Newborn Assessment Flashcards
when is apgar scoring done
1 and 5 mins after birth
what does an apgar measure
how well baby is transitioning
apgar score categories
resp (crying) reflexes (irritability) pulse (HR) skin color (body and extremities) muscle tone
apgar scores
0-2
cold stress
cold stress
- –> hypoglycemia
- -> resp distress
- -> acidosis
when is a baby transferred to a basinet?
when their temps are regulated for a certain amt of time
def conduction
loss of heat from body surface to a cold surface
def convection
loss of heat from body surface to the air
def radiation
loss of heat from body surface to a cooler surface thats close to the baby
ex: nearby window
def evaporation
loss of heat moisture from the skin
what is kangaroo care
baby is placed on mom only wearing a diaper
skin to skin
name the periods of reactivity
first period
sleep phase
second period
how long does the first period of reactivity last
30 -60 mins
what is monitored during the first period of reactivity
VS
color
what should we encourage during the first period of reactivity
attachment and bonding
how long does the sleep phase last?
1-4 hrs after birth
when does the second period of reactivity occur
4-12 hrs after birth
what characterizes the second period of reactivity
intense sensitivity to internal and external stimuli
what occurs during the second period of reactivity
baby voids
meconium/bm
what should be used after the baby expels meconium
A+D
what do we watch for during the second period of reactivity
mucus
apnea
emesis
what measurements are taken after the baby is born
head circumfreence
chest circumfrence
abdominal circumfrence
length
how are glucose levels obtained in babies
heal stick
what is considered a good transition
good reflexes good muscle tone passed meconium breathing well temp regulation
what meds are admin to the baby in the DR
vit k
erythromycin
how do you admin erythromycin
-inner canthus to outer canthus
bulged fontanelle’s indicate
IICP
depressed fontanellels indicate
dehydration
overriding fontanelles indicate
molding
why does molding occur
occurs during birth to fit the babys head
def caput succedaneum
soft tissue edema from birth trauma
does caput succedaneum cross the suture lines
yes
what does caput succedaneum indicate abt the birth
-used a vaccuum
what is caput succedaneum caused by
head rubbing up against moms cervix
def cephalohematoma
bleeding bx the cranial bone an the periosteum in the periosteal space
does cephalohematoma cross suture lines
no
what is cephalohematoma caused by
- use of forceps
- pressure from the pelvis
how long does cephalohematoma take to resolve
3-6 weeks
what will happen when cephalohematoma begins to resolve?
JAUNDICE
what is subconjunctival heorrhage caused by
the trauma of birth
who is subconjunctival hemorrhage seen in
baby
most likely mom from bearing down so hard during birth
when does chemical conjunctivitis occur
if there is a rxn to eye prophylaxis
what should illicit the startle reflex
loud noise
newborns are typically what kind of breathers
obligate nose breathers
what should we monitor for in the nose
nasal discharge
newborns sneeze to
clear nostrils
what is significant abt the structure of newborns nose
absent bridge
what are hallmark signs of potential or actual resp dstress
nasal flaring
grunting
retractions
what is the extrusion reflex
when a baby pushes any food that is placed in the front of their mouth out
-protective
when does the extrusion reflex disappear
approx 4 months
what are epstein pearls?
white, yellowish cysts that form on the gums and roof of a newborns mouth
bowel sounds should be auscultated when?
within 2 hrs after birth
when should the first void occur
within 24 hrs after birth
when should the first meconium be expelled?
within 24-48 hrs after birth
where might lanugo be seen?
shoulders
pinna of ears
forehead
when will lanugo be absent
post mature babies
when will lanugo be abundant
in pre-term babies
purpose of vernix
antibacterial properties
protects newborn skin
def acrocyanosis
blue extremities
what causes acrocyanosis
sluggish peripheral circulation
how long should acrocyanosis last for
no more than a few hrs
what may acrocyanosis indicate?
decreased temp
what is mongolian spots
patch of purple/black/blue color over coccygeal and sacral regions
what groups are more prone to getting mongolian spots
afr americans
asians
are mongolian spots malignant?
no
do mongolian spots resolve
yes- with time
what is mottling
generalized white and red discoloration of the skin of chilled infants with fair complexion
is hyperbili a/w hemolytic disease?
no
when does jaundice occur
24 hrs after birth and peaks @ 72 hrs
bili lab values
6-10 mg/dl
when does jaundice usually resolve
5-7 days
what is milia
tiny white papules located over the nose, cheek, and/or chin
erythema toxicum is aka
fleabite rash
is tx necesary for erythema toxicum
no
when does erythema toxicum appear
in the first 24 hrs of birth
where is erythema toxicum most common
trunk
diaper area
what are signs of drug wd
excessive crying
fretfullness
inability to quiet self
shaking
what tests are run after the baby is born
PKU
t4
hearing
when is the gest age assessment done
2 hrs after birth
normal wt range
2500-4000 grams
normal length
45-55 cm/ 18-22 “
head circumfrence range
32-36.8 cm / 12.6-14.5”
chest circumfrece range
30-33 cm / 12-13”
normal RR
30-60 rpm
normal HR
100-160 bpm
normal S BP
60-80 mm hg
normal D BP
40-50 mm hg
normal temp
36.5-37.2/ 97.7-98.9 F- axillary
normal glucose range
40-60
