New Born Care and Complications

Question 1

fetal circulation

Answer 1

changes when the cord is clamped

Question 2

risks of C/S

Answer 2

fluid in lungs because no compression like VB

Question 3

fetal apnea birth

Answer 3

normal less then 10 seconds

Question 4

first urine voids

Answer 4

pink urine acid crystals is normal

Question 5

immunoglobulin

Answer 5

IgG abundant

IgM first to respond

Question 6

V-K

Answer 6

shot given an hour after birth because they can’t make normal flora in abdomen until a week which is where its made from

Question 7

stomachs

Answer 7

can expand thats why they will spit up

holds 10-20mL first 24 hours

Question 8

APGAR

Answer 8

1 minute then 5 minutes after birth 
appearance 
pulse 
grimace 
activity 
RR

Question 9

VS

Answer 9

Temp 97.7-99.5
RR 30-60
HR 110-160

Question 10

NTE

Answer 10

keep it at the temp 97.7-99.5

Question 11

Erythromycin prevents

Answer 11

chaylmidia and gonnrhea

Question 12

Milia

Answer 12

epistein pearls in mouth

or unopened sebaceous glands nose

Question 13

stork bites

Answer 13

salmon patches

Question 14

harlequin sign

Answer 14

half red face where blood vessels are dilated

Question 15

nevus flames

Answer 15

port wine stain

Question 16

nevus vasculosus

Answer 16

strawberry mark

Question 17

caput succedaneum

Answer 17

edema that crosses suture lines

can be pitting as well

Question 18

cephalhematoma

Answer 18

localized effusion that does not cross suture lines

Question 19

Hep B vaccine

Answer 19

HBIG within 12 hours of birth
hep B at birth
both given before breast feeding

Question 20

PKU

Answer 20

have to get protein first before test done

Question 21

thermoregulation

Answer 21

thin skin
rely on environment 
few subcutaneous fat 
few brown fat 
can't shiver or generate heat through muscles

Question 22

heat loss in newborn- 4 ways

Answer 22

conduction: contact with object
evaporation- water
convection- air currents
radiation- near cold surface

Question 23

Voiding

Answer 23

expect a void in < 8 hrs
1 stool and void first 24 hrs
formula less frequent stools and larger
breast more frequent and less

Question 24

AGA
SGA
LGA

Answer 24

appropriate for gestational age 10-90%
small for gestational age <2500g (5lbs 8oz)
large for gestational age >4000g (8lbs 10oz)

Question 25

factors affecting growth

Answer 25

maternal- HTN, smoking, diabetes, weight gain, drug use placental- calcification ( from aging), previa, abruption fetal- sex (males larger), multiple gestations, anomalies, fetal infection

Question 26

SGA

Answer 26

< 10% assessment findings: large head, thin extremities and trunk, reduced subcutaneous fat, thin umbilical cord, loose dry skin. perform blood glucose frequently because hypoglycemia can occur since they don't have enough energy stores obtain weight, head, length circumference screen for polycythemia >65% because of stress

Question 27

LGA

Answer 27

``` >90% macrosomia poor motor skills difficult to arouse not as alert concerns: traumatic birth injuries hypoglycemia (<40mg)- they had a lot glucose in the placenta because of the mother taking in so much sugar so when the baby comes out their sugar drops because its making so much insulin. hyperbilirubinanemia ```

Question 28

Pre- term health issues effects on prematurity assessment

Answer 28

``` 20-37.6 weeks RDS- respiratory syndrome BPD- bronchuopulmonary dysplasia respiratory- < surfactant cardiovascular- persistent fetal circulation immune- IgG deficiency thermoregulation- hypoglycemia males- undescended testes plentiful langue and vernix poorly framed ear pinna fused eyelids no creases on soles and palms ```

Question 29

pre term management

Answer 29

``` monitor for dehydration <1 ml/kg/hr over dehydrations >3ml/kg/hr monitor RR status radiant warmer kangaroo care nutrition and fluid balance will sleep on their stomach to expand ```

Question 30

Post Term

Answer 30

42 weeks placental issues: decreased O2 nutrient supply wasting of fetus due to using stored nutrients stops working after 40 weeks. R/F placental insufficiency

Question 31

post term assessment

Answer 31

``` dry, cracked, and peeling skin will vernix or lanugo thin umbilical cord meconium stained skin and nails long nails ```

Question 32

post term management

Answer 32

cord compression placental dysfunction screen polycythemia and hyperbilrubinaanemia

Question 33

asphyxia

Answer 33

``` acidosis can occur from placental abruptio cord abruption HTN meconium aspiration ```

Question 34

TTN- transient tachypnea of newborn

Answer 34

self limiting respiratory disorder causes retention in lungs and transient pulmonary edema fluid from lungs doesn't empty completely resolves by 72 hours more common C/S IV fluids or gavage feedings Tx: PEEP: pressurized ventilation to keep alveoli open

Question 35

opposite of hypothermia

Answer 35

hypoglycemia

Question 36

hypoglycemia

Answer 36

listless, lethargic, weak, poor, feeding, tremors, irritability, SEIZURES, apnea, cyanosis, HYPOTHERMIA Txt feedings q2h

Question 37

FAS

Answer 37

``` fetal alcohol effects: growth, craniofacial structure malformations thin upper lip microcephaly missing philtrum narrow forehead micrognathia low nasal bridge poor hand eye coordination cardiac defects ```

Question 38

marijuana

Answer 38

``` high pitched cry tremulouslessness hyper irritability sleep abnormalities photophobia ```

Question 39

cocaine

Answer 39

``` piercing cry irritability hypersensitivity poor feeding decreased responsiveness congenital anomalies ```

Question 40

NAS- neonatal abstinence syndrome

Answer 40

``` test only those at risk CNS, GI effects wakefullness shrill cry apnea diarrhea lacrimation hypoglycemia RR distress ```

Question 41

NAS management

Answer 41

low stimulation | low lighting

Question 42

hyperbilirubinanemia

Answer 42

bilirubin is a byproduct of RBC hemolysis | immature liver, fetal RBC shorter lifespan, delay in meconium excretion

Question 43

physiologic jaundice

Answer 43

1-7 days after birth increased bili load caused by short RBC life >10 mg/dL

Question 44

pathologic jaundice

Answer 44

``` occurs in FIRST 24 hrs yellow skin LIFE THREATENING increased RBC breakdown severe polycythemia, blood incompatibilities (rh -/+) , or systemic acidosis >17 mg/dL kernicterus- brain jaundice/ damage ```

Question 45

physic jaundice tx

Answer 45

``` photothearpy - blacklight eye shield no lotions starts to head then down to feet heals feet to head ```

Question 46

pathological jaundice tx

Answer 46

phototherapy | exchange transfusion

Question 47

newborn infections assessment

Answer 47

``` hypothermia- can't regulate temp pallor hypotonia RR distress poor weight gain irritability hypoglycemia seizures ```

Question 48

neonatal sepsis

Answer 48

presence of viral, microorganisms, most common is GBS | presents as septicemia, (blood infection) pneumonia, meningitis