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Promoting Healthy Populations > Newborn Care > Flashcards

Newborn Care Flashcards

1
Q

What is the age range of the neonatal period ?

A

birth to 28 days

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2
Q

What are some adjustments newborns go through in extra-uterine life ?

A
  • establish respirations
  • adjust to circulatory changes
  • regulate temperature
  • ingest, retain and digest nutrients
  • eliminate waste
  • regulate weight
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2
Q

What is the major difference in a newborns circulatory flow after birth ?

A
  • in the uterus= left to right flow
  • outside mom= right to left flow
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2
Q

Why is vaginal delivery important when related to the liquid in the baby’s lungs ?

A

compression of the newborn chest during vaginal delivery helps squeeze fluid out of chest and draw air into the lungs
- not as effective with C/S and premature delivieries

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2
Q

When does the newborn’s lungs start to exchange gases ?

A

right after the umbilical cord is cut
- this causes the placenta to no longer work as the lungs

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2
Q

What does clamping of the cord cause for prostaglandin levels ?

A

causes a decrease which can inhibit respirations

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2
Q

What sensory stimuli’s helps establish respirations ?

A
  • handling of infant by person doing delivery
  • suctioning of mouth and nose
  • drying by nurse
  • pain associated with birth
  • lights, sounds, and smells
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2
Q

Why is surfactant important for newborns ?

A

surfactant is released when the lungs expand after birth
- lines the alveoli and respiratory passages

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2
Q

Why is the function of surfactant ?

A

prevents alveolar collapse and lowers surface tension which increases lung compliance

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3
Q

What is a sign of a baby not having adequate surfactant levels ?

A

at the end of exhalation, the baby will make a “grunt” sound
- this them popping back open those alveoli

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3
Q

What are the 3 signs of respiratory distress ?

A
  • nasal faring
  • grunting
  • retracting
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3
Q

Why is nasal flaring a sign of respiratory distress ?

A

they are increasing the surface area of their nose to get more air into their lungs
- early sign of distress

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3
Q

When doing the respiratory assessment, what do we look for ?

A
  • 30-60 breaths per min
  • listen for a full min since they are irregular breathers
  • when auscultating for lung sounds make sure that their abdomen matches with the air sounds
  • may have short pauses of < 15 secs (periodic breathing) which is normal
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4
Q

What is meconium ?

A

first bowel movement of newborn
- ASPIRATION RISK
- black, tarry, sticky
- should be passed within 24 hrs

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5
Q

What are some expected findings of the CVPV assessment ?

A
  • fast HR (120-160) and even faster when crying
  • irregular S1 and S2
  • may hear little of a murmur and swooshing (is normal but monitor if they are compensating well for this)
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6
Q

When does the ductus arteriosus close ?

A
  • functionally= 24 hours
  • permanently= 3-4 wks
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7
Q

What causes the functional closure of the foramen ovale ?

A

increased pressure in L atrium caused by 1st breath

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8
Q

How do we regulate their temp ?

A
  • dry quickly after birth
  • place cap on head
  • delay 1st bath (unless mom has known pathogen like Hep B or a STD)
  • skin to skin contact (kangaroo care)
  • radiant warmer (last resort)
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9
Q

Why are they vulnerable to heat loss ?

A

large surface area, only thin layer of fat and unable to shiver to produce heat
- first 12 hours they are the most vulnerable to heat loss

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10
Q

What is the feeding schedule for breastfeeding or formula ?

A
  • Breast: 2-3 hrs
  • Formula: 3-4 hrs
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11
Q

What are infants at risk for is they are born before 32 weeks in relation to surfactant ?

A

they do not have adequate surfactant levels

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12
Q

What is their stomach capacity ?

A

30 mL (size of marble)

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13
Q

What is the urine schedule ?

A
  • voids 2-6x in first 24-48 hrs
  • 6-8x per day after
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14
Q

When is urine formed in utero ?

A

4th month

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15
Q

When is the bacteria establish and when are bowel sounds heard after birth ?

A
  • bacteria in gut in first week
  • bowel sounds heard shortly after birth
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16
Q

What does the feces of a breastfed baby look like ?

A

yellow seedy stool w/ each feed

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17
Q

What does the feces of a formula baby look like ?

A

soft brown
- 1-2x day

18
Q

What does weight looks like after birth ?

A
  • typical loss of 5-10% of birth weight in first 3-5 days of life
  • should regain by 14 days
19
Q

Why do baby’s look all puffed up after birth ?

A

they are very fluid heavy and that’s why they look all puffed up
- its a survival instinct because it protects from potential dehydration

20
Q

What is the temp range ?

A

97.7-99.5 F
- if they have a physiological problem their temp will do down instead of up
- temp decreasing is more significant

21
Q

What is the RR, HR, and BP ?

A
  • RR: 30-60
  • HR: 110-160
  • B/P: 60-80/40-50 (mean arterial BP should correspond with weeks gestation)
22
Q

What is an APGAR score ?

A

systematic method for assessing infant’s condition and transition to extra-uterine life at birth
- used at birth to ensure infants are observed for need of resuscitative care

23
Q

What are the different APGAR scores ?

A
  • 0-3: severe distress
  • 4-6: moderate difficulty
  • done at 60 secs and repeated at 5 mins of life
  • doesn’t predict neurological outcomes
24
Q

What should the Babinski reflex look like ?

A

positive Babinski
- toes flare out

25
Q

What is Jaundice ?

A

yellowish discoloration of the skin and other organs caused by high levels of bilirubin
- phototherapy may be needed

26
Q

What is physiological jaundice ?

A

self-limited caused by immature liver and enzyme system
- 3-4 days after birth
- in 60% of neonates
- may resolve on its own
- baby can compensate and resolve
- cephalocaudal progression

27
Q

What is pathologic jaundice ?

A

caused by hemolytic disease, RH/incompatibility, prematurity
- seen within 24 hrs of birth

28
Q

When performing phototherapy for jaundice what are steps we should take ?

A
  • protect the eyes
  • max skin exposure
  • monitor heat loss, fluid balance status
  • blankets or lights
29
Q

Which babies are at risk for hypoglycemia ?

A
  • preterm
  • low birth weight
  • small/large for gestational age
  • infants of mom with diabetes
  • distress during birth
30
Q

What is hypoglycemia in babies ?

A

may occur in first few hours of life
- early and regular feeding will prevent this
- treat per hospital protocol

31
Q

How is their immune system ?

A
  • immunosuppressed (defenses not well developed)
  • term infants have acquired natural immunity through maternal antibodies which were transferred in last 3 months of pregnancy
  • colostrum and breastmilk provide needed antibodies
32
Q

What are some immediate nursing care ?

A
  • assess respiratory status
    - suction mouth and nose with bulb
    syringe
    • maintain adequate 02 supply
  • dry and stimulate infant
    - maintain temp (skin to skin, under
    warmers, hat & blankets
  • assess temp (axillary)
  • place ID bands
  • footprint baby and mom’s fingerprints
  • obtain measurements & vitals
33
Q

What are some baseline measurement and vital signs taken ?

A
  1. obtain vital signs
  2. obtain body measurements
    - weight, head circumference (OFC), chest circumference, length, gestational age using Ballard tool
    3 physical assessment
34
Q

What is Caput Succedaneum ?

A

lump or bump on head shortly after birth
- more superficial
- goes across multiple plates and sutures

35
Q

What is Cephalohematoma ?

A

deeper injury than just a surface level tissue injury
- contained to one plate of the skull

36
Q

What is Acrycyanosis ?

A

the extremities are not perfusing enough because of the blood flow first goes to the core and the head
- extremities/limbs look slightly bluish

37
Q

What is Molding ?

A

elongated head
- baby took a long time in the birth canal
- just have to wait it out because it will be reversed naturally

38
Q

What is milia ?

A

normal plugged up skin cells
- look like small pimples
- the less you do the better
- don’t apply oils or creams or anything

39
Q

What is mottling ?

A

white and red appearance of the skin
- happens when baby is very cold and “freezing”

40
Q

What is a Mongolian spot ?

A

type of birth mark on baby’s
- is on the sacrum or buttock and looks like a bruise

41
Q

What is Erythema Toxicum ?

A

a common rash found on newborns

42
Q

What is the Erythromycin Ophthalmic Ointment used for ?

A

eye prophylaxis to prevent ophthalmia neonatorum(eye infection)
- due to gonorrhea or chlamydia
- put ribbon of medicine in eye from inner to outer canthus
- administer 1-2 hours of birth

43
Q

When is the Hep B vaccine administered ?

A

IM at birth then 1-2 months and 6 months
- must obtain parental consent

44
Q

Why is the Vitamin K vaccine important ?

A

prevents hemorrhagic disease
- within 2 hrs of birth
- bacteria necessary to synthesize Vit. K not present for 1 week (no intestinal flora yet)

45
Q

When, how and why do we perform the hearing test ?

A
  • When: 24-48 hrs before they leave the hospital
  • important because they are already learning about their environment and speech
46
Q

When and how do we perform the genetic, endocrine, and metabolic screening ?

A
  • When: they have to have eaten something before because they have to be metabolizing something to know if its functioning properly
  • How: blood test
47
Q

When do we perform the congenital heart disease screening ?

A

within 24 hrs

48
Q

What do we educate the family on ?

A
  • needs of newborn can be overwhelming to families
  • education should occur throughout the hospital day and not all at once
  • be aware of any specific cultural needs when planning education
  • encourage early bonding with parents (skin to skin contact)
49
Q

What is some bathing education ?

A
  • no more than every other day
  • daily cleansing of perineum and face
  • wash hair 1-2x per week
50
Q

What is some umbilical cord care ?

A
  • clean cord with warm water and a washcloth with baths or if soiled with urine or stool
  • let cord air day (keep outside of diaper)
  • clamp is removed once the stump is dry & baby is ready for discharge (24-48 hrs after birth)
51
Q

When does the umbilical cord usually fall off ?

A

10-14 days

52
Q

What is some circumcision care ?

A
  • assess for bleeding every 15-30 mins the first hour, then hourly for the next 4-6 hours
  • avoid baby wipes (cleanse with water only)
  • apply vaseline with every diaper change (don’t want penis sticking to diaper)
53
Q

What are the sleep needs ?

A

sleep correlates with rate of growth
- 80% at birth
- 12 hrs at 12 months
- sensitivity to sleep cycles so develop rituals
- not firm “schedule” because they won’t keep it consistent

54
Q

What is Sudden Infant Death Syndrome (SIDS) ?

A
  • 3rd leading cause of death
    -unknown cause
  • nurse role is family coping/grief
55
Q

What are some risk factors to SIDS ?

A
  • prone sleeping
  • exposure to tobacco smoke
  • soft sleeping surfaces
  • hyperthermia
  • bed sharing
  • lack of breast-feeding
  • SIDS sibling
  • preterm
56
Q

What are some recommendations for safe sleep ?

A
  • sleep alone, on their back in a crib
  • offer pacifier
  • breastfeed
  • firm sleeping surface
57
Q

What is some motor vehicle safety ?

A

car seats
- rear-facing safety seat for up tp 2-3 years of age
- always in the back seat
heat stroke
- dangerous temps occur in 15 to 30 mins if left unattended
nurse implications
- teach safety and provide resources

Promoting Healthy Populations (12 decks)

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