OB Class 4 Flashcards
sufficient surfactant is produced at….. and is used for…..
produced at 24-26weeks
used to keep alveoli open
why is the infant’s first breath at birth important
it must force the remaining fetal lung fluid out of the alveoli and into the interstitial spaces to allow air to enter the lungs
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
absorbed by pulmonary circulatory and lymphatic systems
***within 24hrs
chemical factors that initiate breathing
chemoreceptors in the carotid arteries ad aorta sense a decreases in oxygen and increase in carbon dioxide lead to breathing
mechanical mechanism in initiating breathing
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
thermal mechanism that initiates breathing
temperature change
sensory mechanism that initiates breathing
tactile stimuli: sound, light, smell, pain
list newborn characteristics leading to heat loss
skin is thin
blood vessels are close to surface
there is little subQ (white) fat to provide a barrier to loss of heat
evaporation
air-drying of the skin that results in cooling
insensible water loss
conduction
movement of heat away from the body
:coming in contact with cold scale surface, cold steth
convection
transfer of heat from the infant to cooler surrounding air
radiation
transfer of heat to cooler objects that are not in direct contact with the infants
non-shivering thermogenesis
metabolism of brown fat to produce heat
:blood passes thru brown fat, is warmed and then carries heat to the rest of body
metabolizes brown fat
norepinephrine
how to assess jaundice
pressing over firm surface and observe if it blanches yellow
primary source of bilirubin in newborn
hemolysis of erythrocytes
what changes unconjugated bilirubin into conjugated form
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
what is kernicterus
bilirubin toxicity leading to permanent neurological injury
what is physiologic jaundice
caused by transient hyperbilirubinemia
considered normal
appears 2-3 days after birth
nonphysiologic/ pathologic jaundice
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
breastfeeding jaundice
not enough colostrum which is a laxative to eliminate bilirubin rich meconium
begins within first week of life
feedings encouraged 8-12 every 24hrs
acid base balance of newborn
tend to lose bicarb at lower levels and decreased ability to absorb it in kidneys leading to metabolic acidosis
why is the first period of reactivity the best time to begin breastfeeding
infant is wide awake, alert, and seems interested in their enviroment
they ted to latch and suck better
normal values for vitals temp HR RR BP Cap Refill
temp: 97.7- 99.6 HR: 120-160 RR: 30-60 BP: 65-96/ 30-60 Cap Refill: 3-4sec
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
caput succedaneum
***may cross suture lines and usually bilateral
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
cephalhematoma
cord characteristics r/t arteries and veins
2 areteries
1vein
distinct color division with one side of the body being pink to red and the other half is pale
transient and benign
harlequin sign
:lacy, red or blue marbling of skin
:seen in infants who are cold, stressed, or over stimulated
mottling
:white cysts, 1mm in size
:caused by sebaceous gland secretions
:face, forehead, nose, cheeks
milia
:white or yellow papules or vesicles with red base
:resemble small bites or acne
:disappear w/in 24-48hrs after birth
erythema toxicum
:bluish gray marks that resemble bruises
:usually on scrotum, buttocks, arms, shoulder
:disappear with age
mongolian spots
cord care
: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
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
gomco (yellen) clamp
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
Plastibell
circumcision care
:avoid petroleum jelly with which procedure
avoid with plastibell
***can use petroleum jelly with gomco clamp
circumcision care
:clean with…
***clean with water alone
with circumcision, expect
yellow discharge is expected after
**should not be wiped off
how to care for an uncircumcised penis
clean the foreskin
clean with water and keep dry
**dont retract
