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NU314 OB > Nursing Management of Newborn > Flashcards

Nursing Management of Newborn Flashcards

1
Q

Signs that Indicate a Problem

A
  • Nasal flaring, chest retraction
  • Grunting, labored breathing
  • Generalized cyanosis, flaccid body posture
  • Abnormal breathing/respiratory rates
  • Abnormal HR/newborn size
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2
Q

Initial Newborn Assessment

A
  • APGAR score
  • Length/weight, vital signs
  • Gestational age assessment
  • Physical maturity
  • Neuromuscular maturity
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3
Q

Apgar Score

A

used to evaluate a newborn’s physical condition at 1 and 5 minutes after birth

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4
Q

When may an additional Apgar score be done?

A

At 10 minutes if the 5 minute score is less than 7 points

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5
Q

What are the 5 parameters of the Apgar score?

A 
A-appearance 
P-pulse 
G-grimace 
A-activity 
R-respiratory
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6
Q

A

A

appearance; color

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7
Q

P

A

pulse; heart rates

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8
Q

G

A

grimace; reflex irritability

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9
Q

A

A

activity; muscle tone

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10
Q

R

A

respiratory; respiratory effort

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11
Q

How is the newborn HR obtained?

A

taking an apical pulse for 1 minute

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12
Q

When are newborn respirations counted?

A

when they are quiet and sleeping

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13
Q

What tool is typically used to establish gestational age?

A

Ballard Scale

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14
Q

What physical maturity areas are assessed for the Ballard Scale?

A 
Skin texture
Lanugo 
Plantar creases 
Breast tissue 
Eyes and ears
Genitals
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15
Q

What are the 6 maneuvers the newborn must perform to establish neuromuscular maturity with the Ballard Scale?

A 
Posture
Square window 
Arm recoil 
Popliteal angle
Scarf sign 
Heel to ear
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16
Q

Preterm/premature

A

born prior to 37 weeks gestation

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17
Q

Term

A

born between 38 and 42 weeks

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18
Q

Postterm/postdates

A

born after 42 weeks

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19
Q

Postmature

A

born after 42 weeks and demonstrating signs of placental aging

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20
Q

SGA

A

small for gestational age

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21
Q

LGA

A

large for gestational age

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22
Q

AGA

A

appropriate for gestational age

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23
Q

Immediate Newborn Period Nursing Interventions

A

Maintaining airway patency
Ensuring proper identification
Administering prescribed meds
Maintaining thermoregulation

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24
Q

What is the order of suctioning for newborns?

A

mouth then nose

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25
Q

During the immediate newborn period what 2 drugs are commonly ordered?

A

Vitamin K and erythromycin

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26
Q

What will Vitamin K do for the newborns?

A

promote blood clotting

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27
Q

What can happen if their is a vitamin K deficiency?

A

hemorrhage

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28
Q

Why is eye prophylaxis medication mandatory for all newborns in the US?

A

to prevent ophthalmia neonatorum

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29
Q

What is caused by Ophthalmia Neonatorum?

A

neonatal blindness

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30
Q

How often should the newborns temp be taken for the first 2 hours?

A

q 30 minutes

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31
Q

Nursing interventions to promote Thermoregulation

A
  • dry newborn immediately after birth
  • wrap in warmed blankets
  • skin to skin w/ mom ASAP
  • use warmed cover on scale
  • warm stethoscope and hands before exam
  • delay initial bath until temp is stable
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32
Q

When should a physical exam not be started on the newborn?

A

when the newborn is crying or appears to be upset

33
Q

When is the initial newborn physical exam performed?

A

within 24 hours after brith

34
Q

Anthropometric Measurements

A

length, weight, head circumference, chest circumference

35
Q

What is the average length of most newborns?

A

50 cm = 20 inches

36
Q

What is the baby’s weight affected by?

A 
racial origin
genetics
maternal age
size of the parents
maternal nutrition
placental perfusion
37
Q

What is the average newborn head circumference?

A

32-38 cm/13-15 inches

38
Q

Average newborn chest circumference

A

30-36 cm/12-14 inches

39
Q

Skin Assessment

A

color, texture, turgor, integrity

40
Q

Acrocyanosis

A

persistent cyanosis of fingers, hands, toes, and feet w/ mottled blue or red discoloration and coldness

41
Q

What are some common skin variations?

A 
vernix caeosa 
stork bites
milia
Mongolian spots
erythema toxicum 
harlequin sign 
nevus flammeus 
nevus vasculosus
42
Q

Vernix Caeosa

A

thick white substance that protects the skin of the fetus

43
Q

Stork Bites

A

superficial vascular areas found on the nape of the neck, eyelids, between the eyes and and upper lip

44
Q

Milia

A

multiple pearly-white or pale yellow unopened sebaceous glands frequently found on newborns nose

45
Q

What is milia called when it is found in the newborn’s mouth and gums?

A

Epstein pearls

46
Q

Mongolian Spots

A

benign blue or purple splotches that appear on the lower back and buttocks
-may occur as multiples on legs/shoulders

47
Q

Erythema Toxicum

A

“newborn rash”

benign, idiopathic, generalized, transient rash; small papules/pustules

48
Q

Harlequin Sign

A

dilation of blood vessels on only one side of the body giving the newborn the appearance of wearing a clown suit

49
Q

Nevus Flammeus

A

port-wine stain

50
Q

Nevus Vasculosus

A

strawberry mark/hemangioma

51
Q

Head Assessment

A

size
fontanels
variations in size/appearance
abnormalities

52
Q

What are considered common variations of the newborn head size/appearance?

A

Caput succedaneum
Molding
Cephalhematoma

53
Q

Molding

A

elongated shaping of fetal head to accommodate passage through birth canal

54
Q

What are Abnormalities to watch for in the newborn head?

A

Microcephaly
Macrocephaly
Large fontanels
Small or Closed fontanels

55
Q

Face Assessment

A

nose, mouth, eyes, and ears

56
Q

Neurologic Status Assessment

A

Alertness
Posture
Muscle tone
Reflexes

57
Q

What will general newborn care involve?

A 
Bathing/hygiene 
Diaper care
Cord Care
Circumcision care
environmental safety measures 
prevention of infection
58
Q

What are the traditional reasons for why nurses bathe the newborn?

A
  • physical assessment
  • reduce effect of hypothermia
  • allow mom to rest
59
Q

How should the newborn sleep?

A

on their back

60
Q

What are the typical newborn screens?

A

PKU
Congenital hypothyroidism
Galactosemia
Sickle cell anemia

61
Q

PKU

A

autosomal recessive inherited deficiency in one of the enzymes necessary for metabolism of phenylanine to tyrasine

62
Q

Congenital Hypothyroidism Screen

A

deficiency of thyroid hormone necessary for normal brain growth, calorie metabolism, and development

63
Q

Galactosemia Screen

A

absence of the enzyme needed for conversion of the milk sugar galactose to glucose

64
Q

Sickle Cell Anemia Screen

A

recessively inherited abnormality in hemoglobin structure

65
Q

What is the most common birth disorder in the US?

A

hearing loss

66
Q

What are the common concerns during newborn transition?

A

Transient tachypnea
Jaundice
Hypoglycemia

67
Q

When does transient tachypnea occur in newborns?

A

the fetal liquid in the lungs is removed slowly or incompletely

68
Q

What is used to relieve transient tachypnea?

A

low dose oxygen therapy

69
Q

Nursing Interventions for Transient Tachypnea

A

Provide oxygen
Ensuring warmth
Observing respiratory status frequently
Allowing time for pulmonary capillaries and the lymphatics to remove remaining fluid

70
Q

What will be seen with physiologic jaundice?

A

yellow skin, mucous membranes, and sclera w/in the first 3 days of life

71
Q

Hypoglycemia

A

BG level < 30 mg/dL or a plasma concentration of < 40 mg/dL in the first 72 hours of life

72
Q

S/S of hypoglycemia

A 
Mostly asymptomatic 
jitteriness 
lethargy
cyanosis 
apnea
seizures 
high-pitched/weak cry 
hypothermia 
poor feeding
73
Q

Treatment of Hypoglycemia

A

Administration of rapid acting source of glucose such as sugar/water mix or early formula feeding

74
Q

What does the newborn’s caloric needs range from?

A

110-120 cal/kg of body weight

75
Q

Fluid requirements for newborns

A

100-150 mL/kg daily

76
Q

What should be done before feeding the newborn?

A
  • determine ability to suck/swallow
  • clear any mucous
  • auscultate bowel sounds/check for abdominal distention
  • inspect anus for patency
77
Q

How often are mothers encouraged to feed their newborns at home?

A

q 2-4 hours

78
Q

LATCH Method

A 
L- how well infant latches
A- amount of audible swallowing
T- nipple type
C- level of comfort
H- amount of help mom needs

NU314 OB (21 decks)

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