NB Assessment & Care - Care Of Newborn After Birth

Question 1

When does transition from intrauterine to extrauterine life occur for NB?

Answer 1

First 6-8 hours after birth

Question 2

When does first period of reactivity occur?

Answer 2

30-60 minutes of life

Question 3

When does period of decreased responsiveness occur?

Answer 3

1-3 hours after birth

Question 4

When does second period of reactivity occur?

Answer 4

3-8 hours after birth

Question 5

Vital signs for NB?

Answer 5

HR : 110-160 (assess for 1 minute on apical pulse)
RR : 30-60
Temp: 36.5 - 37.5 (check armpit temp. Put skin to skin if abnormal)
BP : 65-95/39-60 (not normally assessed)

Question 6

Preterm infant?

Answer 6

Less than 37 weeks

Question 7

Early term infant?

Answer 7

37 weeks - 38 weeks, 6 days

Question 8

Full term infant?

Answer 8

39 weeks - 40 weeks, 6 days

Question 9

Late term infant?

Answer 9

41 weeks - 41 weeks, 6 days

Question 10

Postterm infant?

Answer 10

42 weeks and beyond

Question 11

What happens if pain is unrelieved in an infant?

Answer 11

Exhaustion, irritability, and delay in healing process

Question 12

What occurs to vital signs when infant experiences pain?

Answer 12

• HR and RR changes
• BP increases

Question 13

Ways to manage pain?

Answer 13

Pharmacological - non opioids, opioids, topical anaesthetic

Non pharmacological - oral sucrose, non nutritive sucking, skin to skin contact, breastfeeding

Question 14

In first 3-4 days, how much birth weight does baby lose? Due to what?

Answer 14

7-10%

May be a result of fluid shifts, loss of feces and urine, withdrawal from maternal hormones

Question 15

Average weight of NB?

Answer 15

6 - 9 pounds

Question 16

What are neonatal reflexes?

Answer 16

Present at birth and crucial for survival of the newborn

Disappears as nervous system matures

Question 17

What are permanent reflexes?

Answer 17

Reflexes that persist throughout life and essential for maintaining basic bodily functions

Ex: blinking, swallowing, breathing, etc

Question 18

What are fontanelles?

Answer 18

Soft spots on the newborns head (protect head during birth and allow is to mold to squeeze through. Also allows further brain growth)

Question 19

When do fontanelles close?

Answer 19

Anterior - 12 to 18 months
Posterior - 2 to 3 months

Question 20

How much circulating blood does a NB have?

Answer 20

300 mL

Question 21

What occurs if ducts in the heart of the NB are unable to close?

Answer 21

May hear murmurs and NB may become cyanotic

Question 22

Two types if cyanosis?

Answer 22

Acrocyanosis - hands and feet turn blue

Central cyanosis - centre of body turns blue

Question 23

First muscles that NB’s gain control of?

Answer 23

Head and neck

Question 24

Skeleton of a NB?

Answer 24

Skeleton is flexible - can cause plagiocephaly

Question 25

What is plagiocephaly?

Answer 25

Asymmetrical flattening of a baby’s head, typically on one side from laying on in the same position for a long time

Question 26

Kidneys of a NB?

Answer 26

Not fully developed at birth

Question 27

Due to the kidneys not being fully developed, what does this mean for the NB?

Answer 27

- able to hold water load is reduced - decreased ability to concentrate urine and cope with fluid imbalances - renal tubules are short and have limited capacity for reabsorbing important substances - glomeruli are small - renal blood flow is about third of an adult

Question 28

What is meconium? What does it look like?

Answer 28

First stool - mixture of amniotic fluid and intestinal glad secretions Sticky, greenish-black, thick

Question 29

When is this stool typically passed?

Answer 29

8 - 24 hours after birth

Question 30

Female genitalia after birth?

Answer 30

May be slightly swollen

Question 31

What is pseudo-menstruation?

Answer 31

Normal small amount of vaginal bleeding - may occur to a female baby due to withdrawals of maternal hormone

Question 32

What is found under the foreskin of a NB male?

Answer 32

White cheesy substance called smegma

Question 33

What is hypospadias and epispadias?

Answer 33

Abnormal positioning of the urethral opening in males

Question 34

Location of hypospadias?

Answer 34

Opening is located on the underside of the penis rather than the tip

Question 35

Where is urethral opening located for epispadias?

Answer 35

Upper side of penis

Question 36

What is cryptorchidism?

Answer 36

When one or both male infant’s testicales have not moved down to scrotum before birth

Question 37

When should breastfeeding begin? Why?

Answer 37

Within first hour of birthing baby Helps establish gut microbiome and stimulates milk production in mother

Question 38

When does saliva produce in infants?

Answer 38

At 2-3 months of age

Question 39

What is regurgitation and hiccoughs?

Answer 39

Hiccoughs - hiccups Regurgitation - effortless, small amounts of milk from the stomach back up the esophagus and out of the mouth

Question 40

What should you assess skin for?

Answer 40

Assess turgor

Question 41

What is physiological jaundice?

Answer 41

Yellow tinge to skin caused by rapid destruction of excess blood cells Normal

Question 42

When is jaundice seen in NB’s? How long does it last?

Answer 42

Between 2-3 days of life, and lasts about a week