OB Class 4

Question 0

sufficient surfactant is produced at….. and is used for…..

Answer 0

produced at 24-26weeks

used to keep alveoli open

Question 1

why is the infant’s first breath at birth important

Answer 1

it must force the remaining fetal lung fluid out of the alveoli and into the interstitial spaces to allow air to enter the lungs

Question 2

as the infant cries, the pressure w/in the lungs increases causing remaining fetal lung fluid to move into the interstitial spaces where it is absorbed by …. and ….. within 24hrs

Answer 2

absorbed by pulmonary circulatory and lymphatic systems

***within 24hrs

Question 3

chemical factors that initiate breathing

Answer 3

chemoreceptors in the carotid arteries ad aorta sense a decreases in oxygen and increase in carbon dioxide lead to breathing

Question 4

mechanical mechanism in initiating breathing

Answer 4

during vaginal birth the fetal chest is compressed by the birth canal leading to a recoil of the chest that draws air into the lungs

Question 5

thermal mechanism that initiates breathing

Answer 5

temperature change

Question 6

sensory mechanism that initiates breathing

Answer 6

tactile stimuli: sound, light, smell, pain

Question 7

list newborn characteristics leading to heat loss

Answer 7

skin is thin
blood vessels are close to surface
there is little subQ (white) fat to provide a barrier to loss of heat

Question 8

evaporation

Answer 8

air-drying of the skin that results in cooling

insensible water loss

Question 9

conduction

Answer 9

movement of heat away from the body

:coming in contact with cold scale surface, cold steth

Question 10

convection

Answer 10

transfer of heat from the infant to cooler surrounding air

Question 11

radiation

Answer 11

transfer of heat to cooler objects that are not in direct contact with the infants

Question 12

non-shivering thermogenesis

Answer 12

metabolism of brown fat to produce heat

:blood passes thru brown fat, is warmed and then carries heat to the rest of body

Question 13

metabolizes brown fat

Answer 13

norepinephrine

Question 14

how to assess jaundice

Answer 14

pressing over firm surface and observe if it blanches yellow

Question 15

primary source of bilirubin in newborn

Answer 15

hemolysis of erythrocytes

Question 16

what changes unconjugated bilirubin into conjugated form

Answer 16

liver

• **bilirubin is released in unconjugated form which gets absorbed into subQ fat: jaundice
• **liver must change unconjugated bilirubin to conjugated in order for it to be water soluble and excreted

Question 17

what is kernicterus

Answer 17

bilirubin toxicity leading to permanent neurological injury

Question 18

what is physiologic jaundice

Answer 18

caused by transient hyperbilirubinemia
considered normal
appears 2-3 days after birth

Question 19

nonphysiologic/ pathologic jaundice

Answer 19

occurs w/in 24hrs of birth
result of abnormalities causing excessive destruction of RBCs or problems with bilirubin conjugation
**has a pathologic reason behind it
**treated with photo therapy

Question 20

breastfeeding jaundice

Answer 20

not enough colostrum which is a laxative to eliminate bilirubin rich meconium
begins within first week of life
feedings encouraged 8-12 every 24hrs

Question 21

acid base balance of newborn

Answer 21

tend to lose bicarb at lower levels and decreased ability to absorb it in kidneys leading to metabolic acidosis

Question 22

why is the first period of reactivity the best time to begin breastfeeding

Answer 22

infant is wide awake, alert, and seems interested in their enviroment
they ted to latch and suck better

Question 23

normal values for vitals
temp
HR
RR
BP 
Cap Refill

Answer 23

temp: 97.7- 99.6
HR: 120-160
RR: 30-60
BP: 65-96/ 30-60
Cap Refill: 3-4sec

Question 24

area of localized edema that often appears over the vertex of the newborn’s head as a result of pressure against the mother’s cervix during labor
***may cross suture lines and usually bilateral

Answer 24

caput succedaneum

***may cross suture lines and usually bilateral

Question 25

results when there is bleeding between the periosteum and th skull from pressure during birth
clear edges that end at suture lines
rabsorbs w/in 2-3weeks

Answer 25

cephalhematoma

Question 26

cord characteristics r/t arteries and veins

Answer 26

2 areteries

1vein

Question 27

distinct color division with one side of the body being pink to red and the other half is pale
transient and benign

Answer 27

harlequin sign

Question 28

:lacy, red or blue marbling of skin

:seen in infants who are cold, stressed, or over stimulated

Answer 28

mottling

Question 29

:white cysts, 1mm in size
:caused by sebaceous gland secretions
:face, forehead, nose, cheeks

Answer 29

milia

Question 30

:white or yellow papules or vesicles with red base
:resemble small bites or acne
:disappear w/in 24-48hrs after birth

Answer 30

erythema toxicum

Question 31

:bluish gray marks that resemble bruises
:usually on scrotum, buttocks, arms, shoulder
:disappear with age

Answer 31

mongolian spots

Question 32

cord care

Answer 32

:clean with water and keep dry and clean
:check for bleeding during early hours of birth
:remove clamp once it is dry and crisp: 2-3days

Question 33

circumcision method:
physician pulls prepuce over a cone-shaped device that rests against the glans. a clamp is placed around the cone and prepuce is tightened to provide enough pressure to crush the blood vessels

Answer 33

gomco (yellen) clamp

Question 34

circumcision method:
physician places a plastic ring over the glans, draws the prepuce over it, and ties a suture around the prepuce and device. ring left in place over glans for 7-14days

Answer 34

Plastibell

Question 35

circumcision care

:avoid petroleum jelly with which procedure

Answer 35

avoid with plastibell

***can use petroleum jelly with gomco clamp

Question 36

circumcision care

:clean with…

Answer 36

***clean with water alone

Question 37

with circumcision, expect

Answer 37

yellow discharge is expected after

**should not be wiped off

Question 38

how to care for an uncircumcised penis

Answer 38

clean the foreskin
clean with water and keep dry
**dont retract