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
2
Q
promote the physical well-being of the newborn by__________
A
giving comprehensive care to NB in the mother baby unit
3
Q
to enhance the establishment of a well-functioning family unit by __________
A
- teaching -how to care for NB
- support- for family to be confident and competent
4
Q
Initiation of admission procedure
A
- Condition of the newborn
- Labor and birth record
- Antepartal history
- Parent-newborn interaction information
5
Q
How to check condition of the newborn?
A
APGAR SCORE
6
Q
APGAR scoring
A
10 - highest
0- lowest
7
Q
e. g 9, 9
A
recorded APGAR score related to time (1st minute of life, 5th minute of life)
8
Q
Immediate newborn care is done at what time?
A
the first 90 minutes
9
Q
Essential Newborn Care is done at what time?
A
from 90 mins to 6 hour
10
Q
3 new born care to be done.
A
- immediate new born care
- essential new born care
- care prior to discharge
11
Q
At perineal bulging, with presenting part visible, give the intervention.
A
Prepare for the
delivery
12
Q
At perineal bulging, with presenting part visible, give action
A
-25-28 degree celsius room temp
-Wash hands
-Double glove
13
Q
1st 30 secs
A
Call out the time of birth
14
Q
1st 30 secs intervention
A
Dry and provide warmth
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.
16
Q
easiest way to check NB breathing
A
A BABY WHO IS CRYING, THE BABY IS BREATHING
17
Q
after 30 secs of thorough drying, newborn is not breathing or is gasping intervention
A
Re-position, suction and
Ventilate
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
19
Q
APGAR score guide to resuscitation >7
A
do not need resuscitate
20
Q
APGAR score guide to resuscitation 4-7
A
back rubbing
21
Q
APGAR score guide to resuscitation 0-4
A
resuscitation
22
Q
after 30 secs of thorough drying, newborn is breathing or crying intervention
A
Do skin-to-skin contact
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
24
Q
baby is crying and breathing normally, what to avoid?
A
manipulation, such as routine suctioning, that may cause trauma or introduce infection
25
why we need to cover newborns back with a blanket?
-keep temperature at optimal range of 36.4 to 37.2 C
-to avoid
metabolic acidosis, hypoxia & shock
26
1st 90 mins: mother intervention
-Deliver the second newborn.
-Palpate the mother's abdomen.
-no 2nd baby, inject oxytocin 10 IU IM in arm or thigh
27
approximate time cord pulsation stops
1-3 mins
28
1-3 mins intervention
Do non-immediate or
appropriately timed cord clamping
29
1-3 mins action
-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
30
Within 90 mins of age intervention
Provide support for initiation
of breastfeeding
31
Within 90 mins of age action
-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.
32
feeding cues early signs
-rooting reflex
-opening of eyes
33
feeding cues mid signs
arms and legs
34
feeding cues late signs
crying
35
why it is important to leave the newborn on mother's chest in
skin-to-skin contact
increase breast feeding success
36
within 90 mins of age for small baby or twin action
-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
37
within 90 mins of age action for eye care
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
38
ENBC: intervention
rooming in
39
ENBC: action
-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
40
PTDC: intervention
-unrestricted per demand breastfeeding
-Ensure warmth the baby
-Washing and bathing
-Sleeping
-Look for signs of serious illness like
jaundice & local infections
-Discharge instructions
41
Where to measure head circumference
above eyebrow
42
where to measure chest circumference
nipple line
43
where to measure abdominal circumference
above umbilical stump
44
signs of neonatal distress
Changes in color or activity
Grunting or “sighing sounds”
Rapid breathing with chest retractions
Facial grimacing
45
how to get temperature
Axillary method
46
normal temperature
36.4 to 37.2 C
47
normal respirations of newborn
30-60cpm, irregular yet normal
48
49
does newborn experience periodic apnea
yes
50
normal pulse of new born
120-160 bpm
51
V/S should be monitored q30mins for 2hrs until stable
true
52
Monitor of output within 24 hrs
voiding
53
Monitor of output within 48 hrs
passage of stools
54
In monitoring output, assess for:
abdominal distention, bowel sounds,
hydration, fluid intake & temperature stability
55
when weighing of the NB should be done?
Same time of the day
56
what percent of of weight loss is normal in 1st week
10%
57
why there is a weight loss during the 1st week
limited intake, loss of excessive extracellular fluid, & passage of meconium
58
how many weeks/days before regaining the weight loss of NB during the first week
2 weeks
59
It is produced by the mother
provides primary source of nutrition for the baby before they are able to eat & digest
milk
60
what are the 3 stages of milk
1. Colostrum
2. Transitional
3. Mature
61
it is yellowish or creamy fluid, thicker than mature milk
colostrum
62
breastmilk that contains more protein, fat-soluble vitamins & minerals
have high level of IgA
colostrum
63
replaced by transitional milk within 2-4 days after birth
colostrum
64
produced from the end of colostrum & production until approximately 2 weeks postpartum
transitional milk
65
Contains lactose, water-soluble vitamins, elevated levels of fats, & more calories than colostrum
transitional
66
10% solids (carbohydrates, proteins, fats) for energy & growth; rest is water, which is vital in maintaining hydration
mature milk
67
type of mature milk
foremilk and hindmilk
68
69
70
advantages of breastfeeding
-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
7 Surprising Superpowers of Breastmilk:
-potential cure cancer4
-can ‘sense’ when your baby is sick
-fight bacteria
-cures acne
-pain-relief medication
-perfect pre-term baby milk
72
what women with flat or inverted nipples may find useful/techniques
breast cup or breast shells
Hoffman technique
syringe method
73
what to avoid in preparation of breast
soap in nipples
use of creams, nipple rolling, pulling & rubbing
to “toughen” nipples
74
when assisting with first feeding happens; mother and baby are stable
Within the first hr of birth
75
Position of mother & baby
during breast feeding
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
Assess infant’s response to feeding
WOF cyanosis & choking
77
4 feeding techniques position
-Cradle
-Football hold
-Cross-cradle hold
-Side lying position
78
Signs of Good Attachment in Latching on techniques
chin touching breast
mouth wide open
lower lip turned outward
more areola visible
above than below the mouth
79
how to remove infant to the breast
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
Suckling effectively
slow deep sucks & sometimes
pausing
81
duration of breastfeeding
10 min. & then increase the time of feeding
in each breast
82
average volume of breast milk/day
1 quart; some women are producing more milk
83
Frequency of breastfeeding
8-12 times in 24hr period
84
common breast problem
No milk
Engorgement
Nipple pain
Nipple trauma
Flat or inverted nipples
Plugged ducts
Mastitis
85
what do you do when there is no milk?
galactogogues
warm compress
lactation massage
good attachment
frequent BF
86
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.
engorgement
87
tx for engorgement
application of heat
& cold
massage & proper breastfeeding techniques
a well-fitting bra may be worn both day & night to help support breasts.
88
Pain for a minute or less
Usually peaks at the 3rd to 6th day & resolves soon afterward
nipple pain
89
appear red, cracked, blistered, or bleeding
nipple trauma
90
treatment for nipple trauma
includes proper positioning, rotating used nipples, application of small amount of BM in affected nipples
91
localized edema and tenderness present, hard area may be palpated
tiny, white area may be
present on the nipple
plugged ducts
92
tx for plugged ducts
massage and proper breastfeeding
93
plugged duct may progress to mastitis if not treated promptly
true
94
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
mastitis
95
tx for mastitis
antibiotics
Analgesics
Antipyretics
Rest
Warm compress
Adequate fluid intake balanced diet
96
expression of milk
manual expression(massaging breast)
frequent stimulation
breast pump
97
life of milk when not refrigerated
3-4 hours
98
life of milk when refrigerated
3 days
99
life of milk when in freezer inside refrigerator
2 weeks
100
Self contained freezer
3 to 4 months
101
separate deep freeze unit at 0⁰F
less tan 6 months
102
Philippine order of marketing of breast milk
Executive Order No. 51
103
the rooming in and breastfeeding act of 0992
republic act no. 7600
104
promotion of skin integrity
Bathing
Cleansing of buttocks & perineal area
Diaper change
Cord care
105
