Mod 6 Flashcards
A 38 week infant is born via spontaneous vaginal delivery. The infant gives a lusty cry after delivery. The most important reason why it is important to have a strong cry after birth is to:
A) burn surfactant the infant has so lung expansion can take place
B) convert to a fluid filled extra uterine environment
C) apply the breathing movements the infant practiced in utero
D initiate respirations and convert to extra uterine air filled environment
D) initiate respirations and convert to extra uterine air filled environment
The obstetrician delivers a term neonate. The baby has a lusty cry and good muscle tone, is placed on the mothers abdomen, and has a good 30 second heart rate. The next thing the doctor would do is:
A) suction the baby until secretions are clear
B) administer oxygen by face mask until cyanosis clears
C) perform APGAR scoring
D) Cut the umbilical cord and put on a cord clip
D) Cut the umbilical cord and put on a cord clip…(this is correct according to the teacher)
True or false when you dry a baby, you are not only keeping it warm but also stimulating it to breathe?
True
What is involved in the initial care and assessment of a newborn?
It is performed immediately after birth, resuscitation is performed if needed, and if not then routine care and an Apgar is performed
What is the gestational age assessment of a newborn and when is it performed?
It is performed at 1 to 4 hours after birth and it involves newborn maturity rating scale and classification, Ballard score system. It rates neuromuscular and physical maturity
Who in and what time frame performs the complete physical assessment of a newborn?
It is performed by the nurse at 2 to 4 hours and then every eight hours. This performed by the doctor within 24 hours and At discharged
What regulates immediate newborn care after delivery?
Neonatal Resuscitation program guidelines, (NRP)
What three factors determine your plan of care in the immediate newborn assessment?
Respiratory effort/airway - breathing or crying?
good muscle tone - flexed posture, moving?
Gestational age - term?
In the initial care of a newborn USS that the baby is term, is breathing and crying, and has flexed posture and is moving what do you do next?
Move on and Perform routine care because you answered yes to all three factors of initial care of the newborn
In the initial care of a newborn assessment, the baby is not term, is breathing and crying, but is not moving, what should you do?
Resuscitation may be needed, start with warming, drying, stimulating, and clearing the airway if needed.
What does the acronym SADA provide guidelines for?
It provides a way to remember the steps needed, not necessarily the order of steps, of the initial care of a newborn
What does S stand for in the SADA acronym?
Skin to skin, warming
What does The first a stand for in the SADA acronym?
Airway
What does D stand for in the SADA acronym?
Dry
What does the second a stand for in the SADA acronym?
APGAR
What are two forms of warming for newborns?
Skin to skin contact with mother, this accounts for 90% of babies
Radiant warmers this accounts for 10% of babies
In order to perform skin to skin contact what parameters must the child meet?
They must have usual findings a delivery, be term, good crying and breathing, good muscle tone
Should you use a bulb syringe routinely on a infant?
No only if it is absolutely necessary
When clearing the airway of an infant do you clear the mouth or the nose first? Why?
You clear the mouth first and then the nose. Because when you section the nose it simulates the baby to gasp
Does the Apgar score dictate resuscitation in newborns?
No
What three things are done in the first five minutes of a newborn is life?
- At birth the airway is established the infant is dried and warmed
- At 30 seconds of life a heart rate is taken if it is greater than 100 continue with drying and warming if it is less than 100 in addition to drying and warming add PPV (positive pressure ventilation) until the one minute apgar
- at 60 seconds of life the Apgar is performed
A 36 week baby is born vaginally, clear fluid. It is floppy, pale, and at apneic. What would you do initially to resuscitate the infant? A) Place skin to skin B) give oxygen by Blow by C) stimulate and dry D) give epinephrine
C) stimulate and dry
List the correct order of the following:
HR
APGAR
Dry Baby
Dry baby, HR, APGAR
A 40 week old baby is born via C-section and makes no effort to breathe. Which finding will indicate that you give oxygen during the first minute of life?
A) HR 90
B) APGAR 3
Heart rate is 90
What is the sacred hour?
Skin to skin contact that forms a bond with the mother try to minimize interruptions during this time
Eyes and thighs are done within what time frame?
Within one hour
What does erythromycin applied to the babies eyes prevent infection from?
Gonorrhea or chlamydia infection from the mother
How much and why and where is vitamin K given to an infant?
0.5 to 1 mg given in the thigh (vastus lateralus) it is a blood clotting factor that infants cannot produce until one week old
What are four activities that are done after birth?
- Place ID security bands
- Measurements (weight, length, head circumference, Chest circumference)
- assessment
- bathe (head/hair only at LLUMC within 12 hr, if infection bathe within 4)
If the baby is born to a mother with infection how soon does it need to be bathed?
Within four hours
When do you clamp The umbilical cord?
After 1 to 2 minutes
How many arteries and veins are in the umbilical cord?
Two arteries one vein
When is the cord unclamped?
At 24 hours of life as long as the cord is dry
If at 24 hours the cord is still moist what should you do?
Wait until dry up to 48 hours
How often is the infant Weighed?
Daily
Where are O2 saturation’s monitored on the infant?
Right hand and either foot
