Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ob - 332 > newborn assessment and care 1 > Flashcards

newborn assessment and care 1 Flashcards

1
Q

suction

A

at delivery
bulb
catheter if meconium or place, limp, no resp effort or tone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

cord

A

clamp and cut - wait 30-60s
milk cord towards baby a few times to increase blood, then clamp and cut

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

delivery stabilization

A

dry (blanket) and stimulate - slap sole of feet, flick heel, rub back
do on mom if stable
warm - kangaroo care/warmer, blankets/hat
1 min apgar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

identification

A

mom finger, baby foot, ID bands (2 parents, 2 baby, remove at discharge)
security band - educate parents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

apgar - HR

A

0 = none
1 = <100
2 = >100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

apgar - resp effort

A

0 = none
1= slow, irregular
2 = good cry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

apgar - muscle tone

A

0 = flaccid
1= some flexion
2 = active

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

apgar - reflex

A

0 = none
1= grimace
2 = vigorous cry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

apgar - color

A

0 = pale blue
1= pink body, blue extremities
2 = pink

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

VS: HR

A

110-160
sleep = 80
cry = 180
apical for 1 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

VS: Temp

A

97.7 - 99.5
axillary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

VS: RR

A

30-60 (1min)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

initiation of respiration: mechanical changes

A

80-100mL of fluid in lungs at delivery, decreased production of lung fluid 2-4 days before
chest compressed during delivery -> fluid out of lungs
altered by c/s and fast deliveries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

initiation of respiration: chm changes

A

1st breath triggered by increasing PCO2, decreasing pH and PO2
trigger brains respiratory center
natural result of vaginal birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

initiation of respiration: thermal changes

A

decreased env temp, newborn responds with increasing RR
avoid prolonged exposure to cold -> cold stress/apnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

initiation of respiration: sensory changes

A

light, sound, gravity (no amniotic fluid), touch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

RR

A

60-70 for first 2 hours -> 30-60
periodic: <20s
apneic: >20s, abn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

respiratory variations: s of distress

A

nasal flare, intercostal or xiphoid retractions, expiratory grunt or sigh, seesaw respirations, tachypnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

clear airway

A

bulb suction, chest percussion (loosen secretions)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

transient tachypnea of newborn

A

progressive respiratory distress 6-72 hrs after birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

transient tachypnea of newborn: causes

A

LGA, late preterm, maternal over sedation, maternal bleed, prolapsed cord, breech, maternal DM, c/s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

transient tachypnea of newborn: tm

A

CXR: hyper expanded lungs, clear by 72hr
oxyhood <40%, O2 cannula -2L
possible IV fluids or tube feed bc r/o aspiration d/t tachypnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

RDS

A

alveoli are last to form, younger GA = less alveoli = more severe RDS
surfactant production: betamethasone, ROM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

RDS: tm

A

O2 therapy: continuous + airway pressure therapy (CPAP), mechanical vent, high frequency vent
surfactant admin: beractant, poractant, calfactant, lucinactant, colfosceril
thermoregulation: incubator
ecmo: severely ill, modified heart/lung machine allows baby’s lungs to rest/heal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

HR

A

assess at rest
newborn circulation: increased systemic vascular resistance, decreased pulmonary vascular resistance, enhance perfusion of body system; foramen ovale close w/n 1-2hr, ductus arteriosus close, ductus venosus close (liver perfusion)
assess brachial and femoral with arms extended, bilaterally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

BP

A

in nursery or before going home
cap refill <2-3s
highest right after birth, lowest 3hr after
sensitive to change in volume, varies by birth weight and GA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

heat loss

A

stabilize internal core temp in narrow range
thermoregulation by metabolic rate and O2 consumption
flexion decreases SA and retains heat
convection (air), radiation (no contact), evaporation (moisture), conduction (contact - warm stethoscope, scale, blanket)

28
Q

issues with thermoregulation: causes of heat loss

A

higher SA to body mass ratio, low SQ fat, higher body water content, immature skin (higher evaporation), poor metabolic mechanism for responding to thermal stress (cant shiver), altered skin blood flow (peripheral cyanosis)
preT at higher risk bc lack of flexes posture for preserving heat, very thin skin with capillaries close to surface

29
Q

hypothermia s/s

A

acrocyanosis and cool, mottled, pale skin
hypoglyc, transient hypergly, brady, tachypnea, restless, shallow and irregular resp, resp distress, apnea, hypoxemia, metabolic acidosis, decreased activity, lethargy, hypotonia, feeble cry, poor feed, decreased weight gain

30
Q

hyperthermic: causes

A

incubator, radiant warmer, ambient env, maternal fever, epidural anesthesia, phototherapy lights, sun, excessive bundling, infection, CNS disorder (asphyxia), dehyd

31
Q

hyperthermic: s/s

A

tachy, tachypnea, apnea, warm extremities, flushing, perspiration (term), dehyd, lethargic, hypotonia, poor feed, irritable, weak cry

32
Q

hyperthermic: consequences

A

hypoT and dehyd: d/t water loss
seizures and apnea: bc increased core temp
hyperNa
resp distress

33
Q

hyperthermic: management

A

adjust env, move way from heat source, undress, decrease air temp, feed freq to replace fluids

34
Q

brown fat

A

non shivering thermogenesis, skin receptors sense temp change, use brown fat for heat
26-28 weeks gestation -> 3-5 weeks after birth

35
Q

temperature management

A

kangaroo care for stable infants
radiant warmers for c/s, unstable, close assessments

36
Q

measurements

A

double weight by 6 months, triple by 12
head circumference > chest circumference (nipple line)
term: lose 5-10%
preT: lose 15%

37
Q

skin

A

color: pink, acrocyanosis (ok after birth and first 24 hours), central cyanosis (circum oral, bad oxygenations, assess)
preT: thin and transparent with veins prominent, less lines on feet
T: opaque and disappearance of vernix (lipid rich)
postT: peeling

38
Q

resting posture

A

extended: preT
flexed: term

39
Q

head

A

1/4 body
fontanelles: soft and flat, bulge with cry, separated, approximated, overlapping sutures (molding)
forceps/vacuum marks

40
Q

head: cephalohematoma

A

collection of blood between cranial bone and periosteal membrane, increased jaundice and anemia and hypoT, does not cross sutures, btw 1st and 2nd day, disappears after 2-3 weeks or may take months

41
Q

head: caput succedaneum

A

soft tissue swelling - collection of fluid, edematous swelling of scalp, crosses sutures, present at birth or shortly after, reabsorbed in 12 hours or a few days after birth

42
Q

eye variation

A

subconjuctival hemorrhage: will resolve, increased P, normal, vessels in sclera break
transient strabismum: cross eyed, eyes still developing, not treated at birth
dolls eyes: turn baby, eyes move in opposite direction, under developed head-eye coord

43
Q

ears

A

low set = in line with eye (intellectual disability)
preT: shapeless and flat, no recoil
terms: some cartilage and slight incurring of upper pinna, good recoil

44
Q

mouth

A

suck, cleft lip and palate (aspiration), precoscious teeth, epstein’s pearls (cysts, harmless)

45
Q

back

A

spine - straight and flat
sacral dimple: pit at base, may have tuffs of hair, US if it doesnt close (hole) bc r/o spina bifida occulta or tethered cord s

46
Q

spina bifida occulta

A

spine doesnt close properly around spinal cord

47
Q

tethered cord s

A

tissue attached to cord limits its movement - causes weakness, numbness and bladder and bowel problems

48
Q

lanugo

A

decreased with increasing GA
more with non White

49
Q

breastbud

A

term = 0.5 to 1cm

50
Q

umbilical cord

A

3 vessels (2A, 1V)
observe for umbilical hernia (AA, close by 2yr)

51
Q

genitalia: M

A

withold circ if issue - consult urologist
hypospadias, epispadias, phimosis (cant retract foreskin), hydrocele (fluid collection around testes), cryptorchidism (dont drop)
preT: small scrotum, few rugae, testes palpable in inguinal canal
T: testes in lower scrotum which is pendulous and covered with rugae

52
Q

genitalia: F

A

preT: clit prominent, labia majora small and separated
T: labia majora covere minora and clit
pseudomenstruation: vaginal discharge tinged with blood d/t withdrawal from maternal hormones

53
Q

vernix

A

lubricate skin

54
Q

milia

A

clear sponatneous (1mo), exposed sebaceous glands, white spots, face and nose, dont bother them

55
Q

telangiectatic nevi

A

pale pink or red spots, fade by age 2

56
Q

mongolian spots

A

non white, note, look like bruise, back or butt, 4yrs, non white

57
Q

nevus flammeus

A

capillary angioma, below dermis, non elevated, red-purple, face, dont go away or fade

58
Q

strawberry mark

A

capillary hemangiomas, dermal and subdermal, raised, dark red, grow rapidly but may shrink and go away (9-10yr), leave alone

59
Q

fractured clavicle

A

birth, large, shoulder dystocia, move both arms equally

60
Q

erbs palsy

A

5th and 6th cervical roots of brachial plexus, move extremities equally

61
Q

simian crease

A

down s
1 transverse palmar crease

62
Q

syndactyly

A

webbing

63
Q

polydactyly

A

extra digits

64
Q

clubfoot

A

cant turn midline or realign

65
Q

sole (plantar) creases

A

higher GA = proceed to heel

66
Q

hip dislocation

A

barlows maneuver: will feel demur move out of acetabulum (pop out)
ortolanis maneuver: + = hip click (pop in)

67
Q

RDS: rf

A

preterm, c/s, infection, cold stress/hypothermia
maternal DM -> hyperinsulinemia and hypergly reduce fetal surfactant production

ob - 332 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions