newborn- week 6

Question 1

APGAR scoring

Answer 1

A = appearance (colour)
P = pulse (heart rate)
G = grimace (reflex irritability)
A = activity (muscle tone)
R = respiratory (respiratory effort)

Question 2

Gestational Age Variations

Answer 2

Full-term (term)
Born from the first day of the 38th week through 42 weeks
Preterm
Born before completion of 37 weeks
Late preterm
Born between 34 0/7 and 36 6/7 weeks
Postterm
Born beyond 42 completed weeks

Question 3

Behavioural Patterns of Newborns

Answer 3

First period of reactivity
Birth to 30 minutes
Newborn is alert, moving, may appear hungry
Period of decreased responsiveness
30 to 120 minutes old
Period of sleep or decreased activity
Second period of reactivity
2 to 8 hours
Newborn awakens and shows an interest in stimuli

Question 4

Newborn assessment

Answer 4

Pre-Assessment
Pregnancy-Birth events

Vitals- Heart rate, Resp rate, Temp
O2 sats

Head to toe- Color, Muscle tone, gestational maturity,
Congenital Anomalies, Birth Injuries, Reflexes,

Behaviour
Normal-hiccups, Variance-jittery,

feeding and elimination

Question 5

resp system adaptations

Answer 5

Initiation of respirations: adjusting from a fluid-filled intrauterine environment to gaseous extrauterine environment
Role of surfactant: surface tension–reducing lipoprotein that prevents alveolar collapse
Respirations: 30 to 60 breaths per minute; irregular, shallow, unlaboured; short periods of apnea (<15 seconds); symmetrical chest movements
Oxygen saturation levels: 97-100%

Question 6

vital sign assessment

Answer 6

Take Heart rate for 1 MIN with Stethoscope
On 4th intercostal space; left of mid-clavicular line
Range: 100 -160 bpm with good variability
Respirations: 30 to 60 per minute – observation of chest & abdomen, breath sounds, using stethoscope
Temperature: 36.5 to 37.5 – peds axilla setting
Check respirations first, then heart rate and then temp (to cause least disturbance in newborn)

Question 7

Signs indicating Respiratory Distress

Answer 7

Tachypnea
Nasal flaring
Inspiratory stridor
Grunting on exhalation
Intercostal or subcostal indrawing
Suprasternal tug or in-drawing
Substernal indrawing
Laboured breathing/Increased work of breathing
Abnormal breath sounds/Absence of breath sounds
Generalized cyanosis, flaccid body posture
Pallor & decreased capillary refill time
O2 sats less than 88%

Question 8

renal system changes

Answer 8

Limited ability to concentrate urine until about 3 months of age (urine has a low specific gravity)
Six to eight voidings per day considered normal
Low glomerular filtration rate and limited excretion and conservation capability
Affect newborn’s ability to excrete salt, water loads, and drugs