Neonate video

Question 1

What is the ear finding that can distinguish term from preterm?

Answer 1

Cartilage will be fully developed in the term infant, and will cause the ear to bounce back

Question 2

What foot findings can distinguish term from preterm?

Answer 2

Wrinkles increase with gestational age

Question 3

What is lanugo?

Answer 3

Fine, white hair that preterm infants may have–this usually is shed before birth

Question 4

What is the relationship of muscle tone with the term of the infant?

Answer 4

Closer to term they are, the more tone they have

Question 5

What skin findings may indicate preterm infants?

Answer 5

Translucent skin

Question 6

What skin findings may indicate postterm infants?

Answer 6

Cracked, peeling skin

Question 7

What genital findings may indicate preterm infants?

Answer 7

Males = undescended testes

Females = prominent labia minora

Question 8

When should meconium pass? If this does not occur, what pathology may this indicate?

Answer 8

Within 24 hours AFTER birth

Early passage = some stressor to the baby

Failure to pass may indicate Hirschsprung’s disease

Question 9

What is the concern with meconium passing prior to birth? How can you tell if this is happening?

Answer 9

Aspiration

If infant is crying = okay. If not, need suction

Question 10

What is the appropriate suction tool for meconium aspiration?

Answer 10

ET tube suctioning

Question 11

What does it mean if you are able to suction meconium out of the trachea? What should be done if this occurs?

Answer 11

Not yet aspirated

Suction again until they breathe

Question 12

What are the three major steps after birth?

Answer 12

• Vigorous drying
• Auscultate the heart
• Suction if needed

Question 13

Why must you vigorously dry the infant after birth?

Answer 13

Stimulates breathing

Question 14

What is the best way to communicate the heart rate to the medical team?

Answer 14

Tap it out

Question 15

What is the best place to find the pulse in a newborn?

Answer 15

Umbilical stump

Question 16

How do you suction appropriately (mouth or nose first)? Why?

Answer 16

Mouth first, then nose

Want to clear mouth first so there is less of a risk of aspiration

Question 17

What should be done after suctioning?

Answer 17

Change blanket

Question 18

How do you fold the blanket for an infant?

Answer 18

Tight wrap + hat

Question 19

When does APGAR scoring begin?

Answer 19

1 minute into life

Question 20

What are the components of the APGAR score?

Answer 20

Appearance/activity
Pulse
Grimace
A
Respirations

Question 21

True or false: the APGAR scoring system is used to determine the need for intervention

Answer 21

False– should not preclude interventions if necessary

Question 22

What must be done if there are points taken off of the APGAR score? What is the one exception to this rule?

Answer 22

Appropriately address the issue that caused it

Acrocyanosis does not indicate the need for intervention

Question 23

What are you assessing for with the appearance of the APGAR score?

Answer 23

Color

Question 24

Red color of the baby indicate what point on APGAR? Blue in the extremities? Fully blue?

Answer 24

Red = 2
Blue = 1 or 0

Question 25

What is the normal pulse rate for a newborn?

Answer 25

100-160

Question 26

What does a 2 and 1 point indicate on the APGAR scoring system?

Answer 26

Greater than 100 = 2
Less than 100 = 1
No pulse = 0

Question 27

What is an appropriate intervention for bradycardia?

Answer 27

Vigorous drying

Question 28

What is a 0, 1, and 2 for the grimace section?

Answer 28

0 = none
1 = not responding appropriately to stimuli
2 = crying loud and proud

Question 29

What is the appropriate intervention for a lack of grimace?

Answer 29

Flick foot or vigorous drying

Question 30

What is a 0, 1, and 2 for the activity section?

Answer 30

0 = no movement
1 = Not all extremity moving and flexing
2 = vigorously moving and flexing

Question 31

What is a 0, 1, and 2 for the respirations section?

Answer 31

0 = none
1 = Weak cry, ssx of respiratory distress
2 = good respiratory effort and crying

Question 32

What is the full score for APGAR?

Answer 32

10

Question 33

When is APGAR assessed?

Answer 33

1 and 5 minutes. If less than 7 on the 5 minute assessment, continue until 20 min mark

Question 34

What should be done when the APGAR score is complete?

Answer 34

Wrap baby, and hand off to mom