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maternal child > Module 3 day 2 > Flashcards

Module 3 day 2 Flashcards

1
Q

When providing newborn care what are the 3 priorities?

A

airway, breathing, temperature

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2
Q

When should vitals be checked

A

at birth
every 30 min x 2
every 1 hour x 2
every 8 hours

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3
Q

how should a newborns weight be assessed?

A

daily on the same scale naked

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4
Q

what should the nurse look for when assessing the umbilical cord?

A

bleeding & infection

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5
Q

What should the umbilical cord look like?

A

AVA (2 arteries & 1 vein)
a pearly color
clamped
Wharton jelly

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6
Q

When should a pain assessment on a newborn be performed?

A

during a routine assessment and following painful procedures

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7
Q

When should newborn screening be done?

A

24 hours after birth & repeated 1-2 weeks later.

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8
Q

What happens during the first period of reactivity?

A

baby is alert, exploring, sucking sounds, HR & RR are rapid. Occurs within 30 minutes post birth.

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9
Q

What happens during the period of relative inactivity?

A

baby is quiet, sleepy, resting, HR & BP is decreased. Occurs within 60 to 100 minutes of life.

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10
Q

what happens during the second period of reactivity?

A

baby becomes responsive again can gag on mucus. Occurs within 2 to 8 hours of life.

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11
Q

In what period should breastfeeding be introduced?

A

In the first period of reactivity

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12
Q

What is Phenylketonuria?

A

deficit in proteins metabolism in which accumulation of amino acids can cause mental retardation.

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13
Q

When should serum level be drawn?

A

before discharge

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14
Q

How is a heel stick obtained?

A 
don clean gloves
warm heel
spring activated lancet
stick outer aspect of heel (2.4mm)
wipe 1st drop
apply pressure with gauze
provide comfort
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15
Q

Why is a newborn hearing screening performed?

A

to detect deficits early

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16
Q

What two things should be done before a Circumcision is done?

A

obtain consent & make sure the family is well informed

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17
Q

Why is a circumcision not done immediately after birth?

A

Vitamin K is low which can lead to bleeding

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18
Q

What should be done before a circumcision’s should be done?

A

a 1st void must be documented

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19
Q

What are the 3 benefits of a Circumcision?

A

hygiene, decreased risk of STI & penile cancer

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20
Q

What are the 2 risk of a Circumcision?

A

hemorrhage & infection

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21
Q

Who should not get Circumcised?

A

Hypospadias
Epispadias
family hx of bleeding disorder
newborns who don’t get vitamin K

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22
Q

Who should a newborn not be given to?

A

a person without an identifier the facility has for newborn nurses

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23
Q

what does a neutral thermal environment help a newborn maintain?

A

normal core temperature

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24
Q

Why is a newborn at high risk for temperature instability?

A

large surface area

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25
What do newborns metabolize to stay warm?
brown fat
26
What is a normal core temperature for newborns?
97.7 to 98.6 F
27
What are the signs of hypothermia?
cyanosis, increased RR, temp < 97.7 F
28
How long does it take a newborn to stablize their temperature?
12 hours
29
What is the best method to promote a stable temperature in the newborn?
skin to skin contact
30
When can a newborn be bathed?
once temperature has stabilized
31
What should be worn during a newborn's 1st bath?
gloves
32
How often is a breastfeed newborn fed?
every 2 to 3 hours
33
How often is a bottle-fed newborn fed?
every 3 to 4 hours
34
How long do newborns sleep a day?
16 to 19 hours
35
What position do newborns sleep & why?
Supine to prevent SIDS
36
What sleeping environment should a newborn have?
``` no bumper pads well fitted sheets (no loose) no toys don't co-sleep no smoking (can lead to SIDS dark & quiet ```
37
When should a newborn void?
24 hours after birth
38
How often should newborn's void?
6 to 8 times in 24 hours
39
what is meconium & when should it be passed?
the 1st stool should be passed within 24 to 48 after birth (dark, tarry, sticky)
40
How often are a newborn's stool?
3 to 4 times/day
41
What is a breastfed newborns stool look like?
yellow, seedy, loose
42
What is a bottle fed newborns stool look like?
more formed soft stool
43
Why should a newborns perineal area be clean & dry?
to prevent diaper rash
44
How to clean a newborn with each diaper change?
water w/ mild soap & pat dry
45
What is a Gomco circumcision?
a metal clamp is put on the penis to loosen to the foreskin & removed. Cover with petroleum gauze
46
What is a Plastibell circumcision?
A cap is place on the penis that stays until it falls off
47
What are findings in a newborn who is having respiratory complications?
Bradypnea tachypnea abnormal breath sounds (grunting, crackles, wheezes) respiratory distress (nasal flaring, retractions, gasping, labored breathing)
48
who is more likely to have excess secretions?
C-section babies
49
If bulb suction is unsuccessful what should the nurse do?
Mechanical suction, then Positive Pressure Ventilation (PPV)
50
Where should the bulb suction be kept?
with the newborn
51
Who should be taught how to use bulb suction?
mom, dad, caregiver
52
How do you evaluate teaching?
return demonstration
53
How do you use a bulb syringe?
squeeze bulb suctioning the mouth before the nose
54
when is an ID applied to a newborn?
immediately after birth
55
who is identiified on the identification bands?
mom, baby, doctor
56
what information is provided on the identification band?
name, sex, date, time. health record #
57
where are the identification bands placed?
ankle & wrist
58
What other identification methods are utilized after delivery?
Footprint (baby) & Fingerprint (mom)
59
When should ID bands be checked?
every time before entering and leaving a room
60
Why is infection control important for newnorns?
immature immune system
61
What measures are used to prevent spread of bacteria?
hand hygiene, dedicated equipment, wear a cover gown
62
How can a nurse promote family-newborn attachment?
skin to skin contact and encourage involvement
63
how long should the umbilical cord clamp stay in place?
24 to 48 hours
64
what should you clean the umbilical cord with?
water
65
what should you assess the stump & base of the cord for?
signs of infection
66
When should the umbilical cord fall off?
10 to 14 days
67
When can a newborn have a submersion bath?
when the umbilical cord has fallen off
68
What 3 medications should a newborn recieve?
Erythromycin Vitamin K (Phytonadione) Hepatitis B immunization
69
What is cold stress?
ineffective thermoregulation
70
What nursing actions are taken if a newborn is experiencing cold stress?
``` monitor skin (pallor/cyanosis) respiratory distress correct acidosis by giving bicarbonate correct hyperglycemia (if able to eat, give D10W if unable) ```
71
When does hypoglycemia occur
first few hours after birth
72
Who is at risk for hypoglycemia?
preterm, gestational diabetes, SGA, LGA
73
What are signs of hypoglycemia?
``` Jitteriness/twitching (hallmark sign) weak cry respiratory distress cyanotic lethargic rolling eyes seizures ```
74
What should be done if there is seeping blood from the cord clamp?
apply pressure, apply new clamp, notify HCP

maternal child (3 decks)

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