Neonate video Flashcards
What is the ear finding that can distinguish term from preterm?
Cartilage will be fully developed in the term infant, and will cause the ear to bounce back
What foot findings can distinguish term from preterm?
Wrinkles increase with gestational age
What is lanugo?
Fine, white hair that preterm infants may have–this usually is shed before birth
What is the relationship of muscle tone with the term of the infant?
Closer to term they are, the more tone they have
What skin findings may indicate preterm infants?
Translucent skin
What skin findings may indicate postterm infants?
Cracked, peeling skin
What genital findings may indicate preterm infants?
Males = undescended testes
Females = prominent labia minora
When should meconium pass? If this does not occur, what pathology may this indicate?
Within 24 hours AFTER birth
Early passage = some stressor to the baby
Failure to pass may indicate Hirschsprung’s disease
What is the concern with meconium passing prior to birth? How can you tell if this is happening?
Aspiration
If infant is crying = okay. If not, need suction
What is the appropriate suction tool for meconium aspiration?
ET tube suctioning
What does it mean if you are able to suction meconium out of the trachea? What should be done if this occurs?
Not yet aspirated
Suction again until they breathe
What are the three major steps after birth?
- Vigorous drying
- Auscultate the heart
- Suction if needed
Why must you vigorously dry the infant after birth?
Stimulates breathing
What is the best way to communicate the heart rate to the medical team?
Tap it out
What is the best place to find the pulse in a newborn?
Umbilical stump
How do you suction appropriately (mouth or nose first)? Why?
Mouth first, then nose
Want to clear mouth first so there is less of a risk of aspiration
What should be done after suctioning?
Change blanket
How do you fold the blanket for an infant?
Tight wrap + hat
When does APGAR scoring begin?
1 minute into life
What are the components of the APGAR score?
Appearance/activity Pulse Grimace A Respirations
True or false: the APGAR scoring system is used to determine the need for intervention
False– should not preclude interventions if necessary
What must be done if there are points taken off of the APGAR score? What is the one exception to this rule?
Appropriately address the issue that caused it
Acrocyanosis does not indicate the need for intervention
What are you assessing for with the appearance of the APGAR score?
Color
Red color of the baby indicate what point on APGAR? Blue in the extremities? Fully blue?
Red = 2 Blue = 1 or 0
What is the normal pulse rate for a newborn?
100-160
What does a 2 and 1 point indicate on the APGAR scoring system?
Greater than 100 = 2
Less than 100 = 1
No pulse = 0
What is an appropriate intervention for bradycardia?
Vigorous drying
What is a 0, 1, and 2 for the grimace section?
0 = none 1 = not responding appropriately to stimuli 2 = crying loud and proud
What is the appropriate intervention for a lack of grimace?
Flick foot or vigorous drying
What is a 0, 1, and 2 for the activity section?
0 = no movement 1 = Not all extremity moving and flexing 2 = vigorously moving and flexing
What is a 0, 1, and 2 for the respirations section?
0 = none 1 = Weak cry, ssx of respiratory distress 2 = good respiratory effort and crying
What is the full score for APGAR?
10
When is APGAR assessed?
1 and 5 minutes. If less than 7 on the 5 minute assessment, continue until 20 min mark
What should be done when the APGAR score is complete?
Wrap baby, and hand off to mom
