Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

N133 > Module 5: neonate > Flashcards

Module 5: neonate Flashcards

1
Q

How long does the neonate period last?

A

birth - 28days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the physiological changes of a postpartal woman?

A

Lochia and uterine involution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is uterine involution?

A

o Process involves contraction of the uterus immediately following delivery of the placenta (living ligature).
o Placental site thrombosis to prevent bleeding.

  • Can include afterpains: Pain related to involution especially in multiparas.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the 3 stages of lochia?

A

♣ 1 - Lochia rubra: Dark red, lasts 3-4 days. Occurring a few days after delivery, it is made up of blood, bits of fetal membranes, decidua (uterine lining of endometrium during pregnancy), meconium, and cervical discharge.
♣ 2 - Lochia serosa: Pinkish brown, lasts 4-10 days. It contains less red blood cells and has more white blood cells, wound discharge from the placenta and other sites, and mucus from the cervix.
♣ 3 – Lochia alba: Whitish yellow, lasts 10-28 days. For about another 1-2 weeks, whitish turbid fluid drains from the vagina, which mainly consists of decidual cells, mucus, white blood cells, and epithelial cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is a uterine subinvolution?

A
  • Failure/slowing of involution of the uterus characterized by prolonged lochia, irregular/excessive bleeding.
  • Primary cause of subinvolution is failure of uterus to contract effectively (boggy uterus).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Wht is health Canada’s recommendation for breastfeeding?

A

(Health Canada recommends exclusive breastfeeding for first 6 months, and then up to 2 years)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What 3 questions does the nurse need to ask to determine need for intervention?

A
  1. Is the baby full term (38-42 weeks gestation)?
  2. Is the baby breathing or crying?
  3. Is the baby demonstrating good muscle tone?
    o If yes to all 3, baby needs little assistance. Baby can be dried while lying prone (to drain fluids from mouth/nose) on mother’s chest.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the APGAR scoring?

A

• Used by nurse when handling/assessing newborn in first minute of life. Each component assigned a value of 0, 1, or 2. Total is added. Should be done at 1 and 5 minutes after birth. If newborn does not attain a 5 minute score of at least 7, new scores are assigned every 5 minutes for up to 20 minutes. Perfect 10 uncommon.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does APGAR stand for?

A 
o	-Appearance (colour)
o	P-Pulse (HR)
o	G-Grimace (reflex irritability)
o	A-Activity (muscle tone)
o	R-Respiratory (effort)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the initial period of reactivity?

A

• Initial period of reactivity: First 30-60 mins of life; alert/active, strong desire to suck. Wide swings in vital parameters. May observe nasal flaring, periodic breathing (pauses up to 15 seconds), and acrocyanosis (bluish hands and feet). Active bowel sounds.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the period of relative inactivity?

A

• Period of relative inactivity: 2-3 hours after birth; falls asleep up to several hours. Difficult to arouse, feeding may be impossible. Should be centrally pink with clear breath sounds/no distress.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the second period of reactivity?

A

• Second period of reactivity: Lasts 4-6 hours, newborn fully awake from first sleep. May pass urine and first meconium.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the 4 factors affecting the mother’s decision to breastfeed vs formula feed?

A
  1. Feeding frequency (if breastfeeding, need to feed every 2-3 hours/8-12 feedings per day. Digests faster than formula)
  2. Family Involvement
  3. Discreet Nursing/Personal Comfort Level
  4. Returning to Work Outside Home
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the health and immunocological benefits to breastfeeding?

A
  • Prebiotics
  • Lactoferrin (binds with iron to remove from gut, prevent bacterial growth)
  • Bioactive factors protect from pathogens (immune cells/fatty acids/nucleotides)
  • Protects against gastroenteritis, respiratory/urinary infections, septicemia, otitis, colitis
  • 5 immunoglobulins (including IgA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the nutritional benefits of breastfeeding

A
  • Easier to digest/absorb
  • Lowest potential renal solute load (especially important for preterm babies)
  • Teaches satiety (baby has to decide when to stop eating)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the pyschological benefits of breastfeeding?

A
  • Skin-to-skin contact increases emotional bonding
  • Enhanced maternal sensitivity to infant behaviour
  • Early weaning may cause maternal feelings of loss, depression, grief
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the breastfeeding health benefits to the mother?

A
  • Enhanced uterine involution
  • Lower risk of postpartum hemorrhage
  • Lose more weight postpartum, keep it off easier
  • Possibly: decreased risk of osteoporosis, diabetes, ovarian cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is peurprium?

A

The mothers first 6 weeks after childbirth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe the cervix, vagina, and ovaries in puerperium

A

Cervix:

  • Remains thin after birth, lacerations along outer margin correspond with external os.
  • Cervical os contracts slowly. Cervix thickens, elongates.
  • Cervical edema may be present for several months after childbirth.
  • Never returns to pregravid state.

Ovaries:
- Menstruation returns 6-10 weeks postpartum for nonlactating client, 8 weeks-18 months for lactating client.

Vagina:

  • Walls smooth and bruised, disappears quickly. - Rugae return after 3 weeks.
  • Pelvic floor muscles regain tone after 6 weeks.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Describe the respiratory system in puerperium

A
  • Intra-abdominal pressure decrease.

- Diaphragmatic pressure decrease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Describe the urinary system in puerperium

A
  • Diuresis of extra intracellular fluid occurs day 2-5.
  • Bladder often has increased capacity and decreased sensation, leading to urinary retention/overdistention.
  • Spontaneous voiding should return within 8 hours after birth, bladder tone in 5-7 days.
  • Postpartum clients may have stress incontinence, especially if episiotomy was required (surgical cut at opening of vagina to aid birth).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Describe the cardiovascular system in puerperium

A
  • Plasma volume decrease (returns to normal volume within a week).
  • Increased BP, risk of thromboembolisms.
  • Cardiac output returns to normal after 1-3 weeks.
  • HR should not change - high HR could indicate hemorrhage/infection.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Describe the hematologic system in puerperium

A

Hemoglobin/hematocrit levels fluctuate, stabilize around 6 weeks.

  • Iron levels should be regained by 2 weeks; deficiency common cause of anemia.
  • Postpartum hemorrhage caused by uterine atony/failure of uterus to contract, placenta previa, etc.
  • Leukocytosis (elevated WBC’s) common postpartum, nonpathologic.
24
Q

Describe the GI system in puerperium

A
  • After birth stretched abdominal muscles remain relaxed, and combined with decreased gastric motility may lead to gaseous distention.
  • Heartburn, usually resolves within 6 weeks.
  • Constipation.
  • Hemorrhoids
25
Q

Describe the endocrine system in puerperium

A
  • After birth of placenta, hormone levels (estrogen/progesterone) sharply decrease.
  • Prolactin begins to rise before birth, drops after birth but levels maintained by suckling of infant.
  • Hypothyroidism after birth may become permanent.
26
Q

What is homan’s sign?

A

Test used to determine if postpartum mother has DVT, positive if dorsiflexion in the foot reveals pain in the calf

27
Q

Hypothyrodism often occurs in pregnancy, what are some indications of this?

A

Memory loss, depression, lack of concentration

28
Q

What are postpartum blues and postpartum depression?

A
  • Society has unrealistic expectations of new moms, may compromise mother’s mental health; 26-84% of mothers experience postpartum blues (cry frequently for no reason).
  • Depression is a more serious condition that can develop from postpartum blues. Women may experience anger, mood swings, sleep disorders, anxiety, thoughts of harming themselves or their baby.
29
Q

How is respiration simulated in a neonate?

A
  • Thoraxic recoil.
  • Clamping of umbilicus.
  • Decreased temperature upon vaginal exit.
30
Q

Descrbe the neonate blood circulation post birth

A
  • Systemic vascular resistance increases.
  • Shunts close.
  • Blood circulates through lungs.
  • Baby changes from gray-blue to pink.
31
Q

Describe the primary survey of neonates after birth

A
  • If baby is apneic after drying/stimulation, SPO2 doesn’t increase with O2, remains limp, shows signs of respiratory distress, or HR <100bpm, nurse begins bag and mask ventilation and activates emergency response system to assemble resuscitation team.
  • Most babies begin to breathe on their own within 30 seconds of bag-and-mask ventilation. If not, and HR <60bpm, very serious-more complex interventions required.
32
Q

Describe the pallor assessment of neonates at birth

A
  • If baby remains dusky/cyanotic at 5 minutes of age, attach SPO2 to right hand.
  • May take several minutes to increase SPO2 over 90% from 60% in intrauterine environment.
  • Supplemental O2 may be needed.
33
Q

How are the airways of neonates manually cleaned post birth?

A

Infant supine with head in “sniffing position” to open airway so mouth (and nose if needed) can be cleared with a bulb syringe or suction.
- Suction too deep in throat may elicit gag/vagal reflex, which can cause bradycardia, apnea, and hypoxia.

34
Q

Describe the initial period of reactivity during neonate transitional period

A
  • Initial period of reactivity: First 30-60 mins of life; alert/active, strong desire to suck.
  • Wide swings in vital parameters.
  • May observe nasal flaring, periodic breathing (pauses up to 15 seconds)
  • Acrocyanosis (bluish hands and feet).
  • Active bowel sounds.
35
Q

What are the behavioural cues during the neonate transitional period?

A
  • Approach Cues: indicate readiness to interact with environment (Ex. Hand to mouth, grasping)
  • Avoidance Cues: indicate newborn is tired/overstimulated (Ex. Frowning, fussing, stiffening, gaze aversion)
36
Q

What are the 6 states of newborn consciousness of Brazleton’s Neonatal Behavioural Assessment?

A
  • Quiet sleep: Infant nearly still, occasional twitch.
  • Active sleep: Body, eye, facial movements, irregular breathing.
  • Drowsy: Irregular breathing, mild startles, body and facial movements.
  • Quiet alert: Little body movement, but wide bright eyes, regular breath.
  • Active alert: Lots of body and facial movements, open eyes.
  • Crying: Tightly closed eyes, grimace and very responsive.
37
Q

What are the sensory abilities of the neonate?

A
  • Can see and follow light.
  • Can hear low to mid range frequencies.
  • Can recognize mothers voice and smell.
  • Responds to touch early as 2m.
38
Q

Why are newborns are wrapped in warm blankets or kept under heaters?

A

Neonates cannot shiver to generate heat, if they get cold they may develop hypothermia or hypoglycemia, possibly even respiratory acidosis which is life threatening

39
Q

What is desquamation milia?

A

Tiny white bumps or cysts on newborns face

40
Q

What is erythma toxicum?

A

Red rash present on newborns

41
Q

What is caput succedaneum?

A

Edematous swelling of fetal scalp from pressure of scalp against cervix in birth

42
Q

What happens to the babies feces during the first 5 days of life?

A

The feces changes from black to yellow

43
Q

What is purple crying?

A 
Purple crying is present in a colic phase of many new babies:
P - Peak of crying.
U - Unexpected.
R - Resists soothing.
P - Pain-like face.
L - Long lasting.
E - Evening.
44
Q

What are the 4 ways a baby loses body heat?

A
  • Evaporation.
  • Conduction.
  • Convection.
  • Radiation
45
Q

What are some contraindictions to breastfeeding?

A
  • Mother has HIV.
  • Mother has human T-cell lymphotrophic virus.
  • Cytomegalovirus.
  • Active herpes simplex on breast.
  • Contagious TB.
  • Chemotherapy treatments.
  • Substance abuse.
  • Lactose intolerant infants.
  • Measles in mother.
46
Q

What are some client teaching and learning interventions for feeding?

A
  • Artificial nipple.
  • Formula preparation.
  • Sterilization of water for formula.
  • Warming formula.
  • Positioning.
  • Burping.
  • Feeding cues.
47
Q

Describe the burping process

A
  • If infant turns head away, stops feeding, may need to burp.
  • Place infant upright over shoulder to create abdominal pressure, pat back to release gas.
  • Or try prone infant over your lap, one hand supporting head, and pat back with other hand.
48
Q

What is optimum weight gain for infants?

A

150-200gm weekly up to 6m

49
Q

At what age the the digestive processes functioning properly?

A

3m

50
Q

What stage of Erikson’s developmental stages are infants in?

A

Trust vs mistrust: gain trust of parents and environment by achieving on there own and by being taken care of by parents

51
Q

What cognitive developmental stage does Piaget place infants in?

A

Sensorimotor: First 2 yr of life infants learn relationship of their bodies to other things

52
Q

How do you tell how many teeth a baby has in relation to its age?

A

Age of the child - 6 = # of teeth

eg. 13m-6=7 teeth

53
Q

What is Failure to Thrive FTT?

A

Inadequate growth from inability to obtain and use calories.

54
Q

What is positional plagiochepaly?

A

Back of infants head flattened from prolonged supine lying

55
Q

How much sleep does an infant need?

A

10-16hrs per day in first year

56
Q

What is otitis media?

A

Group of inflammatory diseases of the middle ear, common in infants who have a short estuchian tube

57
Q

When does teething occur in the infant?

A

Begins at 3-4m and continues until 2yrs

N133 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions