Newborns quiz Flashcards
4 methods of heat loss
conduction, convection, radiation and evaporation
conduction
(3%): transfer from 1 object to another when the 2 objects in direct contact.
Newborn’s skin touches a cold surface, causing body heat to transfer to the colder object.
RN measures:
Pre-warm surfaces that the baby comes into contact with: warming crib sheets, heated mattresses/radiant warmers.
Skin-to-skin
convection (convict the draft)
(34%): heat loss d/t air currents/drafts
Cold air blows over the body of the infant = cooling the infant (open doors, windows, A/C, fan blowing when mom holding baby).
RN measures: maintain a warm & draft-free environment.
Maintain a warm & draft-free environment: clothes & blankets.
Avoid placing cribs near open windows/air vents.
Use incubators/isolettes to create a controlled microclimate to reduce exposure to the cool air.
evaporation
RN measures:
Dry the baby promptly after birth/bathing to prevent evaporative heat loss.
Keep the baby’s head covered to prevent heat loss through the scalp.
Promptly changing wet linens, clothes, or diapers.
S/Sx of hypothermia in the infant: (just 2)
cyanosis & tachypnea
radiation
Radiation (39%): cold objects close to, but not touching, the newborn. (Window open near baby).
RN measures:
Keep the baby away from the cold walls, windows, & other cold surfaces.
Ensure that the baby is not exposed to drafts/cold air.
transient circulatory channels of fetal circulation (vow to be transient)
Ductus Venosus, Ductus Arteriosus:, Foramen Ovale
Ductus Venosus: (veins in my liver are inferior)
Location: liver – connecting umbilical vein to inferior vena cava
Function: ductus venosus allows oxygenated blood from placenta to bypass the fetal liver & flow directly into the inferior vena cava to ensure that O2-rich blood is delivered to the heart & rest of the fetal body.
Ductus Arteriosus: (Art pulls to art for the system)
Location: blood vessel connecting the pulmonary artery (carrying blood from the RT ventricle to the lungs) to the aorta (which carries blood to the systemic circulation).
Function: allows some of the blood that is pumped from the RT ventricle to bypass the nonfunctioning fetal lungs & flow directly into the systemic circulation. This helps ensure a greater supply of oxygenated blood to the rest of the fetal body.
Foramen Ovale: (oval lungs)
Location: btw. RT & LF atrium (upper chambers) of heart
Function: shunt allowing oxygenated blood from RT atrium to pass directly into the LF atrium, bypassing the nonfunctional fetal lungs, ensuring that a greater portion of O2-rich blood is distributed to the systemic circulation.
Jaundice (Keri has jaundice)
assess the level of bilirubin in the blood, baby’s age, & other factors to determine whether jaundice is physiologic/pathological. Early ID & appropriate mgmt. are essential to prevent complications associated w/severe jaundice, such as kernicterus (rare but serious neurological condition).
jaundice - parents
Parents: regular medical checkups & monitoring are essential to ensure baby’s health & well-being.
Pathological Jaundice - when (pathology is not normal)
Pathological Jaundice (Early-Onset; < 24 hrs): req. med. eval. to determine underlying cause.
When: w/in 1st 24hrs of life or is persistent beyond the 1st wk; when total bilirubin levels increase >
Jaundice - treatment - hemolytic - feeding - how often? (normal)
when there is increased bkdn of RBCs, leading to elevated bilirubin levels.
Encourage early initiation of feeding:
Provides proteins to maintain the albumin levels to transport bilirubin to liver & prevents hypoglycemia.
Feed q 2-3 hrs to promote emptying of bilirubin from the bowel.
BF 8-12 x/day prevents inadequate intake & dehydration.
jaundice - liver - what conditions cause it (the worst one)
conditions affecting the liver, such as: infections (sepsis), metabolic disorders, congenital liver diseases, can result in pathological jaundice.
Meds, supportive care, & live transplant (severe).
Physiologic Jaundice (Late; > 24 hrs):
Physiologic Jaundice (Late; > 24 hrs): most common; normal hyperbilirubinemia seen in newborns. A normal response to the bkdn of excess RBCs & the immature liver’s ability to process bilirubin efficiently.
jaundice - meconium
Note: newborn w/delayed passage of meconium – more likely to develop physiologic jaundice (normal jaundice)
Fetal Alcohol Effects (FAE) (fay is less severe)
Fetal Alcohol Effects (FAE): result of moderate drinking through pregnancy
Milder range of effects seen in children who were exposed to alcohol in utero but do not meet all the criteria for a diagnosis of FAS.
Cognitive & behavioral impairments: less severe.
FAS - fetal alcohol syndrome
Fetal Alcohol Syndrome (FAS): result of high doses of alcohol consumption during pregnancy, such as binge drinking &/or drinking on a regular on a regular basis.
FAS - more serious problems (just mental)
Most Serious Problems:
Lifelong: cognitive, behavioral, & developmental challenges
Disabilities: learning, intellectual, attention, memory
Impulsivity, poor judgment, & difficulty w/social interactions
alcohol
There is no known safe amount of alcohol consumption during pregnancy. It is recommended that pregnant individuals avoid alcohol entirely to prevent the risk of FAS. Even small amounts of alcohol can potentially harm the developing fetus. Alcohol crosses the placenta & can interfere w/fetal development, causing a range of physical & neurological impairments.
diabetic mother - 1st 2 hours (just bonding)
1st 2 hrs: ensure smooth transition to the outside world & promote bonding btw newborn & parents. Promoting bonding during this time involves encouraging skin-to-skin contact, allowing parents to hold & interact w/their newborn, supporting BF, & providing a calm & nurturing environment. RNs ensure that the initial hrs of a newborn’s life are safe, comforting, & conducive to bonding btw the newborn & their parents.
diabetic mother - assessment (and what is always done?) (gestational diabetes)
HR, RR, temp, skin color, muscle tone, & reflexes
Evaluate gestational age: Ballard or other appropriate methods.
Administer Vit. K injection to prevent bleeding disorders
diabetic mother - VS for baby - which ones? (just 4)
HR, RR, O2
Assess temp & provide warm environment to prevent hypothermia.
diabetic mother - meds (same as all babies)
Administer erythromycin/tetracycline eye ointment to prevent eye infection.
IM injection of Phytonadione (Vit. K) to produce adequate clotting factors.
Perform cord clamping & cutting, while assessing for signs of nuchal cord/other abnormalities.
APGAR - 1 min
1 min: provides data about the newborn’s initial adaptation to extrauterine life.
APGAR rating (3 is a severe number)
Rating/Points: higher the score indicates the better condition of the newborn.
0: absent/poor response
1: slow, irregular, limited
2: normal, complete response
Normal: 8-10 – no intervention needed other than supporting normal resp efforts & maintaining thermoregulation
Moderate difficult: 4-7
Severe distress: 0-3
Problem List for an Infant of a Diabetic Mother (not what you’d think)
Risk of:
Hypoglycemia
Macrosomia (large birth weight)
Respiratory distress syndrome
Hypocalcemia
Jaundice
Congenital anomalies
Appropriate Care for an Infant of a Diabetic Mother: (don’t forget what)
Monitoring BG levels regularly
Frequent feeding to prevent hypoglycemia.
Early glucose monitoring after birth
Close monitoring after birth
Close monitoring of respiratory status
Monitoring Ca+ levels & providing supplementation, if necessary.
Monitoring bilirubin levels for jaundice
Comprehensive medical examination to detect any congenital anomalies.
Intervention for Hypoglycemia - monitor what?
Early & frequent BF/formula feeding.
IV glucose infusion if BG levels are critically low.
Monitoring BG levels & adjusting feeding freq, as needed.
Close monitoring of s/sx of hypoglycemia (jitteriness, lethargy, poor feeding)
Ensuring the infant receives adequate nutrition & glucose through feeds.
Consulting w/pediatrician or neonatologist for further mgmt if hypoglycemia persists/worsens.
circumcision - pros (pros same as women)
Reduced Risk of UTI: circumcision may lower the risk of UTI infections in infancy
Decreased Risk of Certain STI: circumcision has been associated w/a reduced risk of contracting certain sexually transmitted infections like HIV & HPV.
Potential Decrease in Penile CX Risk: some studies suggest a reduced risk of penile cx among circumcised individuals, although this type of cx is rare overall.
Easier Genital Hygiene: circumcision
circumcision - cons
Pain & Discomfort: circumcision involves a surgical procedure that cause pain & discomfort to the infant.
Risk of Complications: complications can arise from the circumcision procedure, such as: bleeding, infection, or improper healing.
Decreased Sensitivity: some argue that circumcision may lead to decreased sensitivity & sexual pleasure d/t removal of the foreskin.
Lack of Medical Necessity: in many cases, circumcision is not medically necessary & is considered an elective procedure.
Ethical Concerns: some people raise ethical concerns about performing a non-consensual surgical procedure on an infant who cannot provide informed consent.
Cultural/Religious Objections: some individual/groups may oppose circumcision d/t cultural, ethical, or religious reasons.
Respiratory Distress Syndrome (RDS): (RDS is a fact)
hyaline membrane disease, a common breathing disorder that primarily affects premature infants’ d/t underdeveloped lungs & a lack of surfactant, a substance that helps keep the alveoli (tiny air sacs in the lungs) open during breathing.