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Newborn baby Flashcards

1
Q

APGAR scoring
a) when?
b) what assess for?
c) What score are OK?

A

a) 1 and 5 min of life
b) rapidly extrauterine adaption
c) 7-10

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2
Q

What is the New Ballard score?

A

a newborn maturity rating score
range from -1 to 5

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3
Q

Vital sings for newborn
What is the order and normal range.

A

RR
-before NB becomes active 30-60b/m
HR
-110-160/m
BP
-60-80/40-50
Temp
97.7-98.6

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4
Q

What is vernix caseosa?

A

Normal
Protective cheesy curving
More prominent in preemies

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5
Q

What is Lanugo?

A

Normal
Covering hair
More prominent in preemies

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6
Q

What is Milia?

A

Small raised white spots o nose, chin, forehead
Resolve without treatment

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7
Q

What is a Mongolian spots

A

A round blue/black mark on the baby’s sacrum,\
Normal and more common in dark-skinned NB

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8
Q

What’s are they?

A

Telangiectatic Nevi = Stork bites
-flat pink/red marks on back of the neck, nose, upper eyelids, forehead
-fade in 2years
-

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9
Q

a) What is the acrocyanosis?
b) What is the central cyanosis?

A

a) bluish tint if hands and feet
b) bluesish color in the central body
(face, lips, chest)

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10
Q

What is Desquamation?

A

Peeling occur few days post birth

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11
Q
A

Nevus flammeus = port wine stain

Normal
Permanent
flat dark red to purple vascular lesion

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12
Q
A

nevus vasculosus =strawberry mark
Normal capillary hemangioma

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13
Q

What is the erythema toxicum?

A

Pink rash
Normal, no treatment required

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14
Q

Head assessment

Caput succedaneum

A

-Swelling of the scalp in a newborn
-Cross suture line
-By pressure from the uterus
-Gravity

Resolve 3-4 days/ no treatment needed

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15
Q

Head assessment

Cephalohematoma

A

-Does not cross suture
-Skull bone bleeding
-Result from trauma during birth

Risk for jaundice
Resolves in 2-8 weeks

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16
Q

What are the sings of respiratory distress?

A

flaring of bares
flared nostrils
tachypnea
retraction
central cyanotic
grunting

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17
Q

Babinski reflex

A

Open— positive
Close– negative

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18
Q

Expected lab

a) Hbg
b) HCT
c) glucose
d) WBC count

A

a) 14 TO 42g/dl
b) 44%-64%
c) grater than 40 t0 45 mg/dl
d) 9,000 tp 30,000

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19
Q

What methods can the nurse use to manage pain in the newborn? 5

A

-Allowing a parent to hold
-Breastfeeding
-Swaddling with arms and legs “tucked”
-Souse solution,
-Pacifiers

Neonatal Infant Pain Scale (NIPS)

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20
Q

How does the nurse know if an infant is in pain?

A

-Crying
-Grimacing
-Active movement/especially legs
-increased resp

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21
Q

What is the #1 PRIORITY for NB?

A

Thermoregulation
Keep the warm!!!

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22
Q

What is first period of reactivity?

A

Alert (mom + baby wide awake)
↑ HR(160-180) & RR

Lasts ~ 30 minutes

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23
Q

What is the “Golden Hour” ?

A

The best time to initiate breastfeeding (30min to 1hr)

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24
Q

What is the 1st sleep phase?

A

difficult to arouse/ 目を覚まさせる
Lasts 2-4 hours

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25
What is the 2nd period of reactivity?
Teach family warning signs Will probably want to eat Lasts ~ 2-4 hours
26
a) Metabolic screening done by when? b) And NB must have what before have the test?
a) A capillary heel stick should be dine 24 hr b) formula or breastmilk
27
What is the PKU?
A defect in protein metabolism can result in mental retardation (treatment in the first 2 months of life can prevent mental retardation)
28
How is the Vit K shot administered?
IM injection into the Vastus Lateralis Administer the NB shots while baby is skin-to-skin with mom to help with pain.
29
Why NB needs a Phytonadione vitamin K₁ shot?
A one-time dose of 0.5 ml will help prevent vitamin K deficiency bleeding Vitamin K--- for blood clotting
30
Circumcision care What are 2 things to important watch out?
1: bleeding=medical emergency! 2: Document first post circ void If the baby does not pee within 6-8 hours notify the provider
31
Circumcision care Other importance 4
1: use of petroleum jelly to avoid site sticking to the diaper 2: Diaper tight enough to avoid friction rub 3: Fold diaper tp prevent pressure on the area 4: Don’t try to remove the yellow film
32
Respiratory complication a)Respiration less than or equal to 30/min? b) Respiration greater than or equal to 60/min?
a) Bradypnea b) Tachypnea
33
Respiratory complication intervantion
Bulb syringe suction mouth/nose, aspirate mouth then one nostril at a time Maintain thermoregulation
34
Expecting finds Respiratory distress
Tachypnea Nasal flaring Exploratory grunting Retractions Cyanosis Fine crackles
35
Why does thermoregulation so important for NB?
Newborns cannot shiver or sweat to control temp > Burning brown fat > O2 is required to burn fat >An increase in O2 demand leads to respiratory distress acidosis
36
a) Regular temp for NB b) Hypothermia
a) 97.9-98.6 b) less than 97.7 (36.5)
37
NB should void?
Once within first 24hr then 2nd change 2diapar till day 5th
38
The best method for thermoregulation is?
Early skin to skin!!!
39
Heat loss Conduction
resulting from direct contact with a cooler surface. -warm stethoscope -pad on scale before weighting NB -NB should placed direct on the mom's chest and covered with warm blanket
40
Heat loss Radiation
Loss of heat from body to a cooler solid surface close to, but not in direct contact -Baby away form the window
41
Heat loss Convention
Flow of heat from body surface to cooler environmental air -Place bassinet put of the direct line of a fan or air conditioning
42
Infection control a) Risk of infection during first few months d/t ? b) Newborns lack the ability to what?
a) immature immune system b) localize infection= SEPSIS
43
a) What is a meconium? b) When have that?
a) A newborn's first poop sticky, thick, dark green poop b) Within 24-48hr
44
Heat loss Evaporation
Loss of heat as surface liquid is converted to vapor (baby being wet) -Dry newborn immediately
45
Oxygen Saturation in Transition What is the normal range of 1min 5min 10min
1 minute: 60-70% 5 minutes: 80-85% 10 minutes: 85-95%
46
Umbilical cord care a) how long should we keep the clamp? b) most cords fall off within?
a) in place for 24-48 b) first 10-14days
47
Erythromycin?
Prevent eye infection apply to the lower conjunctival sac each eye
48
Hypoglycemia a) T or F An initial drop in blood glucose after birth is common b) The rang that the nurse start intervention for hypoglycemia
a) T b) within the first 4hr <40 4 to 24 hr <45
49
Expecting findings Hypoglycemia
poor feeding Hypothermia weak cry lethargy　無気力 diaphoresis jittery, apneic, problems feeding, seizures
50
What the way stabilized blood sugar level? Non pham
Skin-to- skin
51
When to when? a) Neonate b) Preterm c) Term d) Post-term
a) Birth to 28 days b) 20 weeks-36 6/7 weeks c) 37-42 weeks gestation d) After 42 weeks
52
What is Ballard gestational assessment?
Less than 37 weeks gestation evaluates a baby's appearance, skin texture, motor function, and reflexes
53
Post-mature infant a) dysmaturity d/t? b) dysmaturity result what?
a) placental degeneration and uteroplacental insufficiency (placenta functions effectively for 40 weeks) b) Chronic fetal hypoxia Neonatal respiratory distress
54
Post-mature infants can be either SGA (small for gestational age) or LGA(Large for gestational age), depend what?
Depending on how well the placenta functions during the last week of pregnancy
55
Post-mature infant findings
Peeling, cracked skin dry, leathery skin Meconium stain of fingernail Difficulty establishing respirations
56
Wight loss a) first 48 hr b) within 10 days c) Lose more than the normal range, why?
a) <7% b) 5-10% c) dehydrated/malnourished
57
Breastfeeding a) how many times b) position
a) Feed every 2-3 hrs (8-12 times/day) b) Football hold Cradle Modified cradle Side lying
58
Breastfeeding benefit 7 Infant
Dec risk of infection(pass antibodies from mom milk) Contains electrolytes and minerals Easy for baby to digest Colonizes the newborn gut Dec incidence of SIDS, allergies, childhood obesity Promotes attachment Always available & @ the right temperature
59
Breastfeeding Benefit Mom 3
Dec postpartum bleeding Inc uterine involution Dec risk for ovarian/breast cancer, diabetes, HTN, CVD, RA
60
Bottle Feeding a) How many times should feed? b) Never heat in what? c) A prepared formula can be refrigerated for up to? d) What position should the baby be?
a) Feed every 3-4 hrs b) microwave c) 48 hrs d) Cradled in a semi-upright
61
What action by the NB indicates readiness to feed?　準備
Head to mouth movement sucking motions rooting mouthing
62
Discharge a) Vaginal birth b) Cesarean birth
a) after 48 hrs b) after 72 hrs
63
What is Habitation?
Newborns have the ability to diminish or shut down sound, stimuli
64
Discharge teaching Safe sleep/Wake cycle
Newborns sleep 18 hrs a day Place newborn supine when sleeping (“back to sleep”) Keep the environment dark and quiet Nothing in the crib w/ baby dress them in one more layer Preventing positional plagiocephaly -infant can be on their stomach while supervised when awake
65
Discharge teaching Car seat
A rear-facing car seat until at least age 2 Car seats should always be in the center/middle rear seat to avoid airbags
66
Discharge teaching Clothing
Dress baby as you dress + 1 more layer Cover baby’s head Soft clothes made of cotton
67
Discharge teaching Cord Care
Keep the cord open to the air diaper folded down below the cord No special treatments for the cord Avoid submersion baths until the cord falls off The cord should fall off at 10-14 days Report any d/c or foul smell
68
When to call the provider
Fever ver 100.4 Bleeding or purulent drainage from umbilical cord Dec in voids/stool (No wet diapers for 18 – 24 hours OR fewer than 6 wet diapers a day) Sings of jaundice or cyanosis Projectile vomiting Poor feeding Refusal to eat for more than two feedings
69
This baby is at increased risk for what? a) Parental rejection b) Hyperbilirubinemia c) Hypoglycemia d) Low self-esteem
b
70
Breast milk and formula are what % water? a) 95% b) 90% c) 80% d) 75%
b
71
Which infant would be most at-risk for developing hyperbilirubinemia? The infant who is: a) Bruised b) Post dates c) Asian d) Preterm
d
72
Increased levels of unconjugated bilirubin require treatment in order to prevent: a) Hemorrhage b) Erythema toxicum c) Neurotoxicity d) Infection
c
73
Physiological Jaundice a) Caused? b) peak day?
a) Common immature liver a short lifespan of fetal RBCs cold stress b) 3-5 days Never occurs in the first 24 hr
74
Physiological Jaundice Those at risk
ALL newborns preemies respiratory depression/distress cold stress hypothermia
75
Physiological Jaundice Intervention
Early feeding to stimulate pooping Maintain normal body temp
76
If jaundice occurs within 24 hr, what is this called?
Pathologic jaundice caused by hemolysis ABO incompatibility very BAD
77
Phototherapy Hyperbilirubinemia
Place baby under light wearing just a diaper (phototherapy) Protect baby's eyes with a mask Turn baby every 2 hr Monitor temp and dehydration DO NOT lotion on the baby
78
What do you know about Heb B vaccine?
Give at the birth IM administer the other side of the thigh(of vitamin K shot) Need singed informed consent
79
Which one is a finding of a baby was born in prematurely？ a) Dec amount of vernix b) Leathery/cracked skin c) Dec planter surface crease d) No lanugo
C B is post term
80
Which one needs more education? a) I should be feeding my baby every 2-3 hr b) My baby should have at least 4 wet diapers on day 4th c) I should allow my baby adequate rest for growing and skip feeling if he is asleep d) I should expect to see the baby's stool lighten by day 3
C
81
Which one is the lowest risk of becoming jaundice? a) Premature baby b) baby who has cephalohematoma c) A baby whose mom is diabetes d) A baby had a circumcision done
d cephalohematoma Head/ bone bleeding
82
What are the hunger cues?
Hand-to-mouth motions Sucking Rooting (looking around) Mouthing Before the baby cry **NB does not need to be given water**
83
What is a correct latch?
Baby's nose, cheeks. and shin touch the breast with a portion of the areola in the baby's mouth
84
What are the preemie characteristics?
Thin transparent skin Lanugo Vernix Testes palpable in inguinal canal lack of creases
85
What are the term baby characteristics?
Cartilage on ear 1cm breast bud Rugae on scrotum Deep creases noted
86
Noninverting thermogenesis
Infants produce heat by the metabolism of their blown fat O2 needs more= become jaundice
87
What NB's regular temp?
97.7-99.5 Less than 97.7 = hypothermia

Maternal Newborn (20 decks)

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