Neonatal Assessment

Question 1

Normal APGAR value for a newborn?

Answer 1

7-10

Question 2

What is the definition of APGAR

Answer 2

Appearance
Pulse
Grimace
Activity
Respirations
each given a score ranging 0-2

Question 3

What is the usual gestation age for a newborn?

Answer 3

38-40 weeks (how far along the pregnancy is)
Babies born before 37 weeks are considered premature

Question 4

Definition of SGA, AGA, and LGA, percentile of all, and what the definitions are based on?

Answer 4

SGA = small for gestational age (<10%)
AGA = average for gestational age (10-90%)
LGA = large for gestational age (>90%)
BASED ON = weight, head circumference, and length

Question 5

What is acrocyanosis and when is it seen?

Answer 5

When the baby’s trunk is pink but extremities are blue = present/normal the first 48 hours of life

Question 6

What is molding?

Answer 6

abnormal head shape that results from pressure on baby’s head during birth; suture lines overlap. THIS IS NORMAL TO BE SEEN

Question 7

Breastfeeding pattern?

Answer 7

every 2-3 hours
feed on demand
avg = 10-15 min per breast

Question 8

Bottle feeding pattern?

Answer 8

10-30mL every 2-4 hours

Question 9

When should the newborn void?

Answer 9

within first 24 hours

Question 10

When should the newborn have a BM?

Answer 10

within the first 24 hours = called meconium

Question 11

What is a normal temp for a newborn and where is it taken?

Answer 11

36.5-37.5 Celsius; axillary

Question 12

What is a normal HR for a newborn?

Answer 12

110/120-160/bpm
regular or irregular and MURMUR may be present

Question 13

What is a normal RR for a newborn?

Answer 13

40-60/min
irregular/abnormal

Question 14

What is a normal BP for a newborn?

Answer 14

60-90/20-60 mmHg

Question 15

What should a newborns blood sugar be at?

Answer 15

> 45

Question 16

What is the Coomb’s Test and what should the reading be?

Answer 16

to see if antibodies are attacking baby’s red blood cells and creating disease/infection etc.; should read NEGATIVE

Question 17

If bilirubin is taken, what is the normal level?

Answer 17

less than 12mg/dl

Question 18

What are the findings of Caput Succedaneum?

Answer 18

-onset = as head becomes engaged in pelvis
-location = scalp that had pressure on cervix
-composition = serosanguinous
-duration = last couple of days after birth

Question 19

What are the findings of Cephalohematoma?

Answer 19

-onset = at birth
-location = periosteum of skull bone
-composition = pooling of blood
-duration = can take weeks to resolve

Question 20

What are the four mechanisms of heat loss?

Answer 20

-evaporation
-conduction
-convection
-radiation

Question 21

What is radiation?

Answer 21

NEAR cool object like placed NEXT to a window

Question 22

What is conduction?

Answer 22

placed ON cooler surface like ON a weight scale

Question 23

What is convection?

Answer 23

EXPOSURE to cold air like NOT properly dressed

Question 24

What is evaporation?

Answer 24

heat loss by fluid evaporating like WET body exposed

Question 25

What are the neonatal medications given?

Answer 25

Vitamin K, Ilotycin Ophthalmic, Hep B Vaccine

Question 26

What is the dose, site, time, and route given of Vitamin K?

Answer 26

dose = 0.5-1mg time = at birth site = vastus lateralis route = IM

Question 27

What is the dose, site, time, and route given of Ilotycin?

Answer 27

dose = 1-2cm strip time = within 1 hr of birth route/site = both eyes

Question 28

What is the dose, site, time, and route given of Hep B?

Answer 28

dose = 10mcg time = after birth site = vastus lateralis route = IM

Question 29

What is the rooting reflex and its characteristics?

Answer 29

-turns head toward stimulus and opens mouth -HOW TO: touch lip, cheek, corner of mouth -DISAPPEARS: 1-6 months

Question 30

What is the moro reflex and its characteristics?

Answer 30

-flexion/extensions of arms and legs -HOW TO: startle -DISAPPEARS: 4-6 months

Question 31

What is the tonic neck relfex and its characteristics?

Answer 31

-faces one side, arm and leg same side will extend and opposite arm and leg flex (fencing posture_ -HOW TO: infant supine, turn head to one side -DISAPPEARS: 3-4 months

Question 32

What is palmer/plantar grasp reflex and its characteristics?

Answer 32

-fingers and toes curl around persons finger when pressure applied -HOW TO: place finger in palm/ball of infants hand/foot -DISAPPEARS: Palmer (3-4 months), Plantar (8 months)

Question 33

What is stepping reflex and its characterisitcs?

Answer 33

-stimulate walking -HOW TO: hold upright and allow one foot to touch surface -DISAPPEARS: 3-4 weeks

Question 34

What is a newborn's soft spot on their head?

Answer 34

Fontanels -anterior fontanel is diamond shaped (3cm by 2cm) and lies at the junction of sagittal, coronal, and frontal sutures (closes by 18mo of birth) -posterior fontanel is triangular (1cm by 2cm) and lies at the junction of two parietal bones and occipital bone (closes 6-8 weeks after birth)

Question 35

Causes for white patches in a baby's mouth?

Answer 35

oral fungal infections (THRUSH) and can be caused by overgrowth of yeast in the mouth; EPSTEIN PEARLS happen when skin of baby's mouth becomes trapped during development and fills with keratin

Question 36

Why does the baby's feet look clubbed and turn funny?

Answer 36

NORMAL in first few months of life; similar to how they were in the womb and should change as baby grows and develops

Question 37

Why would a baby look cone-headed?

Answer 37

babies heads form and change when pushed through the vaginal birth canal for easier delivery. NORMAL and will resolve shortly

Question 38

2 PROS and 2 CONS of circumcision?

Answer 38

PROS: -fewer infections/easier to wash and keep clean -decreased risk of STI's CONS: -can be expensive -surgical cx = cause injury or infection

Question 39

Home cares of circumcision babies for parents?

Answer 39

GOMCO: apply vaseline and gauze to area for FIRST 24 hours, loose fitting diaper, do NOT take yellow exudate off (sign of healing) PLASTIBELL: loose fitting diaper, ring will fall off within 7-10 days

Question 40

Home cares of uncircumcised baby?

Answer 40

warm water and mild soap for cleaning, wait for its OWN RETRACTION do not force it for the first time d/t injury; change diapers OFTEN to avoid infection

Question 41

Home cares of umbilical cord and expected healing progression?

Answer 41

-stump will harden and turn dark purple/brown/black -wash GENTLY c mild soap and warm water -do NOT submerge in water until stump falls off -should NOT be red (contact physician)

Question 42

Correct way to use a bulb syringe?

Answer 42

place on SIDES on mouth NOT middle; suction mouth before nose; squeeze bulb and slowly release when inside nose/mouth to pick up secretions