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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
Q

What do newborns metabolize to stay warm?

A

brown fat

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26
Q

What is a normal core temperature for newborns?

A

97.7 to 98.6 F

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27
Q

What are the signs of hypothermia?

A

cyanosis, increased RR, temp < 97.7 F

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28
Q

How long does it take a newborn to stablize their temperature?

A

12 hours

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29
Q

What is the best method to promote a stable temperature in the newborn?

A

skin to skin contact

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30
Q

When can a newborn be bathed?

A

once temperature has stabilized

31
Q

What should be worn during a newborn’s 1st bath?

A

gloves

32
Q

How often is a breastfeed newborn fed?

A

every 2 to 3 hours

33
Q

How often is a bottle-fed newborn fed?

A

every 3 to 4 hours

34
Q

How long do newborns sleep a day?

A

16 to 19 hours

35
Q

What position do newborns sleep & why?

A

Supine to prevent SIDS

36
Q

What sleeping environment should a newborn have?

A 
no bumper pads
well fitted sheets (no loose)
no toys
don't co-sleep
no smoking (can lead to SIDS
dark & quiet
37
Q

When should a newborn void?

A

24 hours after birth

38
Q

How often should newborn’s void?

A

6 to 8 times in 24 hours

39
Q

what is meconium & when should it be passed?

A

the 1st stool should be passed within 24 to 48 after birth (dark, tarry, sticky)

40
Q

How often are a newborn’s stool?

A

3 to 4 times/day

41
Q

What is a breastfed newborns stool look like?

A

yellow, seedy, loose

42
Q

What is a bottle fed newborns stool look like?

A

more formed soft stool

43
Q

Why should a newborns perineal area be clean & dry?

A

to prevent diaper rash

44
Q

How to clean a newborn with each diaper change?

A

water w/ mild soap & pat dry

45
Q

What is a Gomco circumcision?

A

a metal clamp is put on the penis to loosen to the foreskin & removed.
Cover with petroleum gauze

46
Q

What is a Plastibell circumcision?

A

A cap is place on the penis that stays until it falls off

47
Q

What are findings in a newborn who is having respiratory complications?

A

Bradypnea
tachypnea
abnormal breath sounds (grunting, crackles, wheezes)
respiratory distress (nasal flaring, retractions, gasping, labored breathing)

48
Q

who is more likely to have excess secretions?

A

C-section babies

49
Q

If bulb suction is unsuccessful what should the nurse do?

A

Mechanical suction, then Positive Pressure Ventilation (PPV)

50
Q

Where should the bulb suction be kept?

A

with the newborn

51
Q

Who should be taught how to use bulb suction?

A

mom, dad, caregiver

52
Q

How do you evaluate teaching?

A

return demonstration

53
Q

How do you use a bulb syringe?

A

squeeze bulb suctioning the mouth before the nose

54
Q

when is an ID applied to a newborn?

A

immediately after birth

55
Q

who is identiified on the identification bands?

A

mom, baby, doctor

56
Q

what information is provided on the identification band?

A

name, sex, date, time. health record #

57
Q

where are the identification bands placed?

A

ankle & wrist

58
Q

What other identification methods are utilized after delivery?

A

Footprint (baby) & Fingerprint (mom)

59
Q

When should ID bands be checked?

A

every time before entering and leaving a room

60
Q

Why is infection control important for newnorns?

A

immature immune system

61
Q

What measures are used to prevent spread of bacteria?

A

hand hygiene, dedicated equipment, wear a cover gown

62
Q

How can a nurse promote family-newborn attachment?

A

skin to skin contact and encourage involvement

63
Q

how long should the umbilical cord clamp stay in place?

A

24 to 48 hours

64
Q

what should you clean the umbilical cord with?

A

water

65
Q

what should you assess the stump & base of the cord for?

A

signs of infection

66
Q

When should the umbilical cord fall off?

A

10 to 14 days

67
Q

When can a newborn have a submersion bath?

A

when the umbilical cord has fallen off

68
Q

What 3 medications should a newborn recieve?

A

Erythromycin
Vitamin K (Phytonadione)
Hepatitis B immunization

69
Q

What is cold stress?

A

ineffective thermoregulation

70
Q

What nursing actions are taken if a newborn is experiencing cold stress?

A 
monitor skin (pallor/cyanosis)
respiratory distress
correct acidosis by giving bicarbonate
correct hyperglycemia (if able to eat, give D10W if unable)
71
Q

When does hypoglycemia occur

A

first few hours after birth

72
Q

Who is at risk for hypoglycemia?

A

preterm, gestational diabetes, SGA, LGA

73
Q

What are signs of hypoglycemia?

A 
Jitteriness/twitching (hallmark sign)
weak cry
respiratory distress
cyanotic
lethargic
rolling eyes
seizures
74
Q

What should be done if there is seeping blood from the cord clamp?

A

apply pressure, apply new clamp, notify HCP

maternal child (3 decks)

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