Newborn Care- EXAM 2 Flashcards

1
Q

Normal Vital Signs of a Newborn
Respirations
Apical Pulse
BP
Temp

A

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

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2
Q

Murmurs

A

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

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3
Q

Thermoregulation in newborns

A

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

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4
Q

Important liver functions

A

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

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5
Q

Describe why conjugation of bilirubin is important in newborns

A

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

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6
Q

Hyperbilirubinemia

A

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

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7
Q

What is Breast milk jaundice

A

Is caused by a lack of sufficient intake

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8
Q

late onset jaundice

A

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

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9
Q

Risk factors for elevated bilirubin

A

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

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10
Q

Stool transition

A

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

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11
Q

Meconium stool

A

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

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12
Q

Transitional stools

A

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

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13
Q

Entirely fecal

A

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

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14
Q

Urination

A

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%

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15
Q

Immune system and antibodies present

A

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

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16
Q

IgG

A

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

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17
Q

IgM

A

Helps protect against gram-negative bacteria

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18
Q

IgA

A

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

19
Q

Visual capacity

A

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

20
Q

Healthcare team that works with newborn

A

Pediatrician or neonatal specialist
Nurse, lactation consultant and audiology speacialist

21
Q

Clamping the cord

A

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

22
Q

Newborn identification and security

A

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

23
Q

Ballard tool

A

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

24
Q

What physical characteristics do you assess when establishing gestational age

A

Vernix, HAir, Skin firmness and Nails

25
Q

Telanglectatic nevi

A

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

26
Q

Rooting reflex

A

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

26
Q

Rooting reflex

A

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

27
Q

Sucking reflex

A

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

28
Q

Moro reflex

A

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

29
Q

What do you do if someone is Vitamin K deficient

A

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

30
Q

Prevention of eye infection

A

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

31
Q

Why is circumsison done

A

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

32
Q

Complications for circumcision

A

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

33
Q

Safety: Positioning

A

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

34
Q

Swaddling baby reason

A

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

35
Q

Car seat saftey

A

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

36
Q

Apgar scoring

A

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

37
Q

Nonphysiologic jaundice`

A

Begins in first 24 hours, phototherapy will be needed

38
Q

Nevus flammeus

A

Purple/red discoloration. Permenant
Port wine stain

39
Q

Mongolian spots

A

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

40
Q

Nevus vasculosus

A

Strawberry shape mark

41
Q

Heel stick steps

A

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

42
Q

Medications given after delivery

A

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