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Nursing > OB - Module 8 > Flashcards

OB - Module 8 Flashcards

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1
Q

When is kidney function complete in the neonate? when is it functioning at the adult level?

A

35 weeks; 2 years

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2
Q

What eliminates waste from the fetus?

A

Placenta. Kidneys produce the urine

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3
Q

How much does a baby urinate after birth?

A

1-3 mg/kg/hr within the first 24 hours

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4
Q

Why are infants at risk for fluid loss?

A

Increased water loss, kidneys cannot handle fluid overload, and urine dilutes like an adult, but they only have half the ability of adults to concentrate urine

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5
Q

What is the normal intake of fluid for infants?

A

40-60ml/kg daily the first 2 days, and 100-150 ml/kg after.

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6
Q

How many times does an infant void?

A

atleast 1-2 during first 2 days, atleast 6 by the fourth day.

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7
Q

What is Mogan/Gomco?

A

Physician cuts the foreskin off, administering lidocain (anesthetic), and applying vaseline after cutting as well as cleaning.

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8
Q

Circumcision education

A

Change the gauze pad, apply more vaseline after diaper change, and REPORT bleeding greater than the size of a quarter.

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9
Q

What is Plastibell?

A

plastic ring is put over the penis that collects foreskin and a thin thread is tied that cuts off the foreskin in 7-10 days. the ring then falls off with little risk of bleeding

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10
Q

Acrocyanosis

A

Normal. Hands and feet are blue

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11
Q

Vernix

A

Normal. Protective cheesy stuff around the baby

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12
Q

What are mongolian spot\s

A

Bruise-like marks found on the back/buttocks that are NORMAL

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13
Q

What are Nevus simplex, flammeus, and vasculosus

A

Flat pink area located anywhere on the head as a result of capillary dilationl; permanent purple birthmark that can be removed by laser; Rough, red collection of capillaries that appears as a raised surface and disappears in time.

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14
Q

Cafe au lait spots

A

Permanent light brown spots found anywhere on the body. Report 6+ spots greater than 0.5 cm as it can indicate neurofibromatosis.

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15
Q

Lanugo

A

Fine, thin hair on the infants body that protect them and disappears. NORMAL

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16
Q

Milia

A

Tiny, white bumps that are immature sebaceous glands. NORMAL

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17
Q

Erythema toxicum

A

Short-lasting benign rash. NORMAL

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18
Q

Polydactyly

A

Extra digit

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19
Q

What is an indicatiion for down’s syndrome?

A

Simian crease. single crease across the palm

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20
Q

True club foot

A

cannot move foot into neutral position. requires extensive treatment.

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21
Q

Moveable club foot

A

can manipulate into place

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22
Q

Three immunoglubulins involved in the neonate immune system. Roles?

A

IgG - Passive immunity, given by mother
IgM - First one produced, does not cross placenta. high levels indicate infection in utero.
IgA - Does not cross placenta, but comes through breastmilk colostrum. protects from GI/respiratory infections

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23
Q

6 behavioral states

A

Quiet sleep, active sleep, drowsy, quiet alert, active alert, crying.
Sleep, drowsy, alert, crying. Infant moves to these states in THIS ORDER.

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24
Q

Best time to breast feed?

A

Quiet alert. Have to do before they reach crying stage.

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25
Q

Infant nutritional intake

A

110-120kcal/day and water. Average newborn takes in 19-21 oz/day. breastfeeding q2-3hrs, bottle fed q3-4hrs.

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26
Q

What is formula typically made of?

A

80% are made of cow’s milk others are of soy

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27
Q

Infant feeding education

A

NO MICROWAVE, don’t prop it up, head slightlyelevated

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28
Q

Does breastmilk cause allergies?

A

NO

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29
Q

When should a mother not breastfeed?

A

Active TB, Hepatitis B,C, HIV, or taking certain drugs as it passes through the breast milk.

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30
Q

Conditions for Newborn screening

A

Heel Stick, special card paper, no milk for 24 hrs prior, atleast 48 hrs old.

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31
Q

Blood volume of full term newborn

A

85-100 ml/kg, depending on time of cord clamp

32
Q

Benefits of late and early cord clamping

A

Late - extra blood volume opens lungs, enriches iron stores, and increases pulmonary perfusion
Early - Extra blood volume from late increases heart workload and risk for jaundice

33
Q

Newborn blood facts

A

More erythrocytes and higher hemoglocin and hematocrit (H&H) but shorter life span for RBCs.

34
Q

Infant Hematocrit

A

> 65 indicates risk for respiratory distress and jaundice

35
Q

What is given after birth?

A

Vitamin K 1 mg 1 hour after birth.

36
Q

Pallor indicates

A

Hypoxia or anemia

37
Q

Plethora

A

Ruddy skin color that indicates polycythemia. Confirmed by hematocrit >65 and at risk for jaundice.

38
Q

When does the infant stomach empty? (poop)

A

2-4 hrs after feeding. Perstalsis is very rapid

39
Q

Effect of long intestines in newborns

A

prone to water loss with diarrhea

40
Q

When are bowel sounds present in newborns?

A

within 1st hr

41
Q

Newborn digesion

A

Cannot digest complex carbs, no saliva production, but enzymes and saliva begin to appear by 36 weeks.

42
Q

Function of liver in infant

A

Blood glucose maintenance (stored as glycogen in liver), conjugation of billirubin, iron storage.

43
Q

Glucose for newborn

A

45-60. Hypo or Hyper is anything below or above.

44
Q

Signs of hypoglycemia

A

Jitteriness. sweating, tachypnea, low temperature, HI PITCHED CRY, irritability, coma. Can also be asymptomatic.

45
Q

Where to heel stick?

A

Very bottom of heal, farthest side.

46
Q

Why are infants at risk for jaundice?

A

Liver is immature and cannot conjugate billirubin.

47
Q

What happens when hematocrit is >65?

A

Hemolysis of excessive erythrocytes releasing billirubin. causes Jaundice!

48
Q

Difference between Physiologic and Pathologic jaundice

A

Physiological: result of IMMATURE LIVER and RBC hemolysis. Normal in infants 1st 24 hours of life, 3-4 days after delivery. BEGINS IN THE FACE AND MOVES DOWN THE BODY.
Pathlogical: Occurs within 24 hours of life and the billirubin increases above physiological jaundice.

49
Q

Breastfeeding jaundice

A

Occurs with inadequate intake, poor hydration, and delay in elimination.

50
Q

True Breast milk jaundice

A

Occurs within 4-7 days from substances in brreast milk that interfere w/ conjugation. Treated by discontinuing breastfeeding, pumping milk, and phototherapy.

51
Q

Thermoregulation interventions

A

Dry infant, radiant warmer, skin to skin

52
Q

Medications given after birth

A

Eye (Erythromycin) antibiotic ointment, vitamin K injection in vastus lateralis to reduce risk of hemorrhagic disease

53
Q

Normal vitals

A 
Temp: 97.7-99.5
Pulse: 120-160
Resp: 120-160
BP: 70/45 (not usually taken)
Glucose: 40-60
54
Q

Normal measurements

A

Weight: 2500-4000gm, 5’8 oz - 8’13 oz
Length: 48-53 cm
Head: 33-35.5 cm
Chest: 30.5.33cm

55
Q

LGA and SGA

A

Large/Small for gestational age. Large is above 90th percentile, Small is below 10th percentile

56
Q

Surfactant role

A

Keeps alveoli open during first breath. produced after 22 weeks, lines and protects alveoli and reduces surface tension. By 34 weeks, there is enough to breath without difficulty

57
Q

Respiratory assessment

A

COUNT FOR 1 FULL MINUTE. rapid, shallow, irregular respirations with pauses from 5-10 seconds are normal

58
Q

Signs of respiratory distress

A

Tachypnea, retractions, flaring of nostrils, grunting, seesaw respiration (asymmetric chest), Central Cyanosis

59
Q

Difference between Central and Acrocyanosis

A

Central involved the lips, tongue, and trunk while acro is only legs and feet.

60
Q

What openings close after birth?

A

Ductus arteriosus and Ductus venosus, and foramen ovale

61
Q

How often do you assess cardiovascular (heart sounds, pulses)?

A

q30 mins until stable for 2 hrs

62
Q

How do infants lose heat?

A

Evaporation, Conduction (something cold touches skin), Convection (drafts, A/C) , Radiation (heat transferred to cooler objects without skin contact).

63
Q

How do infants maintain heat?

A

Moving (flexion), oxidation of brown fat,

64
Q

Effect of cold stress (hypothermia-ish)

A

Requires more o2/glucose, increased metabolism (to maintain heat), decreased Surfactant/glycogen/brown fat.

65
Q

Effect of Hyperthermia

A

Requires more o2/glucose, causes vasodilation, water/fluid loss

66
Q

How often is temperature assessed?

A

q30 mins until stable for 2 hrs

67
Q

Babinski reflex

A

Stroke lateral sole of foot from heel to base and toes should flare out. Abnormal :No response

68
Q

Moro reflex

A

Startle! Arms extends and it looks like a big hug.

69
Q

Grasp reflex

A

Baby squeezes what’s in the hand or toes curl forward when on foot.

70
Q

Difference between Seizure and Tremor.

A

Tremors (jitteriness) stops when baby is held or low glucose/calcium is fixed (feeding). It is a seizure if this persists with abnormal eye movements.

71
Q

Chignon

A

Normal collection of fluid under the skin (looks like a bump on the head). Resolves itself within a few days

72
Q

Caput succedaneum

A

Normal form of chignon that is a result of pressure from the cervix. Resolves itself within a few days

73
Q

Cephalhematoma

A

Collection of blood under periosteum (bump on the head) that increases risk for jaundice. Resolves itself within a few days.

74
Q

What vessels are in the umbilical cord?

A

2 small arteries and 1 large vein, If less or more, it’s abnormal!

75
Q

What is the significance of Wharton’s jelly in a thin cord or it having a yellow-brown/green tinge

A

Thin cord = Poorly nourished

Yellow-brown/green tinge = Meconium release prior to birth.

Nursing (29 decks)

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