Neonatal Assessment Flashcards
Normal APGAR value for a newborn?
7-10
What is the definition of APGAR
Appearance
Pulse
Grimace
Activity
Respirations
each given a score ranging 0-2
What is the usual gestation age for a newborn?
38-40 weeks (how far along the pregnancy is)
Babies born before 37 weeks are considered premature
Definition of SGA, AGA, and LGA, percentile of all, and what the definitions are based on?
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
What is acrocyanosis and when is it seen?
When the baby’s trunk is pink but extremities are blue = present/normal the first 48 hours of life
What is molding?
abnormal head shape that results from pressure on baby’s head during birth; suture lines overlap. THIS IS NORMAL TO BE SEEN
Breastfeeding pattern?
every 2-3 hours
feed on demand
avg = 10-15 min per breast
Bottle feeding pattern?
10-30mL every 2-4 hours
When should the newborn void?
within first 24 hours
When should the newborn have a BM?
within the first 24 hours = called meconium
What is a normal temp for a newborn and where is it taken?
36.5-37.5 Celsius; axillary
What is a normal HR for a newborn?
110/120-160/bpm
regular or irregular and MURMUR may be present
What is a normal RR for a newborn?
40-60/min
irregular/abnormal
What is a normal BP for a newborn?
60-90/20-60 mmHg
What should a newborns blood sugar be at?
> 45
What is the Coomb’s Test and what should the reading be?
to see if antibodies are attacking baby’s red blood cells and creating disease/infection etc.; should read NEGATIVE
If bilirubin is taken, what is the normal level?
less than 12mg/dl
What are the findings of Caput Succedaneum?
-onset = as head becomes engaged in pelvis
-location = scalp that had pressure on cervix
-composition = serosanguinous
-duration = last couple of days after birth
What are the findings of Cephalohematoma?
-onset = at birth
-location = periosteum of skull bone
-composition = pooling of blood
-duration = can take weeks to resolve
What are the four mechanisms of heat loss?
-evaporation
-conduction
-convection
-radiation
What is radiation?
NEAR cool object like placed NEXT to a window
What is conduction?
placed ON cooler surface like ON a weight scale
What is convection?
EXPOSURE to cold air like NOT properly dressed
What is evaporation?
heat loss by fluid evaporating like WET body exposed
What are the neonatal medications given?
Vitamin K, Ilotycin Ophthalmic, Hep B Vaccine
What is the dose, site, time, and route given of Vitamin K?
dose = 0.5-1mg
time = at birth
site = vastus lateralis
route = IM
What is the dose, site, time, and route given of Ilotycin?
dose = 1-2cm strip
time = within 1 hr of birth
route/site = both eyes
What is the dose, site, time, and route given of Hep B?
dose = 10mcg
time = after birth
site = vastus lateralis
route = IM
What is the rooting reflex and its characteristics?
-turns head toward stimulus and opens mouth
-HOW TO: touch lip, cheek, corner of mouth
-DISAPPEARS: 1-6 months
What is the moro reflex and its characteristics?
-flexion/extensions of arms and legs
-HOW TO: startle
-DISAPPEARS: 4-6 months
What is the tonic neck relfex and its characteristics?
-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
What is palmer/plantar grasp reflex and its characteristics?
-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)
What is stepping reflex and its characterisitcs?
-stimulate walking
-HOW TO: hold upright and allow one foot to touch surface
-DISAPPEARS: 3-4 weeks
What is a newborn’s soft spot on their head?
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)
Causes for white patches in a baby’s mouth?
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
Why does the baby’s feet look clubbed and turn funny?
NORMAL in first few months of life; similar to how they were in the womb and should change as baby grows and develops
Why would a baby look cone-headed?
babies heads form and change when pushed through the vaginal birth canal for easier delivery. NORMAL and will resolve shortly
2 PROS and 2 CONS of circumcision?
PROS:
-fewer infections/easier to wash and keep clean
-decreased risk of STI’s
CONS:
-can be expensive
-surgical cx = cause injury or infection
Home cares of circumcision babies for parents?
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
Home cares of uncircumcised baby?
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
Home cares of umbilical cord and expected healing progression?
-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)
Correct way to use a bulb syringe?
place on SIDES on mouth NOT middle; suction mouth before nose; squeeze bulb and slowly release when inside nose/mouth to pick up secretions
