Newborn Assessment

Question 1

APGAR stands for

Answer 1

Appearance (colour)
Pulse (HR)
Grimace (reflex irritability)
Activity (muscle tone)
Respiratory (effort)

Question 2

APGAR score is done at _____ minutes after birth

Answer 2

1 minute and 5 minutes after birth

Question 3

APGAR score is done a third time if __________ and is done at ________ minutes

Answer 3

score is less than 7 and is done at 10 minutes

Question 4

acrocyanosis is the common for the first _____hrs in most babies

Answer 4

24-48 hrs

Question 5

acrocyanosis is common for the first 24-48 hrs because

Answer 5

it takes a while for blood and circulation to get to all of the body

Question 6

newborn HR normal range

Answer 6

110 - 160

Question 7

newborn RR normal range

Answer 7

30 - 60

Question 8

newborn temp normal range

Answer 8

36.5 - 37.5

Question 9

newborn BP normal range

Answer 9

SBP 50 - 75
DBP 30 - 45

Question 10

when assessing heart rate and respirations for 1 minutes APGAR score listen for _____ seconds and multiply by ____

Answer 10

6 seconds and multiply by 10

Question 11

thermoregulation

Answer 11

process of maintaining balance between heat loss and hear production in order to maintain its core internal temperature

Question 12

_____________ is critical to a newborns survival

Answer 12

thermoregulation

Question 13

“the golden hour”

Answer 13

uninterrupted skin to skin contact with parent 1-2hrs after birth

Question 14

characteristics that predispose newborns to heat loss

Answer 14

• Thin skin with blood vessels close to surface
• Lack of shivering ability to produce heat until 3 months of age
• Limited stores of metabolic substrates (glucose, glycogen, fat)
• Limited use of voluntary muscle activity or movement to produce heat
• Large body surface area relative to body weight
• Lack of subcutaneous fat, which provides insulation
• Little ability to conserve heat by changing posture (fetal position)
• No ability to adjust their own clothing or blankets to achieve warmth
• Inability to communicate that they are too cold or too warm

Question 15

conduction

Answer 15

involves transfer of heat from one object to another when the two objects are in direct contact of each other

Question 16

convection

Answer 16

flow of heat from body surface to cooler surrounding air to air circulating over a body surface

Question 17

cold stress

Answer 17

excessive heat loss that requires a newborn to use compensatory mechanisms to maintain core body temperatures

Question 18

as body temp decreases the newborn becomes

Answer 18

less active, lethargic, hypotonic, and weaker

Question 19

nonshivering thermogenesis uses

Answer 19

brown fat oxidation

Question 20

brown fat is

Answer 20

special fat that converts chemical energy to heat

Question 21

brown fat is special becomes

Answer 21

there is only so much of it, so once it us used up it is gone

Question 22

preterm newborns are at greatest risk for cold stress because

Answer 22

they have fewer fat store, poorer vasomotor repsonses, and less insulation to cope with a hypothermic event

Question 23

cold stress in newborns can lead to

Answer 23

• depleted brown fat stores
• increased oxygen needs
• respiratory distress
• increased glucose consumption leading to hypoglycemia
• metabolic acidosis
• jaundice
• hypoxia
• decreased surfactant production

Question 24

length of a full term newborn is usually

Answer 24

44 to 55 cm

Question 25

term newborn typically weighs

Answer 25

2500g to 4000g

Question 26

low birth weight is considered less than

Answer 26

2500 g

Question 27

very low birth weight is considered less than

Answer 27

1500g

Question 28

extremely low birth weight is considered less than

Answer 28

1000g

Question 29

SGA

Answer 29

small for gestational age

Question 30

LGA

Answer 30

large for gestational age

Question 31

AGA

Answer 31

appropriate for gestational age

Question 32

preterm is _________ weeks

Answer 32

< 37 completed weeks

Question 33

term is _________ weeks

Answer 33

38 - 42 weeks

Question 34

post term is _________ weeks

Answer 34

after 42 completed weeks

Question 35

vitamin K treatment in newborns is administered ideally ________ hours after birth

Answer 35

1-2 hours

Question 36

vitamin K treatment in newborns promotes blood clotting by

Answer 36

increasing the synthesis of prothrombin by the liver

Question 37

without vitamin K treatment after birth newborns are at risk for

Answer 37

vitamin K deficiency and subsequent bleeding

Question 38

_____ mg is given within 6 hours after birth

Answer 38

1mg IM

Question 39

erythromycin 0.5% ophthalmic ointment should be done within the first _______ hours after birth

Answer 39

1-2 hours

Question 40

erythromycin 0.5% ophthalmic ointment provides actions to prevent

Answer 40

Neisseria gonorrhea and chlamydia trachomatis conjunctivitis

Question 41

erythromycin 0.5% ophthalmic ointment prevents ophthalmia neonatorum which can cause __________ in the newborn

Answer 41

blindness

Question 42

erythromycin 0.5% ophthalmic ointment is given based on

Answer 42

risk factors of getting bacteria from mom

Question 43

mom is encouraged to get rubella vaccine before or after birth but cannot have during pregnancy because

Answer 43

it is a live vaccine

Question 44

TRUE or FALSE it is common for newborns to lose weight then gain it back

Answer 44

true

Question 45

it is a concern if newborn baby loses more than ___% of weight

Answer 45

10%

Question 46

small head circumference might indicate

Answer 46

- microcephaly caused by rubella - toxoplasmosis - SGA status

Question 47

large head circumference might indicate

Answer 47

- hydrocephalus - intraventricular bleed - increased intracranial pressure

Question 48

newborn skin should be

Answer 48

- smooth and flexible - colour consistent with genetic background - warm to touch and intact

Question 49

Lanugo is

Answer 49

fine downy hair usually observed over the shoulders and on the sides of the face and upper back

Question 50

cracking and peeling of the skin is most common in babies born

Answer 50

post dates

Question 51

vernix caseosa

Answer 51

- thick white substance that protects skin of fetus - formed by secretions from fetus's oil glands and is found during the first 2-3 days after birth in body creases and hair

Question 52

vernix caseosa does not need to be removed from the skin because

Answer 52

it acts as a protective moisturizer which will be absorbed into the skin

Question 53

stork bites or salmon patches are

Answer 53

superficial vascular areas found on the nape, eyelids and between eyes and upper lip

Question 54

stork bites or salmon patches are caused by

Answer 54

concentration of immature blood vessles and are most visible when the newborn is crying

Question 55

pearly white or pale yellow unopened sebaceous glands are

Answer 55

milia

Question 56

milia are most commonly found on the

Answer 56

nose, chin, forehead

Question 57

milia will disappear on their within 2-4 weeks and should not be popped because

Answer 57

popping them can lead to permanent scarring on baby's face

Question 58

epstein pearls

Answer 58

milia that occur in newborns mouth - occur in approx. 80% of newborns

Question 59

mongolian spots

Answer 59

benign blue or purple splotches that appear solitary on the lower back and buttocks of newborns but may occur as multiple over the legs and shoulders

Question 60

erythema toxicum

Answer 60

newborn rash; is benign, idiopathic, generalized, transient rash that occurs in up to 70% of all newborns during the 1st week of life

Question 61

harlequin

Answer 61

refers to the dilation of blood vessels on only one side of the body, results from immature auto-regulation of blood flow and is commonly seen in low birth weight newborns where there is a positional change – lasts as long as 20 minutes

Question 62

nevus flammeus

Answer 62

commonly appears on the newborns face or body; capillary angioma located directly below the dermis – flat with sharp demarcations and is purple-red; made up of mature capillaries that are congested and dilated – is permanent and will not fade; majority are on head and neck areas

Question 63

nevus vasculosus

Answer 63

also called a strawberry mark or strawberry hemangioma – benign capillary hemangioma in the dermal and subdermal layers – raised, rough, dark red and sharply demarcated

Question 64

newborns head should

Answer 64

- be symmetric and round - 2 fontanels at juncture of cranial bones - skull should feel somewhat smooth and fused except for areas over fontanels, sutures, and moulding areas

Question 65

anterior fontanel is _______ shaped and closes by ______ months

Answer 65

diamond shaped and closes by 18-24 months

Question 66

anterior fontanel typically measures ______ cm at largest diameter

Answer 66

4-6cm

Question 67

posterior fontanel is ______ shaped and closes by ______ weeks

Answer 67

triangular shaped and closes by 6-12 weeks

Question 68

posterior fontanel typically measures

Answer 68

one fingertip or 0.5 - 1 cm

Question 69

fontanelles should feel

Answer 69

soft and flat

Question 70

caput succedaneum

Answer 70

localized edema on scalp that occurs from pressure of birth process

Question 71

caput sucadaneum is commonly seen after

Answer 71

prolonged birth

Question 72

microcephaly

Answer 72

head circumference more than 2 standard deviations below average or less than 10% of normal parameters for gestational afe

Question 73

microcephaly is caused by

Answer 73

inadequate brain development - reduced production of neurons leading to a reduction of brain volume and as a consequence of that a reduced skull size

Question 74

macrocephaly

Answer 74

head circumference more than 90% of normal

Question 75

macrocephaly is typically related to

Answer 75

hydrocephalus

Question 76

a large anterior fontanel is considered _____ cm a large posterior fontanel is considered ____ cm

Answer 76

anterior more 6 cm diameter posterior more than 1 cm diameter

Question 77

large fontanels can be associated with

Answer 77

- malnutrition - hydrocephaly - congenital hypothyroidism - various bone disorders