Newborn (Part 1) - Unit 4 Flashcards
What are some responsibilities at delivery?
Dry & stimulate the baby, provide resuscitation if necessary, assign APGAR, assessment, administer meds, check glucose.
What are some important parts of the history to know at delivery?
Maternal age, gravida/para, infections, labor history, fetal minotoring, ROM, medications, lab work
Should the infant go right on the mom’s chest after birth?
YES
APGAR - Heart rate - 0, 1, 2
0 = Absent 1 = Below 100 2 = 100 or higher.
APGAR - Respiratory Effort - 0, 1, 2
0 = No spontaneous respirations 1 = slow or weak respirations 2 = Strong, lusty cry.
APGAR - Muscle Tone - 0, 1, 2
0 = Limp 1 = Minimal flexion 2 = Flexed posture
APGAR - Reflex Response - 0, 1, 2
0 = No response 1 = Minimal response 2 = prompt response
APGAR - Color - 0, 1, 2
0 = pallor or cyanois 1 = Bluish hand and feet 2 = pink
APGAR scores are assigned at one and five minutes of age, or ever 5 minutes until a score of 7 or higher is achieved. T/F?
TRUE
What are some of the general assessment things we do on the baby after it’s born?
Weight, measurements, bands, vital signs ever 30 minutes for 2 hours.
What are some meds that are given to the baby right after birth? They need to be given within ____ hour of delivery.
When is the Hep B vaccine given?
Erythromycin eye ointment, Vitamin K.
One hour.
Vaccine is given later, unless mom is HBsAG+ - then within 12 hours!
When is the blood sugar checked? What do we want it above?
Within 1st 1/2 hour and then 1/2 hour later - we want it above 40.
What are some risk factors for hypoglycemia?
Maternal history of diabetes and terbutaline, preterm/post term, “late preterm infant”, IUGR, LGA or SGA, Asphyxia, problems at birth, cold stress.
what are some signs of hypoglycemia?
Jitteriness and tremors, poor muscle tone, diaphoresis, poor suck, tachypnea, tachycardia, dyspnea, grunting, cyanosis, apnea, low temp, high pitched cry, irritability, lethargy, seizure/coma :(
What is the purpose of the gestational age exam?
Determines gestational age.
Preemie - will they have sticky or soft skin? Lanugo?
They will have sticky skin and lanugo.
Preemies - are they very straight?
Yes
What’s the scarf sign?
When you can almost wrap the preemies arm around them like a scarf.
What is caput succedaneum? When does it go away?
A bulge on the head that crosses the suture line. Goes away within a few days.
What is cephalematoma? When does it go away?
A bulge that doesn’t cross the suture line. Goes away at a slower pace.
What is the moro reflex?
Startle reflex - pull the hand and they startle.
What is the root/suck reflex? Tonic neck?
Root/suck = stroke their cheek and they move and start sucking.
Tonic looks like fencing!
Hearing - starts at __ to __ weeks gestation.
Sight = __ to __ inches away.
23-24 weeks.
8-12 inches.
Should we assess all the skin on da baby?
YES
Mongolian spots - look like what?
Bruising.
Milia - pick them. T/F?
FALSE
Strawberry hemangioma - fall off and disappear on their own. T/F?
FALSE - they have to be removed in order to disappear.
What causes the first breath (Internal Stimuli)?
Decreased PO2, increased Pc02, decreased pH that affects the chemoreceptors —-> message is transmitted to repsiratory center in the medulla —-> diapgrahm is stimulated to contract —> infant draws first breath.
What causes the first breath (external stimuli?)
Cold air and touch stimulate skin sensors — > impulses from skin sensors and responses to sound and light affect respiratory center —> infant draws first breath —> chest compression and release during birth causes air to be drawn into lungs.
What’s the normal RR for a bambino? What is apnea?
30-60 RPM. Apnea is defined as 20 seconds without a breath.
If the baby gets too hot, what happens to their breathing? Too cold?
Warm = panting. Cold = conserve energy.
Is grunting a good thing?
NO - it may sound cute, but it is NOT
What is the normal pulse rate? What is bradycardia defined as?
120-160 - bradycardia is defined as less than 80 BPM.
What’s the normal BP?
Systolic = 65-95 Diastolic = 30-60
Weak femoral pulse = what?
Might have pressure issues.
MAP - should be equal or great then what?
Gestational age.
What should the temp be? What’s the preferred method for measuring it?
97-99.
Axillary.
Bowel sounds occur within __ hour of birth.
1 hr
Gut is sterile prior to birth - but changes a few days after birth. T/F?
TRUE
Abdomen should be soft & rounded but not distended. T/F?
TRUE
Stools should occur within 24 hours of birth. T/F?
TRUE
meconium - sticky and tar like.
Transition - light green.
then depends on what is being eaten.
T/F?
TRUE
What is hypospadius?
Opening of pee pee is on the underside.
What is epispadias?
Opening of the pee pee is on the top.
What is cryptorchidism?
Undescended testy.
What is phimosis?
Tightening of the foreskin.
What is a hydrocele?
Fluid filled sac - typically goes away on their own.
Is it normal for girls to have some mucus and discharge after birth?
YES - parents worry but still.
Babies should void within 12-24 hours. T/F?
TRUE
1-2 voids a day for first 2 days is common, then 6 a day. T/F?
TRUE
For a circumcision, there shouldn’t be a dripping/discharge but a yellow crust is okay. Although, it heals within 10 days. T/F?
TRUE
