OB final - Newborn 1 Flashcards
when is meconium suctioning done
when infant is pale, limp and have no respiratory effort or tone
healthy babies just get bulb suction
which was do you milk the umbilical cord
towards the baby
components of apgar
heart rate
respiratory effort
muscle tone
reflex irritability
color
normal newborn vitals
pulse: 110-160 (can go to 80 during sleep & 180 during crying)
temp: 97.7-99.5
res: 30-60
changes in respiration: mechanical
during the birth process, the fetal chest is compressed and squeezes fluid out
c section babies are more prone to fluid in the lungs & moms who had quick labor
changes in respiration: chemical stimuli
the first breath is triggered by increased pCO2 and decreased pH and pO2 triggers brain respiratory center to breath, this is a natural result of a normal vaginal birth
changes in respiration: thermal stimuli
-decrease in environmental temp after birth
-newborn responds w/ increase in respirations
avoid prolonged exposure to cold
changes in respiration: sensory stimuli
lights
sounds
gravity
touch
periodic breathing
when the baby pauses in respiration for up to 20 seconds and that os considered normal
apneic breathing
when breathing breaks are greater than 20 seconds and is considered abnormal
transient tachypnea of the newborn
progressive respiratory distress noted by at least 6 hours of age until 72 hours in more severe cases caused by
-LGA, late preterm, maternal over sedation, maternal bleeding, prolapsed cord, breech birth, maternal DM, C sections
transient tachypnea treatment
-chest xray
-oxyhood
-IV fluids or feeding tube
what can stimulate development of surfactant in the alveoli
-giving mother betamethasone
-rupture of membranes
respiratory distress is treated by
-oxygen therapy
-surfactant administration
-thermoregulation
-ECMO
newborn circulation
-increased systemic vascular resistance
-decreased pulmonary vascular resistance
enhances perfusion of body systems
-closure of ductus arteriosus so that blood goes from the aorta to the pulmonary artery
closure of the ductus venosus which forces perfusion to the liver
when should the foramen ovale close after birth
within 2 hours
at birth blood pressure is “” and is “” around 3 hours of age
highest, lowest
convection heat loss in babies
loss of heat from warm body surface to the cooler air temps
radiation heat loss in babies
heat is transferred from the heated body surface to a cooler surface or object not in direct contact with the baby
evaporation heat loss in babies
loss of heat when water turns to vapor
conduction heat loss in babies
loss of heat to a cooler surface by direct content
causes of heat loss
-large surface area to body mass ratio
-decreased subQ fat
-increase body water content
-immature skin leading to increase evaporative water and heat losses
-poorly developed metabolic mechanism for responding to thermal stress
-altered skin blood flow
why are preterms are at an even higher risk for thermoregulation issues
-lack a flexed posture for preserving heat
-very thin skin w/ capillaries close to the surface
S/s of hypothermia
-acrocyanosis
-hypoglycemia
-transient hyperglycemia
-bradycardia
-tachypnea
-res distress
-decreased activity/lethargy
-feeble cry & poor feed
-decrease wt gain
S/s of hyperthermia
-tachy
-apnea
-warm extremities, flushing, perspiration
-dehydration
-lethargic
-poor feeding
-irritability
-weak cry
consequences of hypertermia
-hypotension & dehydration
-seizures & apnea
-hypernatremia
-res distress
mgt of hyperthermia
-adjust environmental conditions
-move baby away from source of heat
-allow air temp if not already
-breastfeed frequently
when does brown fat begin to form and stay until
26-28 weeks gestation and used until 3-5 weeks after birth for temp regulation
cephalohematoma
a collection of blood that results from ruptured blood vessels between the cranial bone and the periosteum membrane
bleeding does not cross the sutures, which is a distinguishing factor
what is a risk for babies with cephalohematoma
they have an increased risk for jaundice because the blood is going to have to break down so they’re going to have increased bilirubin + risk for anemia and hypotension
caput succedaneum
soft tissue swelling that is in a localized soft area of the scalp and it does cross the sutures
transient strabismus
cross eyed -> not treated at birth
doll eyes
if you turn the baby, their eyes will go in the opposite direction d/t underdeveloped head eye coordination
epstein pearls
small cysts in the mouth that are harmless and will go away
how do you dx tethered cord syndrome and what does it cause
sacral dimple on exam then xray
can lead to weakness, numbness, and bladder/bowel problems
phimosis
small opening of the foreskin that cannot be retracted causing urination problems
hydrocele
fluid surrounding testes and scrotum
cryptorchidism
failure of the testes to descend
when do stork bites heal
by age 2
nevus flammeus (port wine stain)
a capillary angioedema that is below the epidermis which is non elevated and looks red/purple on the face and it does not go away
strawberry mark
a capillary human genomia that is newly formed in enlarged capillaries in the dermal and sub dermal layers. they are raised, dark red and rough type of birthmark that grows rapidly but later may shrink and resolves spontaneously
