Newborns

Question 1

vital signs how often?

Answer 1

Vital signs are taken q 15-30 minutes for the first hour of life, then q 1 hour x 4, then q 4 hours

Question 2

apical HR

Answer 2

​is heard best on the left side of the chest between the sternum and the nipple​.

The rate is normally 120- 160, although variations can occur related to activity (example, during sleep as low as 90 or vigorous activity such as crying to 180. However, any heart rate below 100 or above 160 should be reported​. The heart rate should be counted for a period of ​one full minute​, due to normal fluctuations in rate.

Question 3

RR

Answer 3

​are shallow, rapid, irregular and abdominal in the newborn​. ​Chest and abdomen move together.​ Normal respiratory rate ​is 30-60 breaths​/ minute. Any rate above or below normal should be reported. Respiratory rate should be counted for ​one full minute​, because newborns have very irregular breathing patterns. Take respirations by observing chest or abdominal wall. Use stethoscope to determine if breath sounds are equal in both lungs. Listen to lungs both front and back

Question 4

temp

Answer 4

​. Normal axillary newborn temperature ​is 36.5 C to 37 C (97.7- 98.6).​

Question 5

eye Prophylaxis

Answer 5

ophthalmia neonatorum (blindness
resulting from a gonococcal infection in the eyes).​ Prophylaxis ​can be delayed up to two hours after birth so that it does not interfere with the bonding between parent and infant. ​Erythromycin Ophthalmic Ointment ​is one of the medications approved in California for eye prophylaxis.

Question 6

vitamin K

Answer 6

e Vitamin K, about 75% of all normal newborns have
decreased clotting factors - ​prolonged prothrombin time​.

Question 7

The prothrombin time is most prolonged at

Answer 7

3-4 days of life and continues for 2-3 additional days.

Question 8

vitamin K injections

Answer 8

Vitamin K 1.0 mg. IM is given to all newborns shortly after birth.​ It is given in the thigh as this is the largest (therefore safest) muscle in the infant’s body. ​No injections are given into the buttocks of the newborn.

Question 9

hematocrit

Answer 9

The time of ​greatest hemoconcentration is at 3-4 hours of life​. Some hospitals check the hematocrit by heelstick at 4 hours.​ The ​heel must be warmed first​. Normal value for hematocrit is 45-65 %.​ If the value does not fall WNL, a central hematocrit is obtained via venipunctur

Question 10

glucose

Answer 10

Glucose evaluation is the most common blood test done on neonates. Glucometers are usually used. ​Normal blood sugar level in the newborn is equal to or greater than 40 mg.%.​ If the value obtained is low, or if the infant shows ​symptoms of hypoglycemia (jittery, tremors, lethargy) blood is obtained by venipuncture for a more accurate blood glucose level.

Question 11

urine

Answer 11

arefully recorded, especially the first voiding. ​Report to the nurse when an infant does not void by 24 hours.​ Occasionally, red or peach-colored specks appear in the urine and are uric acid crystals. This is a normal finding, and may last for several days. This should be noted and explained to the parents. Hematuria is not normal.

Question 12

stools

Answer 12

Bowel movements for the first 2-4 days are meconium​. Meconium is present in the intestine of the fetus at birth. ​Meconium is a black, tarry, sticky, unformed stool​. After the infant has been feeding for a couple of days, he passes ​transitional stools, which are greenish-black (part meconium), green-yellow, or yellow-seedy material. The transitional stools are also unformed.

Question 13

The normal ​breast fed​ stool is

Answer 13

light yellow, loose, soft, putty-like, with an ​acid pH​, which makes it almost ​odorless​.​ The breast fed baby usually has ​very frequent stools, more than the bottle fed baby.

Question 14

The ​bottle fed ​stool is .

Answer 14

darker yellow, more formed, often containing undigested curds​. It has an alkaline pH​, and ​a stronger odor​.

Question 15

The diarrhea stool is

Answer 15

green or yellow, very watery, loose, frequent, foul smelling, and leaves a watery ring on the diaper.

Question 16

When the reflexes are present in a newborn, it affirms that​

Answer 16

this newborn has an intact nervous system. ​It is normal for term newborn infants to have immature, uncoordinated, random jerky movements.​

Question 17

warmth

Answer 17

Babies should be pink all over. They often ​have cool hands and feet, which is normal​. They
should have on at least as many layers of clothing as the adult plus one more. Check the color of their hands and feet after dressing for an indication of warmth. ​The hands and feet can be pale or even slightly blue if the infant is cold.​ On the other hand, do not over bundle. Keep away from drafts. Dress a little warmer than usual after a bath.

Question 18

feeding

Answer 18

Breastfed babies often feed every 1-3 hours.
Breast fed​ babies usually will need to eat more frequently than bottle fed babies.
Bottle fed​ babies usually need to eat every 3-4 hours​.

Question 19

With breast-fed babies, the need for food and sucking may be

Answer 19

satisfied simultaneously, however, both breast and bottle babies may need additional sucking beyond the normal feeding period. An orthodontic-type pacifier may be helpful at these times.

Question 20

sleep

Answer 20

Sleep requirements vary, but most infants benefit from periods of time each day and night when they can sleep undisturbed. Some newborns sleep as much as 18- 20 hours each day, others seem to only “catnap” during the day.