Neonatal 2 Flashcards
jaundice on the first day of life and for ______ days indicates pathological process
7 days
loss of heat in newborns may result in ___ leading to _______
acidosis; cold stress
when do you do APGAR score
1 min and 5 min
when would you do APGAR score again
at 10 min if the 5 min score was < 7
what does an APGAR score of 0-3 mean
severe distress
**resuscitations
what does an APGAR score of 4-6 mean
moderate difficulty
*may need blow by O2
what does an APGAR score of 7-10 mean
no difficulty
*no measures needed
what are the components of the APGAR score
heart rate, respiratory rate, muscle tone, reflex irritability, color
airway interventions
suction mouth THEN nose
infant is a obligate nose breather
suction SIDE of mouth (prevent gag)
side laying position
what are the types of gestational age
AGA (appropriate)
LGA (large)
SGA (small)
what is a normal BP
60-80 over 40-50
what is a normal pulse (apical)
120-160 bpm
what is a normal resp
30-60/min
what is a normal temp
97.7-99.5
describe why and when eye prophylaxis is given
can be delayed up to 2 hrs after birth
protection from gonorrhea and chlamydia
either erythomycin or tetracycline are the treatment
what measurements are done in the nursery
weight, length
abdomen and chest (should equal the same)
chest (should be 2-3 cm < head)
needs to void within _____
24 hrs (6-10x a day)
meconium within ____
24-48 hrs (viscous, green, black)
describe why and when vitamin k
give within 1 hr of birth
promote hepatic biosynthesis of vitamin K dependent clotting factors
neonates are predisposed to vitamin k deficiency (absence of bacteria which are major source of vitamin k)
what is the name of the vitamin k injection
aquamephyton
1 mg IM (vastus lateralis at 90 degree)
what is mili
little spots of white on nose
what is epstein pearls
white hard balls in upper gums
what is epicanthal fold
over inner corner of eye fold
what is epispadias (hypo)
urethra below or above meatus
what is omphalocele
abdominal organs stick outside belly
what is myelomeningocele
backbone and spine dont close
what is hypothermia
body temp < 97.7 F
what are the signs of cold stress
increased activity level crying increased respiratory rate cyanosis mottling of skin
describe bathing
first bath delayed until body temp is stable 1-2 hrs
skin needs to be at least 97.7
core needs to be at least 98.6
when should you wear gloves with infant
always until first bath is given
when do you remove cord clamp
after 24 hrs
describe ABO incompatibility
- mom is blood type O and baby is type A, B, or AB
- O types naturally develop anti A or B antibodies tha cross placental barrier
what can ABO incompatibility cause
hemolysis of fetal RBC
Coombs is positive
less severe hemolysis than Rh incompatibility
describe Rh incompatibility
Rh negative mother
Rh positive baby
Positive Coombs
if mom is Rh negative and dad is hetero for…
Rh + so baby will have 50% chance of being Rh +
if mom is Rh negative and dad is homo for…
Rh + so baby will have 100% chance of being Rh +
what are the potential effects of phototherapy
bronze, rash, decreased activity, green stool
phototherapy interventions
protect eyes and genitals
turn 2q hours
maintain hydration/nutrition
monitor temp, urine specific gravity (I and O)
what is phototherapy
treatment for newborn jaundice
turns bilirubin into conjugated form so that it can excreted
what is the fluid requirement of of a newborn
80-100 ml in 24 hr period
should infants drink water
no, decreases caloric consumption
how often should an infant feed
every 3-4 hrs
what would an allergy to formula look like
colic, rash, D/V
describe circumcision and anethesia used
removal of prepuce (foreskin)
local anesthesia-Lidocaine
wait 5-10 min after anesthesia injection to begin procedure
immediate nursing care after birth
maintain patent airway
prevent heat loss
stabilize infant
promote parent infant interactions
assessment of neonatal pain scales
neonatal infant pain scale (NIPS)
premature infant Pain profile (PIPP)
CRIES
what is the proper sleep position of a baby
BACK TO SLEEP
difficulty maintaining respiratory function adequate to meet O2 demands
d/t decreased surfactant
respiratory distress syndrome (RDS)
what are the symptoms of RDS
cyanosis, tachypnea, bradypnea, dyspnea, decreased temp
**nasal flaring, grunting, retractions
what may you need if RDS
surfactant
describe how to determine if small infant or IGR or low maturity
determined by Ballard or Dubouitz score
<10th % for gestational age
Ballard score: 5 is mature on a -1 to 5 score
what are predisposing factors for IGR
smoking, alcohol, preeclampsia, malnutrition
if baby does not poop within 24 hrs then they are at risk for what
cystic fibrosis
what are the s/s of infections in infants
lethargy, poor feeding, increased respiration rate, increased WBC, wt loss, tremors, restlessness, D/V, abdominal distension
what are s/s of neonatal abstinence syndrome
hyperactivity, shrill cry, tremors, seizures, tachypnea, poor feedings, sweating, mottling, nasal congestion
perforation of acute abdomen
necrotizing enterocolitis (NEC)
s/s of necrotizing enterocolitis
abdominal distention, pallor, poor feeding, gastric residual, increase apnea
what is important to remember about necrotizing enterocolitis
infectious disease: WASH HANDS
