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MCN > NEWBORN CARE > Flashcards

NEWBORN CARE Flashcards

1
Q

Two broad goals of nursing care during this period

A

-promote the physical well-being of the newborn
-establishment of well-functioning family unit

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2
Q

promote the physical well-being of the newborn by__________

A

giving comprehensive care to NB in the mother baby unit

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3
Q

to enhance the establishment of a well-functioning family unit by __________

A
  1. teaching -how to care for NB
  2. support- for family to be confident and competent
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4
Q

Initiation of admission procedure

A
  1. Condition of the newborn
  2. Labor and birth record
  3. Antepartal history
  4. Parent-newborn interaction information
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5
Q

How to check condition of the newborn?

A

APGAR SCORE

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6
Q

APGAR scoring

A

10 - highest
0- lowest

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7
Q

e. g 9, 9

A

recorded APGAR score related to time (1st minute of life, 5th minute of life)

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8
Q

Immediate newborn care is done at what time?

A

the first 90 minutes

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9
Q

Essential Newborn Care is done at what time?

A

from 90 mins to 6 hour

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10
Q

3 new born care to be done.

A
  1. immediate new born care
  2. essential new born care
  3. care prior to discharge
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11
Q

At perineal bulging, with presenting part visible, give the intervention.

A

Prepare for the
delivery

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12
Q

At perineal bulging, with presenting part visible, give action

A

-25-28 degree celsius room temp
-Wash hands
-Double glove

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13
Q

1st 30 secs

A

Call out the time of birth

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14
Q

1st 30 secs intervention

A

Dry and provide warmth

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15
Q

1st 30 secs action

A
  • Use clean, dry cloth to dry the baby in yes, face, head, front and back, arms and legs
  • Remove the wet cloth
    -quick check of breathing while drying.
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16
Q

easiest way to check NB breathing

A

A BABY WHO IS CRYING, THE BABY IS BREATHING

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17
Q

after 30 secs of thorough drying, newborn is not breathing or is gasping intervention

A

Re-position, suction and
Ventilate

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18
Q

after 30 secs of thorough drying, newborn is not breathing or is gasping intervention action

A

-Call for help

-Transfer to a warm, firm surface

-Inform mother that NB has difficulty breathing and that you will help the baby to breathe

-Start resuscitation protocol

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19
Q

APGAR score guide to resuscitation >7

A

do not need resuscitate

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20
Q

APGAR score guide to resuscitation 4-7

A

back rubbing

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21
Q

APGAR score guide to resuscitation 0-4

A

resuscitation

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22
Q

after 30 secs of thorough drying, newborn is breathing or crying intervention

A

Do skin-to-skin contact

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23
Q

after 30 secs of thorough drying, newborn is breathing or crying action

A
  • newborn prone on the mother’s
    abdomen or chest skin-to-skin

-Turn the newborn’s head to one side

-Cover newborn’s back with a blanket and head with bonnet

-Place identification band on ankle

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24
Q

baby is crying and breathing normally, what to avoid?

A

manipulation, such as routine suctioning, that may cause trauma or introduce infection

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25
Q

why we need to cover newborns back with a blanket?

A

-keep temperature at optimal range of 36.4 to 37.2 C

-to avoid
metabolic acidosis, hypoxia & shock

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26
Q

1st 90 mins: mother intervention

A

-Deliver the second newborn.

-Palpate the mother’s abdomen.

-no 2nd baby, inject oxytocin 10 IU IM in arm or thigh

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27
Q

approximate time cord pulsation stops

A

1-3 mins

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28
Q

1-3 mins intervention

A

Do non-immediate or
appropriately timed cord clamping

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29
Q

1-3 mins action

A

-Remove the first set of gloves immediately
prior touching or handling the cord

-Clamp and cut the cord after cord pulsations have stopped

-sterile plastic clamp at 2cm, second
clamp at 5cm from the umbilical base

-Cut close to the first clamp with sterile scissors

-Observe for oozing blood. It should have 2 arteries & 1 vein

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30
Q

Within 90 mins of age intervention

A

Provide support for initiation
of breastfeeding

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31
Q

Within 90 mins of age action

A

-Leave the newborn on mother’s chest in
skin-to-skin contact

-Observe newborn for feeding cues

-Counsel on positioning and attachment.

-Look for signs of good attachment and suckling.

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32
Q

feeding cues early signs

A

-rooting reflex
-opening of eyes

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33
Q

feeding cues mid signs

A

arms and legs

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34
Q

feeding cues late signs

A

crying

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35
Q

why it is important to leave the newborn on mother’s chest in
skin-to-skin contact

A

increase breast feeding success

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36
Q

within 90 mins of age for small baby or twin action

A

-Skin-to-skin contact as much as possible

-kangaroo mother care

-Provide extra blankets to keep baby warm

-mother cannot provide skin-to- skin contact, use warm blanket or radiant warmer

-Do not bathe the small baby.

-Ensure hygiene by wiping with a damp cloth but only after 6 hours.

-Prepare a very small baby(1.5kg) or a baby
born >2 months early for referral

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37
Q

within 90 mins of age action for eye care

A

Administer erythromycin or tetracycline ointment
- Administer erythromycin or tetracycline ointment

-or 2.5% Povidone- iodine drops to both eyes after newborn has located breast

-Do not wash away the eye antimicrobial

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38
Q

ENBC: intervention

A

rooming in

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39
Q

ENBC: action

A

-Check for birth injuries, malformations or defects.

-Weigh the newborn.

-Get the head, chest, abdominal circumference and length.

-Get the vital signs

-Give Vit K prophylaxis

-Inject hepa B & BCG vaccine

-Perform cord care

-Dress the newborn

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40
Q

PTDC: intervention

A

-unrestricted per demand breastfeeding

-Ensure warmth the baby

-Washing and bathing

-Sleeping

-Look for signs of serious illness like
jaundice & local infections

-Discharge instructions

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41
Q

Where to measure head circumference

A

above eyebrow

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42
Q

where to measure chest circumference

A

nipple line

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43
Q

where to measure abdominal circumference

A

above umbilical stump

44
Q

signs of neonatal distress

A

Changes in color or activity

Grunting or “sighing sounds”

Rapid breathing with chest retractions

Facial grimacing

45
Q

how to get temperature

A

Axillary method

46
Q

normal temperature

A

36.4 to 37.2 C

47
Q

normal respirations of newborn

A

30-60cpm, irregular yet normal

48
Q
A
49
Q

does newborn experience periodic apnea

A

yes

50
Q

normal pulse of new born

A

120-160 bpm

51
Q

V/S should be monitored q30mins for 2hrs until stable

A

true

52
Q

Monitor of output within 24 hrs

A

voiding

53
Q

Monitor of output within 48 hrs

A

passage of stools

54
Q

In monitoring output, assess for:

A

abdominal distention, bowel sounds,
hydration, fluid intake & temperature stability

55
Q

when weighing of the NB should be done?

A

Same time of the day

56
Q

what percent of of weight loss is normal in 1st week

A

10%

57
Q

why there is a weight loss during the 1st week

A

limited intake, loss of excessive extracellular fluid, & passage of meconium

58
Q

how many weeks/days before regaining the weight loss of NB during the first week

A

2 weeks

59
Q

It is produced by the mother
provides primary source of nutrition for the baby before they are able to eat & digest

A

milk

60
Q

what are the 3 stages of milk

A
  1. Colostrum
  2. Transitional
  3. Mature
61
Q

it is yellowish or creamy fluid, thicker than mature milk

A

colostrum

62
Q

breastmilk that contains more protein, fat-soluble vitamins & minerals

have high level of IgA

A

colostrum

63
Q

replaced by transitional milk within 2-4 days after birth

A

colostrum

64
Q

produced from the end of colostrum & production until approximately 2 weeks postpartum

A

transitional milk

65
Q

Contains lactose, water-soluble vitamins, elevated levels of fats, & more calories than colostrum

A

transitional

66
Q

10% solids (carbohydrates, proteins, fats) for energy & growth; rest is water, which is vital in maintaining hydration

A

mature milk

67
Q

type of mature milk

A

foremilk and hindmilk

68
Q
A
69
Q
A
70
Q

advantages of breastfeeding

A

-best for baby
– reduces incidence of allergies
-economical, no cost & waste
-antibodies, greater immunity to infections
-satisfies infant’s nutritional needs
-temperature always correct & constant
-fresh milk- never spoils
-emotional bonding
-easy once established/convenient
-digested easily
-inhibits ovulation
-no mixing required

71
Q

7 Surprising Superpowers of Breastmilk:

A

-potential cure cancer4
-can ‘sense’ when your baby is sick
-fight bacteria
-cures acne
-pain-relief medication
-perfect pre-term baby milk

72
Q

what women with flat or inverted nipples may find useful/techniques

A

breast cup or breast shells

Hoffman technique

syringe method

73
Q

what to avoid in preparation of breast

A

soap in nipples

use of creams, nipple rolling, pulling & rubbing
to “toughen” nipples

74
Q

when assisting with first feeding happens; mother and baby are stable

A

Within the first hr of birth

75
Q

Position of mother & baby
during breast feeding

A

w/ infant’s head & body straight

facing her breast, w/ infant’s nose opposite her nipple

infant’s body close to her body

supporting infant’s whole body, not just neck & shoulders

76
Q

Assess infant’s response to feeding

A

WOF cyanosis & choking

77
Q

4 feeding techniques position

A

-Cradle
-Football hold
-Cross-cradle hold
-Side lying position

78
Q

Signs of Good Attachment in Latching on techniques

A

chin touching breast

mouth wide open

lower lip turned outward

more areola visible
above than below the mouth

79
Q

how to remove infant to the breast

A

inserting finger into the corner of the
infant’s mouth between the gums

Mother should remove breast quickly before the
infant begins to suck again.

Indent the breast tissue with a finger near the infant’s mouth & remove infant when suction is released.

80
Q

Suckling effectively

A

slow deep sucks & sometimes
pausing

81
Q

duration of breastfeeding

A

10 min. & then increase the time of feeding
in each breast

82
Q

average volume of breast milk/day

A

1 quart; some women are producing more milk

83
Q

Frequency of breastfeeding

A

8-12 times in 24hr period

84
Q

common breast problem

A

No milk
Engorgement
Nipple pain
Nipple trauma
Flat or inverted nipples
Plugged ducts
Mastitis

85
Q

what do you do when there is no milk?

A

galactogogues

warm compress

lactation massage

good attachment

frequent BF

86
Q

Temporary swelling or fullness of the breast when milk begins to “come in” or change from colostrum to transitional breast milk

2-3 days after birth

Result of accumulation of milk, enlarged lymph glands & increased blood flow.

May also be caused by milk retention if feedings are
delayed, too short, or infrequent.

A

engorgement

87
Q

tx for engorgement

A

application of heat
& cold

massage & proper breastfeeding techniques

a well-fitting bra may be worn both day & night to help support breasts.

88
Q

Pain for a minute or less

Usually peaks at the 3rd to 6th day & resolves soon afterward

A

nipple pain

89
Q

appear red, cracked, blistered, or bleeding

A

nipple trauma

90
Q

treatment for nipple trauma

A

includes proper positioning, rotating used nipples, application of small amount of BM in affected nipples

91
Q

localized edema and tenderness present, hard area may be palpated

tiny, white area may be
present on the nipple

A

plugged ducts

92
Q

tx for plugged ducts

A

massage and proper breastfeeding

93
Q

plugged duct may progress to mastitis if not treated promptly

A

true

94
Q

Inflammation of breast tissue

caused by blocked milk ducts or milk excess

Onset of flu-like symptoms: fever, chills, body aches & headache

Localized breast pain, tenderness, a hot reddened area on breast; usually on upper outer quadrant

A

mastitis

95
Q

tx for mastitis

A

antibiotics
Analgesics
Antipyretics
Rest
Warm compress
Adequate fluid intake balanced diet

96
Q

expression of milk

A

manual expression(massaging breast)

frequent stimulation

breast pump

97
Q

life of milk when not refrigerated

A

3-4 hours

98
Q

life of milk when refrigerated

A

3 days

99
Q

life of milk when in freezer inside refrigerator

A

2 weeks

100
Q

Self contained freezer

A

3 to 4 months

101
Q

separate deep freeze unit at 0⁰F

A

less tan 6 months

102
Q

Philippine order of marketing of breast milk

A

Executive Order No. 51

103
Q

the rooming in and breastfeeding act of 0992

A

republic act no. 7600

104
Q

promotion of skin integrity

A

Bathing
Cleansing of buttocks & perineal area
Diaper change
Cord care

105
Q
A

MCN (8 decks)

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