Neonate

Question 1

Goals of Newborn Care

Answer 1

To establish and maintain airway
Support respirations
Maintain warmth and prevent hypothermia
To identify actual or potential problems

Question 2

S/S of cold stress

Answer 2

Axils art temp of 97.6 or lower, skin is cool, lethargic, pallor, grunting, hypoglycemic, hypotonia, jittery, don’t suck well

Question 3

When do you do an apgar score?

Answer 3

1 and 5 minutes after birth

Question 4

Cold stress

Answer 4

When they have a cold stress they have excessive heat loss, this links to their hypothermia, decreased compensatory mechanisms to create and maintain body temperature

Question 5

4 ways baby can lose their body heat

Answer 5

Convection (body surface is open to air); radiation (body surface is next to cool solid surface but not direct contact); evaporation (liquid converts to vapors, most significant way baby loses heat first few days); conduction (the body is in direct contact with cool surface)

Question 6

Good baby’s skin temperature

Answer 6

97.7-99 degrees Fahrenheit

Question 7

Nursing interventions for cold stress

Answer 7

Maintain neutral thermal environment, swaddled in warm blankets, put skin to skin with mom, dry baby thoroughly, put cap on head, assess for hypoglycemia

Question 8

Risk factors for cold stress

Answer 8

Prematurity, small for gestational age, become hypoglycemic, prolonged resuscitating efforts, septic, neurological/endocrine/cardio/respiratory problems

Question 9

Brown fat distribution

Answer 9

Majority located:
Major thoracic vessels
Neck
Clavicles
Axillae
Sternum
Kidneys
Adrenal glands

Question 10

Respiratory rate in newborns

Answer 10

30-60

Question 11

What helps stimulate breathing?

Answer 11

When babies are first born they have mild hypoxia, acidosis, and hyperkinepia which stimulates them to breath (breathing onset)!

Question 12

2 factors that negatively affect respiratory effort

Answer 12

Decreased surfactant level OR have persistent hypoxemia or acidosis

Question 13

What is mom given if baby is born prematurely?

Answer 13

If baby is born prior to 36 weeks mother has had betamethazon (12 mg- 2 doses 24 hrs apart)
If baby comes before mom receives betamethazone they can give baby artificial surfactant through an ET tube

Question 14

Other respiratory system extra uterine life information.

Answer 14

Small amounts of fluid retained in lungs is absorbed
When the chest wall expands after delivery the first breath of air is inhaled
Causes an increase in alveolar PO2 with subsequent relaxation of pulmonary arteries
Pulmonary vascular resistance decreased allowing increased pulmonary vascular flow
Results in oxygenation of newborn tissues

Question 15

Respiratory Distress syndrome S/S

Answer 15

Nasal flaring, intercostal or subcostal retraction, grunting with respirations, sea saw or paridoxical respirations, tachyons, cyanosis, hypotonia

Question 16

Severe respiratory syndrome

Answer 16

When in severe respiratory distress baby will have shock like symptoms, diminished cardiac return, bradycardia, low systemic BP, rapid breathing

Question 17

When is majority of surfactant made?

Answer 17

36 weeks gestation

Question 18

Foramen Ovale

Answer 18

Causes increased PO2
It is an opening between the two atrias
Usually closes functionally in minutes to an hour after birth
Structurally it closes within a week

Question 19

Ductus Arteriosus

Answer 19

Increased PO2 leads to closure of ductus Arteriosus
Opening between pulmonary artery and aorta
Functionally it usually closes within 96 hours of birth
Structurally it closes within 4 months of birth

Question 20

Ductus Venosus

Answer 20

Closure of ductus Venosus and umbilical arteries veins r/t decreased blood flow
Opening between the umbilical vein and inferior vena cava
Functionally closes within 2-3 days
Structurally closes within 1 week

Question 21

Newborn BP

Answer 21

72/47

Question 22

Premature BP

Answer 22

64/39

Question 23

Apical pulse

Answer 23

Want to take apical pulse for a full minute
Take it at point of maximum impulse (4th intercostal space left of midclavicular line

Not unusual to hear. Murmur on a baby.

Question 24

What happens as respiratory distress syndrome continues?

Answer 24

They may develop apnea, unresponsive, may not hear breath sounds, may have mottling

Question 25

What does increased pulmonary resistance do?

Answer 25

Increased pulmonary resistance forces most of the blood through the ductus Arteriosus into the descending aorta.

Question 26

What does the umbilical cord contain?

Answer 26

2 arteries and 1 vein

Question 27

Conditions that affect the transport of oxygen:

Answer 27

Alkalosis
Hypothermia
Acidosis
Hypercarbia 
Hyperthermia
HbF fetal hemoglobin 70-90% 
HbA adult hemoglobin