete closure of fetal circulation shunts.
When crying, pulse usually elevates to
180 bpm and decreases to 90 to 110 bpm during sleep.
_________________________ pulses are palpable compared to radial and temporal pulses which are more difficult to palpate with any degree of accuracy.
Brachial and femoral
Newborn’s heart rate is always determined by listening for an ____________________ for a full minute, rather than assessing a pulse in an extremity.
apical heartbeat
Always palpate for ______________________
femoral pulses
RESPIRATION
30 to 60 breaths per minute (at rest)
Irregular respiratory depth, rate, and rhythm
NORMAL
Respirations are observed most easily by watching the movement of a newborn’s _____________________, because breathing primarily involves the use of the ___________________________________________
abdomen; diaphragm and abdominal muscles
are present at birth to clear the airway
Coughing and sneezing reflexes
Newborns are obligate
nose-breathers
may be beneficial to a newborn.
Short periods of crying, which increase the depth of respirations and aid in aerating deep portions of the lungs
APGAR meaning
Apperance, Pulse, Grimace, Activity, Respiration
Proponent of APGAR SCREENING TEST:
Dr. Virginia Apgar
Used to evaluate the prognosis of a newborn to determine if there is adjustment on extrauterine life.
APGAR SCREENING TEST
APGAR SCREENING TEST is done
twice at 1 and 5 minutes respectively
The Newborn Maturity Rating and Classification
BALLARD’S ASSESSMENT OF GESTATIONAL AGE
A. Physical Maturity
6 categories
- Skin
- Lanugo
- Plantar creases
- Breast buds
- Ears
- Genitals
Neuromuscular Maturity
6 Categories:
- Posture
- Square window (measurement of wrist angle with flexion toward forearm until resistance is met)
- Arm recoil (extension and release of arm after arm is completely flexed and held in position for approximately 5 seconds)
- Popliteal angle (measurement of knee angle on flexion of thigh with extension of lower leg until resistance is met).
- Scarf sign (arm pulled gently in front of and across top portion of body until resistance is met).
- Heel to ear (movement of foot to near the head as possible)
measurement of wrist angle with flexion toward forearm until resistance is met
Square window
extension and release of arm after arm is completely flexed and held in position for approximately 5 seconds
Arm recoil
measurement of knee angle on flexion of thigh with extension of lower leg until resistance is met
Popliteal angle
arm pulled gently in front of and across top portion of body until resistance is met
Scarf sign
movement of foot to near the head as possible
Heel to ear
Mucus is removed using a ____________________________________________________ only when necessary
bulb syringe and/or with a suction catheter
Never suction vigorously—- Why?
- to prevent irritation of mucous membranes
- to prevent infection
- to prevent bradycardia due to vagal nerve stimulation.
an excellent way to meet the needs of the newborn and provide family-centered care
Kangaroo care
If a clamp loosens before thrombosis obliterates the umbilical vessels, ____________________ could result.
hemorrhage
Count number of cord vessels after cutting:
AVA- 2 arteries, 1 vein
diapers are folded ______________________________, so that, when the diaper becomes wet, the cord does not become wet as well.
below the level of the umbilical cord
Newborns receive prophylactic eye treatment to prevent _____________________________
ophthalmia neonatorum
a severe eye infection contracted in the birth canal of a woman with gonorrhea or chlamydia.
ophthalmia neonatorum
Three ophthalmic agents that have been approved
for eye prophylaxis:
1% silver nitrate, 0.5% erythromycin, and 1%
tetracycline
VITAMIN K ADMINISTRATION
1.0 mg of vitamin K, administered IM within the first
hour of life to prevent bleeding problems.
VITAMIN K ADMINISTRATION
Possible adverse reactions:
Local irritation, such as pain and swelling at the site of
injection.
Administer IM injection into large muscle
(anterolateral muscle of a newborn’s thigh)
Assess for signs of bleeding
black, tarry stools, hematuria, decreased hemoglobin and hematocrit levels, and bleeding from any open wounds or base of the cord
All newborns receive a first vaccination against
hepatitis B within 12 hours after birth
Infants whose mothers are positive for the hepatitis B surface antigen (HBsAg) also receive ______________________________ at birth
hepatitis B immune globulin (HBIG)
Bath water should be approximately ________________________________, a temperature that feels pleasantly warm to the elbow or wrist.
98° to 100° F (37° to 38° C)
soap should be mild and without a __________________ base
hexachlorophene
Bathing should proceed from the ______________________________________________________ of the body—that is, from the __________________________________________________________
cleanest to the most soiled areas; eyes and face to the trunk and extremities and, last, to the diaper area
Eyes: Wipe with clear water from the ________________________________, using a clean portion of the washcloth for each eye
inner canthus outward
serves as a lubricant and is protective against infections
Vernix
Remains the ideal nutritional source for infants through the first year of life
BREASTFEEDING
A thin, watery, yellow fluid composed of protein, sugar, fat, water, minerals, vitamins, and maternal antibodies.
COLOSTRUM
COLOSTRUM is secreted starting in the
fourth month of pregnancy.
COLOSTRUM production continues for the
first 3 or 4 days after birth.
high in protein and fairly low in sugar and fat, making it easy to digest and capable of providing adequate nutrition for a newborn until it is replaced by transitional breast milk on the second to fourth day.
COLOSTRUM
True or mature breast milk is produced by
the
10th day
______________________________________________ is an acceptable position
Placing the baby over one shoulder and gently patting or stroking the back
is often the best position to use for burping
Holding the baby in a sitting position on the
lap, then leaning the child forward against
one hand, with the index finger and thumb
supporting the heads
