Newborn Transitioning Flashcards
Neonatal period
From birth thru first 28 days of life.
Transition to extrauterine life
First period of reactivity:
Takes how long
How long is the period of decreased responsiveness after period of reactivity?
-Reactivity lasts 30 mins
(Alert, active)
-After we have a decrease responsiveness for 30-120 mins
(Sleeps or has decreased motor activity)
Second period of reactivity
Occurs when
Last how long
S/s (3)
Occurs 2-8 hours after birth
Lasts 10min to several hours
S/s:
-tachycardia/tachypnea
-increased muscle tone and color
-meconium typically passes
New borns vitals
BP
Temp
HR (where)
RR
BP: 60-90/20-60
Temp: 97.7-99.5
HR: 110-160 (apical x1 min)
RR 30-60/min (count full minute)
Brown fat in newborns
Keeps them warm and can be metabolized to warm them up
Respiratory system
Rate
Periodic breathing
What you may hear in the first few hours
What type of breathers are babies
30-60/min
Apnea <20 secs
Fine crackles in first few hours not unusual
Nose breathers
Signs of respiratory distress
Nasal flaring
Intercostal or subcostal retractions
Grunting
Acrocyanosis (normal in first 24hrs)
Cardiac system
Delay cord clamping for how long
HR
PMI location
1 min at least
HR: 110-160
PMI apical impulse, 4th ICS LMCL
When does foramen ovale and ductus arteriosus close
Foramen ovale: 6months
Ductus arteriosus: 2-3 days
Signs of risk for cardiovascular problems
HR >160 and <80
Pallor, central cyanosis
Poor feeding
Newborn
H&H
WBC
Where we get bllod type and Rh
Iron store sufficient when
PLT
Clotting factors
H&H: higher (14-24) (44-64%)
WBC: 9k-30k (stablize around 12k)
Blood type and Rh from cord blood
Iron sufficienct by 4-5months
Plt similar to adults
Clotting: decrease bc low vit K but reach adult level 6months
Neuromuscular
Myelination does what
Seizures and tremors
Has all senses at birth except
Myelination of nerves increses first several years
Normal tremors of hypoglycemia
Seizure activity must be differentiated (work out the kinks/works) for first few days
Have all senses but vision
Newborns lose heat how
Conduction
Convection
Evaporation
Radiation
Conduction: direct contact with cooler surface
Convection: cool ambient air
Evaporation: from water
Radiation: cooler solid surface not in direct contact but in close proximity (window)
Thermogenesis is what
Non-shivering thermogenesis is what
Cold stress leads to what
Thermogenesis: increasing muscle activity (crying, restlessness)
Non-shivering: metabolism of brown fat
Cold stress leads to:
-metabolic/respiratory acidosis
Renal system newborn
Void within when
Day 1/2
Day 4
Pink-tinged uric crystal stains (brick dust) is
Wt loss from fluid shift but will return to birth wt by when
Should void within 24hrs
Day 1/2: 2-6x
Day 4: 6-8x
Pink-tinged uric crystal stain normal first week
(Uric acid is high in newborn but will pee and poo out
5-10% wt loss
By week 2 return to birth wt
GI system
Stomach grow when
Meconium pass when (how to assist)
Rectum stimulation
Yellow seedy stool indicates what
Stomach grows within days
Meconium first 24hrs (bicycle legs, massage abdomen, apply pressure)
Rectum stim: temp prob, use lube, stimulate to go to bathroom
Yellow: good gi
Hunger cues
Hand in mouth
Sucking on hand
Rooting
Tongue thrusting
Lip smacking
Crying
Hepatic system in newborn
Iron store for how long
Blood glucose
Destroys and breaks down what
Conjugation of what
Iron stores for 4-5months
Blood glucose: 40-80mg/dl <40 hypoglycemia
Destruction of RBC
Conjugation of bilirubin
Jaundice causes
(4)
Breastfed babies take longer to what
Increased destruction of RBCs
Increased unconjugated bilirubin
Inadequate calories
Decrease in bowel motility
Breastfed babies take longer to regulate gut and reduce bili levels
Jaundice appear when (does it need treatment)
After 24hrs
No tx needed usually
Immune system
Passive immunity from what (2)
Acquired immunity (2)
Passive:
Mom during pregnancy
Breast milk
Acquired:
Immunizations
Response to foreign organism or toxin
IgG from where
IgA from where
IgA prevents what
IgG from mom
IgA from breast milk
IgA prevent gut and respiratory illness
