Newborn nursery Flashcards
Capital SUCcedaneum
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
Cephalohematoma
Does NOT cross the suture line
Disappear in 2weeks - 3 months
Can lead to anemia
Epstein pearls
Keratin filled cyst in mouth
Normal fetal respiration
30-60 breathes/min
Periodic breathing
Pauses less than 20 seconds
Anything over 20 seconds is considered apnea and could be signs of SEPSIS
Why is suctioning NOT recommended?
Can cause vagal response
Why is Aquameohyton (Vit K) given?
Route?
Needle, gauge, angle?
Do you aspirate or massage?
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
Umbilical cord
How often is care?
When is cord clamp removed?
When should cord fall off?
Care: on admission and every 8 hours
Clamp: remove 24-48
Falls: 10-14 days / 2 weeks
Who would they check the cord blood?
For infants with type O blood or Rh negative mom, infants with Coombs
What are they checking the umbilical cord blood for?
Blood incompatibilities like pathological jaundice
Neonatal bilirubin on the cord blood, do heel stick CBC and reticulocyte count
What does GBS cause?
When are abx given?
Most common is RESP DISTRESS
Also sepsis, pneumonia, or meningitis
Intrapartum
What/ when is Newborn screening test?
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
What does the EVOKED OTOACOUSTIC EMISSIONS (EOAE) measure?
Sound waves generated in cochlea
What does the Auditory brain stem Response measure?
Measures EEG activity generated in response to clicks
What are you monitoring for after circumcision?
How often should you change there diaper?
Note the first void and adequacy of stream
Watch for bleeding (report)
Keep area dry and clean, change diapers every 4 hours
When does surfactant production begins?
What is surfactant?
24-28 weeks
Coating in lungs to keep alveolar from sticking
When do fetal breathing movements begin?
What are these essential fall?
17-20weeks
Chest wall muscles and diaphragm
What are the two significant changes tha must occur after delivery for sufficient breathing?
Pulmonary ventilation
Increased pulmonary circulation
Factors that stimulate infant breathing:
What happens in MECHANICAL EVENTS?
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
What establishes Functional Residual Capacity (FRC) in eh MECHANICAL EVENTS of breathing?
High Intrathoracic pressure
What is the Chemical stimuli in the initiation of breathing?
Prostaglandin
What does the ductus venosus do?
Increases arterial pressure due to mechanical pressure from severing of cord
Why are babies usually anemic after birth and for how long?
Erythropoietin does not restart until 2-3 months of life
Hgb declines first 2-3 months
What is the most important way for temperature regulation?
Evaporation
What should be neutral thermal environment?
89.6- 93
What is chemical thermogenesis “non shivering thermogenesis”?
Stimulation of sympathetic nervous system when skin perceives cold
What are the babies methods of thermogenesis?
Increased BMR
Muscle activity
Chemical thermogenesis “Brown fat”
What is the newborn liver function?
Iron storage and RBC production
Carbohydrate metabolism
Conjugation of bilirubin
Coagulation
How long does infant have iron stored from mom, before they need foods containing iron?
5-6 months supply is stored in liver, after that they will need iron fortified foods
What is the main source of energy at birth and for how long?
Glucose ; 4-6hours
When glucose decreases the newborn changes to fat metabolism (of brown fats)
When does bilirubin peak?
3-5 days
When does Physiologic jaundice occur and last till?
During the first week bilirubin should not get higher than?
AFTER the first 24 hours
LAST 3-5 days
13-15mg
When does Pathologic Jaundice occur and how long does it last?
WITHIN first 24 hours of life
PERSISTENT VISIBLE JAUNDICEafter 1 week in term infants and 2 weeks in preterm
Explain IgG
How it’s transferred?
Only immunoglobulin to cross placenta
Transferred during 3rd trimester
PASSIVE ACQUIRED IMMUNITY
Explain IgA
Protects SECRETING SURFACES on Resp, intestinal, eye
Colostrum in breast milk provides PASSIVE IMMUNITY
4 weeks newborn produces IgA in intestine
What is habituation?
Ability to ignore repetitious disturbing stimuli
Can alter response to repeated stimuli
How do babies see best ?
Near sighted, 8-15 inches
When should gestational age “Ballard scale” be done and what components are done?
Most accurate 24 hours after birth, not later than 4 hours ( gestational age decreases
Components:
Physical characteristics
Neurological/ neuromuscular development
When is the gestational age assessment most accurate?
28- 43 weeks gestation
