Newborn nursery Flashcards

0
Q

Capital SUCcedaneum

A

Cause: From the sustained pressure of long,difficult labor or vacuum extraction causes slow venous return
Def: soft fluid-filled area on scalp
CROSSES THE SUTURE LINE

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1
Q

Cephalohematoma

A

Does NOT cross the suture line
Disappear in 2weeks - 3 months
Can lead to anemia

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2
Q

Epstein pearls

A

Keratin filled cyst in mouth

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3
Q

Normal fetal respiration

A

30-60 breathes/min

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4
Q

Periodic breathing

A

Pauses less than 20 seconds

Anything over 20 seconds is considered apnea and could be signs of SEPSIS

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5
Q

Why is suctioning NOT recommended?

A

Can cause vagal response

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6
Q

Why is Aquameohyton (Vit K) given?
Route?
Needle, gauge, angle?
Do you aspirate or massage?

A

To prevent hemorrhage, since Vit K is produced in the intestines but needs a food source to activate it

IM (Bunch tissue of upper outer thigh VASTUS LATERALIS )
Not given in rectus femoras be it is immature

5/8 inch needle, 25 gauge at 90 degree angle
Aspirate, then gently massage the site with alcohol swab

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7
Q

Umbilical cord
How often is care?
When is cord clamp removed?
When should cord fall off?

A

Care: on admission and every 8 hours
Clamp: remove 24-48
Falls: 10-14 days / 2 weeks

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8
Q

Who would they check the cord blood?

A

For infants with type O blood or Rh negative mom, infants with Coombs

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9
Q

What are they checking the umbilical cord blood for?

A

Blood incompatibilities like pathological jaundice

Neonatal bilirubin on the cord blood, do heel stick CBC and reticulocyte count

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10
Q

What does GBS cause?

When are abx given?

A

Most common is RESP DISTRESS
Also sepsis, pneumonia, or meningitis
Intrapartum

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11
Q

What/ when is Newborn screening test?

A

Drops of blood collected on paper to test for things like cystic fibrosis.
Heel stick or venipuncture 24hours AFTER FEEDINGS INITIATED and repeated in 2 WEEKS

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12
Q

What does the EVOKED OTOACOUSTIC EMISSIONS (EOAE) measure?

A

Sound waves generated in cochlea

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13
Q

What does the Auditory brain stem Response measure?

A

Measures EEG activity generated in response to clicks

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14
Q

What are you monitoring for after circumcision?

How often should you change there diaper?

A

Note the first void and adequacy of stream
Watch for bleeding (report)

Keep area dry and clean, change diapers every 4 hours

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15
Q

When does surfactant production begins?

What is surfactant?

A

24-28 weeks

Coating in lungs to keep alveolar from sticking

16
Q

When do fetal breathing movements begin?

What are these essential fall?

A

17-20weeks

Chest wall muscles and diaphragm

17
Q

What are the two significant changes tha must occur after delivery for sufficient breathing?

A

Pulmonary ventilation

Increased pulmonary circulation

18
Q

Factors that stimulate infant breathing:

What happens in MECHANICAL EVENTS?

A

Vaginal birth: increasing thoracic pressure causes SQUEEZING fluid out of lungs
At Delivery: chest wall recoils, creating NEGATIVE pressure thought to produce small passive inspiration of air
After First Inspiration: exhales against a partially closed glottis, creating POSITIVE pressure

19
Q

What establishes Functional Residual Capacity (FRC) in eh MECHANICAL EVENTS of breathing?

A

High Intrathoracic pressure

20
Q

What is the Chemical stimuli in the initiation of breathing?

A

Prostaglandin

21
Q

What does the ductus venosus do?

A

Increases arterial pressure due to mechanical pressure from severing of cord

22
Q

Why are babies usually anemic after birth and for how long?

A

Erythropoietin does not restart until 2-3 months of life

Hgb declines first 2-3 months

23
Q

What is the most important way for temperature regulation?

A

Evaporation

24
Q

What should be neutral thermal environment?

A

89.6- 93

25
Q

What is chemical thermogenesis “non shivering thermogenesis”?

A

Stimulation of sympathetic nervous system when skin perceives cold

26
Q

What are the babies methods of thermogenesis?

A

Increased BMR
Muscle activity
Chemical thermogenesis “Brown fat”

27
Q

What is the newborn liver function?

A

Iron storage and RBC production
Carbohydrate metabolism
Conjugation of bilirubin
Coagulation

28
Q

How long does infant have iron stored from mom, before they need foods containing iron?

A

5-6 months supply is stored in liver, after that they will need iron fortified foods

29
Q

What is the main source of energy at birth and for how long?

A

Glucose ; 4-6hours

When glucose decreases the newborn changes to fat metabolism (of brown fats)

30
Q

When does bilirubin peak?

A

3-5 days

31
Q

When does Physiologic jaundice occur and last till?

During the first week bilirubin should not get higher than?

A

AFTER the first 24 hours
LAST 3-5 days
13-15mg

32
Q

When does Pathologic Jaundice occur and how long does it last?

A

WITHIN first 24 hours of life

PERSISTENT VISIBLE JAUNDICEafter 1 week in term infants and 2 weeks in preterm

33
Q

Explain IgG

How it’s transferred?

A

Only immunoglobulin to cross placenta
Transferred during 3rd trimester
PASSIVE ACQUIRED IMMUNITY

34
Q

Explain IgA

A

Protects SECRETING SURFACES on Resp, intestinal, eye
Colostrum in breast milk provides PASSIVE IMMUNITY
4 weeks newborn produces IgA in intestine

35
Q

What is habituation?

A

Ability to ignore repetitious disturbing stimuli

Can alter response to repeated stimuli

36
Q

How do babies see best ?

A

Near sighted, 8-15 inches

37
Q

When should gestational age “Ballard scale” be done and what components are done?

A

Most accurate 24 hours after birth, not later than 4 hours ( gestational age decreases
Components:
Physical characteristics
Neurological/ neuromuscular development

38
Q

When is the gestational age assessment most accurate?

A

28- 43 weeks gestation