Newborn Assessment Flashcards
How to promote physical well-being of newborn
Nursing care - Keep baby warm, wash after 24 hours, swaddle,
Physical assessment - reflexes, vitals
Nutrition - get them breastfeeding or on formula
How to promote and establish a functioning family?
we must educate and support both parents and grandparents
What are respiratory changes from fetus to newborn?
Respirations initiate
Chemically - surfactant reduces tension to reduce O2 concentration
Thermally - Moist infant is cold from exposed air
Mechanical - think vaginal compression or fetal chest during vaginal delivery
Apgar scoring. Scoring the Activity
0 - Absent
1 - Flexed arms and legs
2 - Active and moving around
APGAR - Pulse scoring
0 - No pulse
1 - Less than 100 bpm
2 - More than 100 bpm
APGAR Grimace scoring (Reflex)
0 - Floppy
1 - Minimal response to stimulation
2 - Prompt to respond
APGAR Appearance scoring
0 - Blue/pale
1 - Pink body with acrycyanosis
2 - Pink all over
APGAR - Respiration scoring
0 - No breathing
1- Slow & Irregular
2- Vigorous cry
When to assess APGAR
1 minute of birth
5 Minutes
Again at 10 min is the first two readings were low
Assess and intervene then reassess after interventions are done
Methods of heat loss - Evaporation
Wet surface exposed to air = loses heat
Baby comes out wet and water evaporates so baby loses heat
Conduction
Newborn comes into direct contact with object cooler than skin
Warm blankets and stethoscopes before placing on the baby
Convection
Heat is transferred to air that surrounds he newborn
Losing heat through airflow - try to decrease airflow in room to maintain babys temperature
Radiation
Transfer of heat to colder objects that arents in contact with infant.
What are the effects of cold stress?
Increased metabolic rate
Non-shivering thermogenesis-metabolism of brown fat
Vasoconstriction
How does increased metabolic rate in cold stress effect the baby?
Increase use of glucose and low production of surfactant hypoglycemia with respiratory distress
How non-shivering thermogenesis metabolism of brown fat effects the baby?
Increased production of free fatty acids leading to metabolic acidosis and jaundice
How does vasoconstriction of cold stress effect the baby?
Pale mottled skin leading to fetal circulatory patterns
What are kennel and klaus’ theory on bonding?
Must bond within the first hour of life or it will effect baby for the next 20 years
How to encourage bonding with parents?
En face -babies can see 6-8 in in front of them
Encourage breastfeeding asap after delivery
Skin to skin
Periods of reactivity
First period
30-60 Min
Vitals - eyes are the most open
Encourage bonding
APGAR
Radiant warming
Meds - Vit K & arithromycin
What are the periods of reactivity?
First period - 30 - 60 min
Sleep phase - 1 to 4 hours
Second period - 4 to 12 hours
What happens in the second period
4 to 12 hours after birth
Increased sensitivity to internal and external stimuly
Voiding and meconium
Mucus, apnea, emesis
Most active in this phase
Risk of not giving vit K injection to newborns
Neonatal hemorrhaging
Normal weight in pounds and gms for newborns
2500-4000gms
5.5 - 8lbs