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old Sophomore cards > Newborn Care > Flashcards

Newborn Care Flashcards

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0
Q

What must happen in establishment of respiratory function?

A

Fluid in the lungs must be replaced by air

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1
Q

What is the first few hours of life as the neonate stabilizes respiratory and circulatory function?

A

Neonatal transition

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2
Q

How is fluid in the lungs replaced by air?

A

It occurs by mechanical force or “squeezing”

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3
Q

Where is the fluid in the lungs absorbed?

A

Into the interstitial tissue, lymphatics and vascular system

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4
Q

How much fluid is in the lungs at birth?

A

Approx 20mL

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5
Q

How much fluid is in the entire respiratory tract at birth?

A

80-120mL

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6
Q

What does crying against closed glottis do at birth?

A

It creates positive pressure inflates alveoli

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7
Q

What does lungs expanding with subsequent breaths result in?

A

Decrease pulmonary vascular resistance

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8
Q

What does lungs expanding with subsequent breaths which decrease pulmonary vascular resistance allow?

A

More pulmonary blood flow (oncotic pressure)

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9
Q

What does the fetal experience in chemical stimulation of breathing?

A

Elevated CO2
Decreased O2
Decreased pH (acidosis)

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10
Q

What does the chemical change simulate?

A

Chemoreceptors in the aorta and carotid arteries

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11
Q

What happens after chemoreceptors are stimulated in the aorta and carotid arteries?

A

Causes stimulation of the respiratory center in medulla which triggers a breath

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12
Q

What three things are stimulated that cause a breath to trigger in an newborn?

A

Chemoreceptors in the aorta and carotid arteries and respiratory center in medulla

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13
Q

What is the thermal stimulation of breathing in the newborn?

A

The decrease in ambient temperature at birth

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14
Q

What does decrease in ambient temperature at birth stimulate?

A

Stimulates nerve endings in skin which sends signal to medulla which triggers a breath

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15
Q

When nerve endings in the skin are stimulated what does it send a signal to?

A

To the medulla which triggers a breath

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16
Q

What three things stimulate sensory of breathing?

A

Touch
Noise
Light

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17
Q

If newborn is depressed, what do you do to stimulate breathing?

A

Rub back vigorously

Flick bottom of foot

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18
Q

What is the fluid that lines the alveoli?

A

Surfactant

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19
Q

What is surfactant composed of?

A

Phospholipids
• lecithin
• sphingomyelin

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20
Q

What is the role of Surfactant?

A

Lowers alveolar surface tension promotes lung compliance

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21
Q

When does Lecithin production peak?

A

At 35 weeks

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22
Q

What does Sphingomyelin do?

A

Remains constant

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23
Q

What does the mature L/S ratio?

A

2:1

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24
Q

When a newborn grunts, what is it doing?

A

Attempting to increase positive pressure in alveoli to keep them down

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25
Q

What are the structures of fetal circulation?

A

Foramen Ovale
Ductus Ateriosus
Ductus Venosus

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26
Q

What takes place with the foramen ovale in the first breath?

A

Decrease in pulmonary vascular resistance

Increase in pulmonary flow

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27
Q

What does a fecrease in pulmonary vascular resistance and an increase in pulmonary flow result in?

A

An increase in venous flow to L heart an increased pressure in L atrium which closes the foramen ovale

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28
Q

What causes the foramen ovale to close?

A

Pressure change

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29
Q

When is there a permanent closure in the Foramn Ovale?

A

6 months

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30
Q

What takes place on closure of ductus arteriosus?

A

Systemic vascular pressure becomes greater than pulmonary vascular pressure

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31
Q

When systemic vascular pressure becomes greater than pulmonary vascular pressure what happens?

A

Blood flow is reversed through the DA and increased pO2 levels cause construction of DA

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32
Q

When does the closure of the ductus venosus occur?

A

When umbilical cord is clamped

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33
Q

What us neonatal jaundice?

A

Physiologic hyperbilirubinemia

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34
Q

What percentage of newborns does neonatal jaundice effect?

A

60% full term and 80% of preterm infants

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35
Q

What is the liver of a newborn responsible for?

A

Conjugating bilirubin for excretion (iron storage)

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36
Q

Where is Bilirubin is released in?

A

In unconjugated form from RBC’s

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37
Q

Where does bilirubin deposited in?

A

In tissues, skin, sclera

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38
Q

How long does fetal iron stora last?

A

5 months

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39
Q

What bilirubin levels may result in brain damage?

A

Levels > 17

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40
Q

What helps manage neonatal jaundice?

A

Phototherapy with bili-lights

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41
Q

When is jaundice observable?

A

When bilirubin levels reach 5 mg/dL in caucasions and AA

10-15 in Asians

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42
Q

When are bilirubin peak levels?

A

Term (3-5 days)

Preterm (5-7 days)

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43
Q

What are kernicteris?

A

Pigment deposit in brain

44
Q

What should kernicteris levels be?

A

25-30mg/dL

45
Q

What should newborn diet contain?

A 
Protein
Fat
Carbohydrate
Water
Vitamins and minerals
46
Q

How long should mother breast feed exclusively?

A

6 months

47
Q

What is extrusive reflex?

A

Newborn infant spits out

48
Q

What should the caloric intake be for a newborn?

A

50-55 kcal/lb/day

49
Q

What is the fluid requirement for a newborn?

A

64-73 ml/lb/day

50
Q

How much should an infant gain in the first 6 months?

A

1 oz per day

51
Q

How much should an infant gain in the second 6 months?

A

0.5 oz per day

52
Q

When should birthweight be regained when formula fed?

A

10 days

53
Q

When should birthweight be regained when breast fed?

A

14 days

54
Q

What properties does breast milk have?

A

Antiviral
Antibacterial
Antigenic inhibiting properties (fewer allergies)

55
Q

What does breast milk lower the risk of?

A 
Childhood:
obesity 
Diabetes
Ear infections/tubes
Childhood cancers
56
Q

When breast fed, infants have less _____ and bowel movements are less _________.

A

Less spit-ups

BM less offensive

57
Q

When is breastfeeding contraindicated?

A

HIV/AIDS in mother
Breast cancer
When mother requires certain medications
Active TB, HSI in breast

58
Q

When should mother initiate breast feeding?

A

1st 30 minutes

59
Q

What are the first signs of hunger before crying?

A

Hand to mouth motions
Whimpering
Sucking
Rooting

60
Q

How often should mother breast feed?

A

On demand - usually every 1 1/2 to 3 hours

8-10 feedings in 24 hours

61
Q

What can “watching the clock” do to milk production?

A

Impair milk production

62
Q

When should mother feed until?

A

Until signs of infant satiety - relaxes, falls asleep, slows down r stops sucking

63
Q

When does Colostrum production begin and end?

A

Begins during pregnancy and ends a few days after birth?

64
Q

What is colostrum high in?

A

Protein
Fat-soluble vitamins
Minerals
Antibodies

65
Q

Transitional milk

A

Until about two weeks

66
Q

What does transitional milk contain?

A

More fat,
lactose,
water-soluble vitamins
More calories than colostrum

67
Q

What does mature milk contain?

A

Carbohydrates
Protiens
Fats
Water

68
Q

What is foremilk and hindmilk in?

A

Mature milk

69
Q

When assessing proper breastfeeding, feeding is appropriate if?

A
  • 6 or more wet diapers/day
  • adequate weight gain
  • adequate bowel movements
  • infant is satisfied
70
Q

What can pacifiers help prevent?

A

SIDS

71
Q

What helps assess for proper breastfeeding?

A

LATCH

72
Q

What does L in LATCH stand for?

A

Latch

73
Q

What does A in LATCH stand for?

A

Audible swallowing

74
Q

What does the T in LATCH stand for?

A

Type of nipple

75
Q

What does the C in LATCH stand for?

A

Comfort

76
Q

What does the H in LATCH stand for?

A

Hold or positioning

77
Q

What amount size should breast milk be stored in?

A

2-4 ounces

78
Q

Refrigeration time for breast milk?

A

72 hours to 8 days

79
Q

Freezer time for breast milk?

A

6 months

80
Q

Whole milk should be used until when?

A

For the 1st to years of life

81
Q

When is semi-solid foods be introduced?

A

At 4-6 months

82
Q

What food seldom causes allergies when introduced at 4-6 months?

A

Rice cereal with iron

83
Q

What foods can be introduced 6-8 months?

A

Vegetables and fruits

84
Q

How should you introduce fruits and vegetables?

A

Introduce one new food at a time and then wait 3 days to introduce another

85
Q

What foods can be introduced at 8-10 months?

A

Strained meats and proteins
Soft finger foods
Begins to use cup with a lid

86
Q

What can be introduced between 10-12 months?

A

Eats soft table foods w/ family
Attempts to feed self with spoon
Eats 4x/day

87
Q

What foods need to be delayed until 4 months?

A

Carrots
Beets
Spinach

88
Q

What foods need to be delayed until 1 year?

A

Cow milk

89
Q

What foods need to be delayed until 2 years?

A

Eggs

90
Q

What foods need to be delayed until 3 years of age?

A

Peanuts
Nuts
Fish
Shellfish

91
Q

What foods need to avoided to prevent choking?

A 
Hot dogs
Hard vegetables 
Candy
Whole grapes
Chunks of peanut butter
92
Q

What food needs to be avoided to prevent botulism?

A

Honey

93
Q

When can newborn have first tub bath?

A

After cord fall off

94
Q

How should cord be taken care of?

A

Kept dry and exposed to air
Clean cord and skin with cotton ball 2-3 x per day. Alcohol 1-2 x per day.
Fold diaper below the cord

95
Q

Following circumcision how often do you check for signs of bleeding or infection?

A

q 30 min X 2 hours

96
Q

How should circumcision care be cared for?

A

Clean with Soap and water, rinse, pat dry

97
Q

What does normal drainage look like after circumcision?

A

Light, sticky, and yello

98
Q

If circumcision has a plastibell, when should it fall off?

A

In 8 days

99
Q

If there is no plastibell placed after circumcision, what needs to be applied with each diaper change?

A

Petroleum jelly

100
Q

When should head control be achieved by newborn?

A

3-4 months

101
Q

How should newborn be positioned for sleeping?

A

On their backs

102
Q

What things help reduce SIDS risk?

A

Sleep on back
Baby’s head uncovered
Avoid overheating
Offer a pacifier for sleep

103
Q

What does the AAP say about tummy time?

A

Recommends that when the infant is alert, he should be placed in his tummy for “play” sessions

104
Q

If baby chokes, how should parents help?

A

Turn baby’s head to the side to bulb suction

105
Q

Where is the safest spot for the car seat?

A

Middle of the back seat

106
Q

How long does the baby need to face the rear in the car?

A

Until 1 year-old or weighs 20 pounds

107
Q

What temperature are signs of illness?

A

Above 101 R or 100.4 ax

Below 97 R or 97.8 ax

old Sophomore cards (28 decks)

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