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OB > OB Test 2: Newborn Nursing Care > Flashcards

OB Test 2: Newborn Nursing Care Flashcards

0
Q

What are neonatal risk factors?

A

Prenatal record: happens before birth, record late D-cells
Labor and birth records
Condition of newborn
Parent-newborn interaction

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1
Q

What are the goals of nursing care?

A

Physical well being of neonate

Promote family development

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2
Q

When is the neonatal transition period?

A

First 4 hours

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3
Q

What are the 4 main care areas during the transition period?

A

Airway: clean mouth then nares, in mouth do cheek pockets first, suction no longer then 5 seconds and no longer then 50
Breathing
Circulation: check skin color
Glucose: if LGA (larger then gestational age) then hyperglycemia

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4
Q

How can you incorporate thermoregulation for the newborn?

A

Kangaroo care: skin-to-skin contact

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5
Q

What are precautions for the newborns first bath?

A

Gloves
Stable vital signs: once temperature stabilized
Warmth: only expose 1 area at a time

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6
Q

What are the first 4 medications given to newborn?

A

Eye prophylaxis
Vitamin K
Hepatitis B vaccine
Vitamins

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7
Q

Why do we do eye prophylaxis medication, when and what dose?

A

Prevent blindness caused by gonorrhea or chlamydia
Done at 2 hours post-birth
0.5% erythromycin ophthalmic

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8
Q

Where do you inject vitamin k?

A

In Vastus lateralis

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9
Q

When do you give the hepatitis b vaccine, what teaching do you do?

A

12-24 hours
Not live virus
Get 3 doses
Don’t take if allergic to yeast

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10
Q

What cord care is done?

A 
Care providers order
Monitor s&s of omphalits: red around cord
Artery sticks up
Put in triple dye and wash with water
Fall off at day 10
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11
Q

What assessment are done before first feeding?

A

Need to be alert

Good time if rooting or sucking

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12
Q

When and why do you breast feed

A

Q2-3 hours

Easier digested, more nutrition and has what baby needs

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13
Q

When do you have the first bottle feeding and what is a negative side effect?

A

In second period of reactivity

Have more fluid

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14
Q

What are two negative reactions to feeding?

A

Esophageal atresia

Tracheal esophageal defect

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15
Q

What is a tracheal esophageal defect? When do you feed and how much can they hold?

A

Fluid directly in lungs
Feed 3-4 mL
Hold 30-90 mL

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16
Q

What are some ongoing nursing care?

A 
Vitals
Assessment
Weight
I&O
Skin care 
Positioning
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17
Q

How do you monitor I&O?

A

Document how often and long breast feed

18
Q

Why is the newborn weight loss?

A

Upto 10% in 1 week

19
Q

How do you position the newborn?

A

Sleep on back

Lift head off crib after eating

20
Q

What are specific tests we give the newborn?

A

Hearing screen

Lab exams

21
Q

How do you practice newborn safety?

A

Hand washing
Prevent cross contamination
Identification bands
Preventing abduction by alert and security system

22
Q

How can you prevent cross contamination?

A

Hand washing
Don’t put shared items in crib
3 feet apart in all directions
Isolation if infection suspected

23
Q

How can the nurse promote attachment?

A 
En face positioning: eye contact before separation
Observe interactions
Teach
Model care: how to hold or bathe
Support
Rooming-in and breast feeding 
Cultural difference
24
Q

What are signs of distress in newborn?

A 
Tachypnea: R>60 
Flaring and grunting
Retraction: sub costal and substernal
Excessive mucous
Cyanosis
T instability: infection or sepsis
Jittery
Early jaundice
25
Q

Why would the newborn be jittery?

A

Hypoglycemia
Hypocalcemia
Narcotic withdraw

26
Q

What is physiologic jaundice?

A

After 24 hours
Is a “well baby”
Labs: indirect and direct bilirubin
Blanch test: cephalocaudal

27
Q

Why do you do phototherapy?

A

Because bilirubin is in skin and UV breaks it down

28
Q

What do you do if the Bilirubin is above 12

A

Take out 5-10cc of blood and put in 5-10 cc of donor blood until all of the blood is replaced.

29
Q

What causes physiological jaundice?

A

rH antigens

30
Q

What safety measures do you implement with phototherapy?

A 
Eye protection via eye patches
Temperature
Skin care: lotion causes burn
Stools: loose stool cause diaper rash
Only thing worn should be the diaper
31
Q

What is circumcision and what can it help to prevent?

A

Elective removal of foreskin

Prevents HIV transmission

32
Q

When is circumcision done. For Jews?

A

After 12 hours

Jews on day 8 of life and not in the hospital

33
Q

What does the 2012 AAP position statement say?

A

That newborns must have pain medication before the procedure

34
Q

What are the medications and their descriptions for circumcision?

A

EMLA: lidocaine cream
Acetometophin
Sucrose solution
Dorsal penile block: inject lidocaine and block off nerves

35
Q

What are complications of circumcision?

A 
Hemorrhage from clamp
Voiding difficulty can cause edema
Pain
Infection
Scarring and stenosis
36
Q

What is preoperative nursing care?

A 
Family history of bleeding disorders or penile disorders
Signed consent
Restraint board
Promote comfort
Assist with sterile procedure
37
Q

What is some postoperative nursing care?

A

Bleeding: check every 30 min for 2 hours then every hour for 12 hours. Apply light intermittent pressure
Comfort: fan fold diaper, take to mother
Voiding may be painful

38
Q

What s some circumcision patient teaching?

A

It is red right after
Yellow exudate: develop yellow crust at 2 days, don’t wash off
Was only with water until healed
Complications are not voided and pus

39
Q

What is some discharge parent teaching?

A

How to use the bulb syringe
Feeding: never give honey
Elimination: breastmilk makes poop seedy, cheesy and yellow
Bathing: in tub or sink, keep warm, never leave, no baby powder
Cord care
Uncircumcised: don’t retract foreskin
No co-bedding
Warm layer it not over heated
Sleep on back with nothing n crib
Cars eat in the middle of back of car facing backwards
Have them demonstrate how to hold, feed, bathe and diaper change

40
Q

What are the types of newborn stools?

A

Meconium
Transitional
Formula
Breastmilk

41
Q

What tests need to be done before discharge?

A

Hearing screen
Metabolic screen: PKU, CF, hypothyroidism, maple syrup urine
Follow up visit planned

42
Q

When should the parents call the physican?

A 
If temperature is > 100.4
Vomit: pyloric stenosis
Not eating 
No wet diapers
Bleeding from cord or circumcision

OB (10 decks)

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