OB test 1 Flashcards
Ductus venosus
oxygenated blood enters through umbilical vein. 1/3 of blood is directed away from liver to inferior vena cava.
Foramen ovale
between R and L atria. 50-60 % goes to left atria, the rest goes to right atria, flow to lungs is restricted by the narrow pulomary artery and pulmonary blood vessels, causing a high pressure in R side of <3.
Ductus arteriosus
connects pulmonary artery and the descending aorta during fetal life. perfusion only.
Fetal Lungs
Contain no air, O2 is delievered through placenta - umbilical vein to ductus venosus.
alveoli secrete fluid to keep them partically open, before delivery start to close so when they take 1st brath dont take much fluid in.
newborn GI
Immature shincter, thats why they spit up a lot.
1st stool - dark and tarry, 2nd stool - green-brown, loose.
Breast milk stool- seedy, mustard type, can stool up to 10x/day = natural laxative
formula stool- yellow-brown, only go 1-2 x/day.
babies stomach only the size of a walnut, commonly are overfed.
newborn urinary system
most newborns void immediatley after birth, indicationg adeqaute renal function.
Full kindey function doesnt happen until 3-4 months.
6-10 wet diapers a day.
newborn immune system
Immature WBC- trabel slow.
Look out for cahnges in activity, color, tone and/or feelings. wont generally see a fever like in adults.
IgG- cross placenta
IgM - after babys born-exposed to environment
IgA- found in colstrum (breast feeding)
thermoregulation
important to keep babies warm, have think skin and little sub-q fat.
Dry babies off completely, warm stethoscope beforing touching the baby, keep a hat on them, they loose heat through head.
Do not over heat the baby either, dangerous as well.
Newborn hepatic system
BS should not be less then 40.
Bilirubin- too much can be toxic to the baby.
Iron is stored in liver/spleen. have enough if breat feed for 3-6 months, supp if not.
Two types of jaundice:
patho- happens within 1st 24 hrs.
physiological- happens after 1st 24 hrs
to test: push finger on skin, when life, if yellow means jaundice.
Newborn hematologic system
Risk for clotting deficiency due to having a Vit K deficiency, they can not produce Vit K until about a week after birth, they get an IM of it at birth.
Range for normal <3 rate
120-160
take apical <3 rate for a complete min.
can be higher if baby crying.
range for normal respirations
30-60
periods of apnea <20 secs is normal
Range for normal temp
36.5-37.3 C or 97.7-99.1 F
NO rectal temps ! only axillary !
range for normal weight
2500-3999 grams or 5#8oz - 8#13oz)
Small for gestational age (SGA)
infants that are below the 10th percentile in size on growth chart.
Problems: perinatal asphyzia (unable to tolerate stress of labor), hypo/hyperthermia, polycythemia, meconium aspiration
Appearance: head disproportionally large, thin skin, wasted appearance of extermities, thin cord, decreased sub-q fat and breat tissue.
Large for gestational age (LGA)
Infants who are about the 90% on intrauterine growth charts.
Problems: bith trauma, hypoglycemia, polycythemia, jaundice secondary to hyperbilirubinemia
risk factors: maternal diabetes, genetics, mutiparity, hx of macrosomic infant, post date gestation, maternal obesity, male fetus
Stork bites
reddish pink areas on eyelids of around neck, that blanch when pressed on, go away by 2 years.
Vernix Caseosa- thick white substance that provides a protective covering for baby in utero, sometimes born with some still on them, more term thy are , the less there is.
Lanugo
fine har that covers fetus intrauterine, some are born with it still on them, found on shoulders, forehead, sides of face, upper back,
Vernix Caseosa
thick white substance that provides a protective covering for baby in utero, sometimes born with some still on them, more term thy are , the less there is.
Mongolian spots
bluish-black marks that look like bruises - found on darker skin tones around sacral areas, sometimes found on shoulders, arms and buttocks.
Document these at birth so they arent mistake as bruises.
Erythema toxicum
newborn rash- common- goes away.
Milia
White cysts, 1-2 mm in size, they disappear without treatment.
Occur on face over forhead, nose, cheeks, and chin
Harlequin sign
half pale. half red- usually fixes it self
Nevux flammeus/vasculosus
Flammeus (port-wine stain) permanent, flat, pink to dark reddish-purple mark that varies in size.
Vasculosus (strawberry hemangioma) enlarged capillaries in the outer layers of the skin. dark red and rasied with a rough surface. can get larger for 5-6 months but usually goes away by early school years.
Molding is important why?
to help the babys head get into a shape that it can move through the birth canal.
babies head should move bakc into shape.
The soft spot should close after how long?
14-18 months, allows for brain to develop
Caput succedaneum
often appears over vertex of newborns head as a result fo pressure againts mothers cervix.
the edematous area crosses suture lines, is soft, and varies in size.
resolves quickly and generally disappears within 12-48 hrs after birth.
Cephal hematoma
Bleeding between the periosteum and the skull, as the result of pressure during birth.
occurs on one or both sides of head over parietal bones or sometimes occipital bone. swelling may not present at birth but may develop within first 24-48 hours.
does not cross sutures lines.
preterm labor (PTL) risk factors
maternal medical conditions, present and past OB conditions, fetal conditions, social and enviornmental factors,
Diabetes, drugs, lupus, infections, STDS, can cause an unsuccessful pregnancy
pre-term characteristics
birth weight <5.5, scrawny look, head >chest, poor tone, minimal sub-q fat, undescended testes, lots of lanugo, soft ear pinna, fused eyelids, spongy skull bones, absent to few sole and palm creases, minimal rugae or prominent labia and clitoris, think skin, visible veins, lots of vernix
problems with premature babies
problems with: respirations, thermoregulation, fluid and electrolyte balance, infections, and pain.
they should be be prone, laying on side to decrease secretions.
Post-term problems
if placenta function decreased, the amniotic sluid will decrease, could lead to a compressed umbilical cord.
If not getting enough 02 and nutrients the baby can become hypoxic or malnurished.
Fetus may pass meconium which is bad if the baby aspirates it.
Post-term characteristics
dry, cracked wrinkled skin, long thin extermities, creases cover entire soles of feet, wide-eyed, alert expression, abundant hair on scalp, thin umbilical cord, limited vernix and lanugo, meconium stained skin, long nails
Transient-tachypnea of the newborn (TTN)
liquid in lungs removed slowly or incompletely, will see grunting, nasal flaring, tachypnea and retractions, usually resolves in 24-48 hours.
Seen commonly in c-section babies, sent to nicu.
Treatment: supportive, NPO, 02, neutral thermal environment, assessment.
