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NURB 3230 > mgmt of newborn > Flashcards

mgmt of newborn Flashcards

1
Q

at birth assessment

A

-APGAR
-length & weight
-VS
-gestational age assessment
-physical maturity
-neuromuscular maturity
-place id bands before leaving room

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2
Q

newborn distress

A

-nasal flaring
-chest retractions
-grunting
-labored breathing
-cyanosis
-flaccid tone
-tachypnea/bradypnea
-tachycardia/bradycardia
-abnormal size, LGA & SGA
-periods of apnea greater than 15 seconds

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3
Q

APGAR

A

-appearance
-pulse
-grimace
-activity
-respiratory

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4
Q

newborn vitals

A

-hr: 100-160
-rr: 30-60bpm
-temp: 97.7-99.5
-bp: systolic- 50-75, diastolic: 30-45

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5
Q

AGA

A

appropriate for gestational age

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6
Q

SGA

A

-small for gestational age
-malnutrition, vascular comp., IUGR, maternal smoking, poor weight gain, htn

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7
Q

LGA

A

-large for gestational age
-maternal DM, maternal obesity

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8
Q

physical maturity assessment

A

-skin texture
-lanugo: soft downy hair, absent in preterm, appears with maturity then disappears with post-maturity
-plantar creases: slick feet- premature, more creases- more mature
-breast tissue: thickness and size of breast and areola increase with maturity
-eyes and ears: eyelids can be fused or open, ear cartilage stiffness increases with maturity
-genitals: males, testicular descent and scrotum appearance; female, premature clitoris, mature labia

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9
Q

interventions for immediate newborn period

A

-maintain patent airway, mouth before nose
-ensure proper id
-thermoregulation
-meds: aquamephyton (vit. K), erythromycin ointment, hep. b vaccine (im, consent, vastus lateralis, change legs)

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10
Q

thermoregulation interventions

A

-dry immediately after birth
-skin to skin
-warm blanket/hat
-place warmed blanket over scale
-warm stethoscope and hands
-avoid placing near vents
-delay inital bath
-avoid cribs near cold outer walls/windows
-place under warmer
-prevent cold stress

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11
Q

vernix caseosa

A

-thick white, cheesy substance
-protects infant, dont remove, absorbs into the skin

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12
Q

telangiectactic nevi

A

-stork bites
-back of the neck, eyelids, between eyes, upper lips
-fade within 1 year, blanches
-milia

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13
Q

unopened sebaceous gland

A

-small white spots- nose, chin, forehead
-disappear in 2-4 weeks
-mongolian spots

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14
Q

mimic bruising

A

-dark blue, gray, brown, black spots- back or buttocks
-more common in darker ethnicities
-disappears within 4 years

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15
Q

erythema toxicum

A

-new born rash
-pink/red, generalized location
-no tx needed
-appears around 24hrs in all ethnicities

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16
Q

harlequin sign

A

-dilation of blood vessels on one side of the body
-transient, lasts up to 20 minutes
-no intervention needed

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17
Q

nevus flammeus

A

-port wine stain
-capillary angioma, purple or red in color
-doesn’t blanch or disappear

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18
Q

nevus vasculosus

A

-strawberry hemangioma
-resolves by 3 years

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19
Q

head variations

A

-molding, usually resolves in a week
-caput succedaneum, fluid underneath the scalp, crosses suture line
-cephalohematoma, doesn’t cross suture line, reddish color, may not show until 203 days after birth, collection of blood, risk for jaundice

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20
Q

ortolani maneuver

A

-abduct hips at 90 degrees while applying upward pressure
-listen for any noise, should not hear a click

21
Q

barlow maneuver

A

-adduct the thighs while applying outward and downward pressure to the thighs.
-Feel for the femoral head slipping out of the acetabulum; also listen for a click.
-inspect back

22
Q

sucking and rooting reflex

A

stroking cheek, mouth- infant head should move to that side/sucks

23
Q

palmar grasp

A

infant curls fingers around examiner’s finger

24
Q

moro

A

infant should stretch arms and then abduct at elbows when falling backwards

25
Q

tonic neck

A

-fencer position
-turn head to side, will extend arm and leg to the side head is facing with opposite arm and leg flexed

26
Q

babinski

A

stroke the outer sole of the food, infant should fan toes outward

27
Q

stepping

A

hold infant upright with feet touching surface, infant should start stepping

28
Q

cord care

A

-s/s infection
-air exposure, helps dry out
-stump will dry, darken in color
-will fall on own, dont pull

29
Q

circumcision risks

A

-infection
-hemorrhage
-skin dehiscence
-adhesions
-ureteral fistula
-pain

30
Q

circumcision benefits

A

-easier hygiene, less UTI & STI, lower rate of penile cancer

31
Q

criteria for circumcision

A

-atleast 12 hours old
-vit. k prophylactically
-voided normally atlease once
-no food 1hr prior
-correct id

32
Q

circumcision mgmt

A

-cover with petroleum jelly immediately
-clean with mild soap and water
-assess for bleeding, s/s infection
-need to void within 8hr post

33
Q

newborn screening

A

-phenylketonuria (pku), 24-48hrs, infant can’t break down phenylalanine
-hearing screen, risk factors: family hx, CMV, rubella, herpes, head trauma, hyperbilirubinemia, ototoxic drugs

34
Q

transient tachypnea of newborn (TTN)

A

-slow or incomplete removal of fluids in the lungs
-resp. distress present at birth or within first 6 hrs
-usually revolves around 24-72 hrs

35
Q

TTN assessment

A

-resp. distress
-rr rate 100-140
-decreased breath sounds

36
Q

TTN tx

A

-O2, if low
-warmth, prevent cold stress
-observe resp. status
-allow time for pulmonary capillaries and lymphatics to remove remaining fluid

37
Q

hyperbilirubinemia

A

-imbalance in bilirubin production and elimination rate
-pathologic v. physiologic

38
Q

pathologic hyperbilirubinemia

A

-also called kernicterus
-within first 24hrs
-Rh isoimmunization; ABO incompatibility

39
Q

physiologic hyperbilirubinemia

A

-normal
-after 24hrs, usually 3 or 4th day
-more common in preterm
-bilirubin levels peak on days 3-5
-good feedings essential

40
Q

hypoglycemia

A

-glucose less than 30 in the first 72 hrs of life
-higher risk: DM mothers, SGA, LGA

41
Q

hypoglycemia s/s

A

-most asymptomatic
-jitteriness
-lethargy
-cyanosis
-apnea
-seizures
-high pitched, weak cry
-hypothermia
-poor feeding

42
Q

interventions for hypoglycemia

A

-rapid acting glucose: dextrose gel, breastfeeding, formula feeding, iv glucose
-provide warmth, prevent cold stress
-reassess glucose levels, monitor for sx

43
Q

nutrition mgmt

A

-calorie requirements: 110-120/kg body weight
-fluid requirements: 1001-150mL/kg daily
-breast feeding: q2-3 hrs, 8-12x in 24hrs
-formula q3-4 hrs

44
Q

breastmilk changes

A

-colostrum: thick, yellow “syrup”, first few days
-transitional: thinner, less yellow, 3-10 days (approx.)
-mature milk: approx. day 10, appears more like cow’s milk, even thinner

45
Q

breastmilk containments

A

-carbs
-protein
-fat
-water
-minerals
-enzymes
-vitamins
-mom’s immunities

46
Q

benefits to breastmilk

A

-low risk for SIDS & infection
-easily digested
-low risk for allergies and obesity
-promotes bonding and attachment

47
Q

breastfeeding concerns

A

-sore nipples: express colostrum and allow to dry
-engorgement: breasts full & tight, get in shower or place hot towel on breasts, opens milk ducts to dilate
-mastitis: infection of clogged milk ducts, s/s infection, call dr. if suspected

48
Q

discharge prep: when to call dr

A

-temp above 100.4 or below 97.8
-forceful, projectile vomiting
-refusal of two feedings in a row
-cyanosis with or w/out feedings
-no wet diapers for 18-24hrs, or fewer than 6-8 wet/day after 4days of age
-2 or more consecutive green, watery diarrheal stools
-lethargy
-abd. distention
-diff. breathing
-color: pale, dusky, cyanotic
-circumcision: s/s of infection

NURB 3230 (13 decks)

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