MCN Final Reviewer 1 Flashcards
includes weight of the newborn, length head chest and abdominal circumference
Vital statistics
Weight of neonate
2.5 - 3.4kg
Several Factors of weight:
- Nutritional status of the mother during pregnancy
2. Genetic factors- Heredity * mother is low weight
Weight of the baby doubles after
6 mos
Weight of the baby triples after
1 yr
Weight of the baby quadruple after
2 yrs or 24 mos
Percentage of the body weight in fluid
75% - 90%
Over 3.4kg
(Large Gestational Age - LGA) or macro somnia
Less 3.4kg
(Small Gestational Age- SGA)
What mothers usually give macro somnia baby
DM mothers
Length of neonate
48cm-54cm M and
47cm-53cm F
Birth length increases of 50% in
1year
Birth length double
2yrs
Head Circumference of neonate
33cm to 35 cm
Largest part of the body and 1/4 of the total length of the newborn
Head Circumference
Big head or Supersize head
macrocephaly
Head with 33cm below
microcephaly
if more than 37 cm - may involve abnormality in
neurological or nervous system
Chest Circumference of neonate
31cm to 33cm
*2cm less than the head circumference
Abdomina Circumference
29cm to 31cm
*2 cm less than the chest circumference
Vital signs for neonate in order
- RR
- PR
- Temp
Normal Temp of neonate
37.2C
At the moment of birth 37.2C because the newborn has been
confined in an internal body organ.
Immediate fall down of newborn temp because of the
immaturity of the hypothalamus and heat loss
4 Mechanism of Heat Lost
- Convection
- Conduction
- Radiation
- Evaporation
the flow of heat from the body surface to cooler surrounding
Convection
transfer of heat to a cooler solid object in contact with the baby *ex. stethoscope, weighing scale
Conduction
a transfer of heat to a cooler solid surfaces or object not in contact with the body *ex. open window
Radiation
a lost of heat through conversion from a liquid to vapor
* The newborns head is the greatest contributor of heat lost because it is the largest part of the body
Evaporation
Nursing Care to Maintain appropriate temp
- Normal Temp 36.5 to 37.5 C
- Take the newborn at rectal route to check the patency of the anus * check if their is an opening
- Dry and rap the newborn
- Placing them in a warm crib
- Expose in drop light *radiant warmer
placing the newborn against the mothers skin and covering them to help transfer heat from the mother to the newborn.
KANGAROO Care
Pulse Rate of neonate
120 to 160bpm
Immediate pulse rate after birth
180bmp
* Irregular PR because of immaturity of the cardiac regularity center - medulla
An hour after birth
120 - 140bpm
* Immaturity of the cardiac regulatory center - medulla
most preferred side for pulse rate for neonate
apical pulse
pulse can be felt readily in a newborn by hands
Femoral pulse
are difficult to palpate in neonate
Radial and temporal
the preferred area for checking pulse children over 3years old
Radial pulse
preferred area for checking pulse children for 3 years old below
Apical Pulse
If no femoral pulse in neonate
- Contraction or narrowing of the aorta vapor
Respiration of neonate
30 to 60bpm
Respiration of neonate for First few minutes of life
80bpm
the respiratory depth, rate and rhythm are irregular and short periods of apnea
Periodic Respiration
Coughing reflexes are present
to clear the airway
Newborn are what breather
obligatory nose breathers
* no mouth
Short period of crying is beneficial to the newborn
to expand the lungs
Long Period of crying can
exhaust the cardio vascular system of the newborn
Observe sign and symptoms of respiratory distress
- Increase in respiratory rate - tachypnea
- Nasal flaring - widening of the nose drill
- Chest retractions
Blood Pressure of neonate
80/46 mmHg
Blood Pressure of neonate in 10th day
100/50 mmHg
Newborn Appearance
- Skin
- Head
- Eyes
- Ears
Skin color of neonate
- Cyanosis
- Jaundice
- Pallor
- Harlequin Sign
Normal color of neonate
Ruddy
“ruddy” complexion because of increase concentration of _____ and decrease the amount of __________.
- RBC
2. Subcutaneous fat
bluish discoloration of the skin
cyanosis
decrease oxygenation and maybe result of a temporary respiratory obstruction
central cyanosis
Jaundice that develop within 24 hours ABNORMAL
pathologic jaundice
Develop after the first 24 hours unto 3 to 4 days after birth NORMAL
This occurs as a result as the breakdown of the fetal RBC NORMAL
physiologic jaundice
Measures to treat jaundice
- Encourage early feeding - to speed passage of feces and prevent the absorption of bilirubin
- Photo Therapy- to initiate the maturation of liver enzymes
- Incubator
- Light Source
usually a result of anemia
*cause excessive blood lost from cord cutting
Pallor
- deep red color on one side of the body while the other side of the body remain pale
- depended side is red and pale and upper side during side lying
- it is temporary
- immature circulation
Harlequin Sign
Birth Marks
- Nevus Flammeus
- Nevus Vasculosus
- Cavernous Hemangiomas
it is a macular purple or dark red lesion which appear on the face and open on the thighs and extremities
also known as:
Nevus Flammeus
“port wine stain”
benign limiting tumor
- they are elevated and formed by immature capillaries and endothelial
- most common tumor of infancy, most presence on the most full term neonates
- appear unto 2 weeks after birth
- not common among immature infants because of immature epidermis
also known as:
Nevus Vasculosus
strawberry hemangiomas
- it may continue to enlarge its size up to what age
- decrease it size after what age
- the lesion disappear at what age and percentage
- completely disappear at what age
- 1yr old
- after 1 year old
- 7yrs old 50%- 75%
- 10 yrs old
ointment can help it disappear
hydrocortisone
raise or dilated vascular or blood vessels from a tumor and never disappear in time
Cavernous Hemangiomas
white cream cheese like substance that serves as a skin lubricant
the color is like amniotic fluid
Vermix Caseosa
the fine downy hair that covers a newborn shoulder, back and upper arms that decreases as gestational age increases
- eventually disappear in 2 weeks
Lanugo
AOG rarely have lanugo
AOG have more lanugo
- post mature (40up AOG)
2. 37 - 39 AOG have more lanugo
refers to a dry peeling skin, evident on the palms of the hand and shoal of the feet.
Desquamation
pinpoint white papule found on the chicks and bridge of the nose
- disappear by 2-4 weeks after birth as the sebaceous glands mature and drain
Milia
newborn rash in neonate
temporary rash on a new born
appears 1-4 days of life , disappear 2 weeks of age
Erythema Toxicum Neoratorum
forceps use during birth
- circular or linear contusion matching the ring of the blade of the forceps on the infants chicks
- disappears 1-2 days after delivery
Forceps Marks
Bluish and black pigmentation more commonly noted on the back and buttocks of neonate
Mongolian Spots
compresses 1/4 of the total body length of the newborn
Head
8 Bones of Fetal Skull (Cranium)
- Frontal
- Occipital-The are of occipital bone is called occiput
Add Chin- latin name is “mentum” - Parietal (x2)
- Sphenoid
- Ethmoid
- Temporal (x2)
- membrane covered spaces found at the junction of the main suture lines
- compressed during birth to aid in molding of the fetal head
- membrane covered spaces found at the junction of the main suture lines
- compressed during birth to aid in molding of the fetal head
Fontanelles
2 Types of fontanelles
- Anterior Fontanelles
2. Posterior Fontanelles
Anterior fontanelle
- Location
- Shape
- Closes at
- W and L
It lies at the junction of coronal and sagittal suture
- diamond shape, larger than posterior
- closes at 18 months 1 1/2yrs
- 2-3cm in W and 2-3cm L
Posterior fontanelle
- Location
- Shape
- Closes at
- L
- suture found at Lambdoid and Sagittal suture line
- triangular shape
- 6 to 8 weeks 2 mos
- 1cm L
- refers to the separation the exerted by the passage of the newborn through the birth canal
- they allow the cranial bone to move and overlap thus molding or diminishing the size of the skull occurs so it can pass through the birth canal more ready.
Suture Lines
Indications of problem in suture lines
- Wide separation of suture line - increase intracranial pressure from abnormal brain formation
- Hydrocephalus - abnormal accumulation of CSF in the cranium
- There is accumulation of blood from a birth injury
- over riding the cranial bones during labor and delivery
- it is the change in the shape of the fetal skull produce by the force of uterine contraction
Molding
- collection of fluid and edema under the scalp of the presenting part of the head
- cause by prolong labor
- the edema and fluid crosses the suture line but this will gradually absorb and disappear on the 3rd day of life
Caput Succedanum
- collection of blood in periosteum of the skull bone
- cause by pressure during delivery
- disappear in 3-4weeks
- does not cross the suture line
Cephalhematoma
- localize softening of the cranial bones - parietal and occipital bone
- the bone is so soft that the pressure can be feel during palpation
- cause by the pressure of the fetal skull against the mother pelvis - *lightening
- common among first born babies
- latin word from cranium- skull, tabbies - wasting
Craniotabes
Eyes
- usually baby cries tearlessly- because of immature lacrimal duct * until 3months
- iris color usually gray or blue
- permanent color assume at 3-12months of age
- erythromycin and theramycin eye ointment against gonorrhea for 24hours of life
white pupil - indicate
congenital cataract
