Newborn Care- EXAM 2

Question 1

Normal Vital Signs of a Newborn
Respirations
Apical Pulse
BP
Temp

Answer 1

30-60 breaths per minute
Apical pulse: 12-=160 bpm
65/30 to 95/60
36.5-37.3 in Celsius // 97.7-99.5 in Fahrenheit

Question 2

Murmurs

Answer 2

90% of them are not associated with anomalies
Usually due to incomplete closure of ductus arteriuosis or foramen ovale

Question 3

Thermoregulation in newborns

Answer 3

Want to prevent heat loss!!
Keep them dry and covered, avoid cold surfaces and keep away from drafts

Question 4

Important liver functions

Answer 4

Maintain bg levels
Conjugate bilirubin
Necessary production for blood coagulation
Store iron and metabolism drugs

Question 5

Describe why conjugation of bilirubin is important in newborns

Answer 5

Turns yellow lipid to water soluble
Newborn liver must begin to conjugate once born or can be toxic and increased susceptibility to jaundice
Relevant in babies with high beta-D-glucuronidase

Question 6

Hyperbilirubinemia

Answer 6

Occurs after the first 24 hours of life due to large load of bilirubin; liver immaturity

Question 7

What is Breast milk jaundice

Answer 7

Is caused by a lack of sufficient intake

Question 8

late onset jaundice

Answer 8

Occurs after 3-5 days of life from breastmilk
3 weeks to 3 months to resolve

Question 9

Risk factors for elevated bilirubin

Answer 9

Excess production of erythrocytes
Short RBC life
Liver immaturity
Blood incompatibility
Preterm and late preterm infants
Lack of intestinal flora
Delayed feeding
Trauma resulting in bruising
Diabetic mother
Hypoglycemia, infection

Question 10

Stool transition

Answer 10

Progress from thick greenish black ,meconium, to loose greenish brown ,transitional stool, to milk stools
Breastfeed= frequent, seedy and mustard colored

Question 11

Meconium stool

Answer 11

passes within first 8-24 hours
Formed in utero
Thick, tarry black or dark green

Question 12

Transitional stools

Answer 12

Occurs next day or two after meconium
Part meconium part fecal matter
Thin brown to green

Question 13

Entirely fecal

Answer 13

Stools of breastfeed newborn
Pale yellow or pasty green
More liquid and frequent
Less pale then those of formula fed newborns

Question 14

Urination

Answer 14

First void should occur within 24 hours
Normal diuresis after birth causes a 5-10% weight loss since they are composed of a greater percentage of water; 75%

Question 15

Immune system and antibodies present

Answer 15

Not fully activated until some time after birth
IgG, IgM, IgA

Question 16

IgG

Answer 16

Crosses the placenta in utero and provides a newborn with passive temporary immunity

Question 17

IgM

Answer 17

Helps protect against gram-negative bacteria

Question 18

IgA

Answer 18

Does not cross the placenta and must be produced by the infant

Question 19

Visual capacity

Answer 19

Ability to be alert and follow visual stimuli
Prefers human face and eyes, high contrast objects and patterns
Uses vision to become familiar with family, friends and surroundings

Question 20

Healthcare team that works with newborn

Answer 20

Pediatrician or neonatal specialist
Nurse, lactation consultant and audiology speacialist

Question 21

Clamping the cord

Answer 21

Placed after identification of vessels
1.3-2.5 cm from abdomen, abdomen skin must not be clamped
Clamp is removed 24 hours after cord has dried

Question 22

Newborn identification and security

Answer 22

ID band on wrist and ankle, mother and partner, 4 in total
Baby is kept on side of the bed, away from window
Should be retuned to nursery when mother naps or showers if no other family member is present
ABDUCTORS OFTEN POSE AS MEDICAL PERSONNEL

Question 23

Ballard tool

Answer 23

Used to establish gestational age
Less accurate
<28 weeks >43 weeks

Question 24

What physical characteristics do you assess when establishing gestational age

Answer 24

Vernix, HAir, Skin firmness and Nails

Question 25

Telanglectatic nevi

Answer 25

"stork bite" Pink discoloration found on eyelids, between eyes or neck faded within 18 months. can be genetic

Question 26

Rooting reflex

Answer 26

Head is turned Light touch of finger on the cheek close to the mouth, the infant will turn toward the stimuli

Question 26

Rooting reflex

Answer 26

Head is turned Light touch of finger on the cheek close to the mouth, the infant will turn toward the stimuli

Question 27

Sucking reflex

Answer 27

Infant tries to suck thumb Finger or nipple is inserted into the infants mouth and will begin to suck on the object

Question 28

Moro reflex

Answer 28

Infant lies on its back with arms and legs raised When an infant is suddenly lowered after being lifted, it will straighten arms, hands and flex its knees

Question 29

What do you do if someone is Vitamin K deficient

Answer 29

Prophylactic injection is given, Prevents hemorrhage Given IM in middle third of vistas laterals muscle

Question 30

Prevention of eye infection

Answer 30

Ophthalmic ointment is given in lower sac of the eye Infection caused by gonorrhea or chlamydia exposed through birth canal

Question 31

Why is circumsison done

Answer 31

To prevent certain conditions Religious reasons Parental preference Lack of knowledge regarding care of the foreskin

Question 32

Complications for circumcision

Answer 32

Hemorrhage Infection Urinary retention Stenosis or fistula Adhesions Necrosis Injury to glans Pain during and after surgery

Question 33

Safety: Positioning

Answer 33

Newborn needs to be put on his back at night to sleep, no pillow at the head! If they are put down after they eat, position head on the side

Question 34

Swaddling baby reason

Answer 34

Helps maintain body temperature Provides feeling of safety Effective in quieting baby

Question 35

Car seat saftey

Answer 35

Should never be placed un front seat of the car with passenger side bags Should face rear of care until the baby is 2 years old

Question 36

Apgar scoring

Answer 36

Done 1-5 min after birth Scoring of 0-2 in 5 topics HR, Resp.,Muscle tone, Reflex, Skin color 0-3 total= Beverly depressed 4-6 total= moderately depressed, additional help needed ( oxygen, suctioning or stimulation 7-10=excellent condition If scored under 7 REPEAT EVERY 5 MIN FOR 20 MIN

Question 37

Nonphysiologic jaundice`

Answer 37

Begins in first 24 hours, phototherapy will be needed

Question 38

Nevus flammeus

Answer 38

Purple/red discoloration. Permenant Port wine stain

Question 39

Mongolian spots

Answer 39

now known as dermo melanocytosis Blue/purple pigment on buttocks and back, looks like bruises

Question 40

Nevus vasculosus

Answer 40

Strawberry shape mark

Question 41

Heel stick steps

Answer 41

Warm heel Cleanse with alcohol and let dry Use spring activated lancet on medial or lateral, NEVER on soles Apply pressure with dry gauze and bandage

Question 42

Medications given after delivery

Answer 42

Erythromycin or tetracycline Ophthalmic Ointment Vitamin K or Phytonadione Hepatitis B Vaccine