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NP 2- TOP 8 > PEDIATRIC 1: EINC > Flashcards

PEDIATRIC 1: EINC Flashcards

1
Q

ENC (NEW); EINC (OLD)

A

TIME BOUND INTERVENTIONS:
Birth-90 Mins: (1.5 hours)

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2
Q

GOAL OF THE WHO WITH ENC/EIN?

A

↓ NMR (28 days)
↓ MMR

Before ENC/EINC: increase number of neonatal death in the first 7 hours.

2009: Adopted by the DOH:
EINC/Unang Yakap

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3
Q

ENC/ EINC:

4 INTERVENTIONS

A

D-S-P/D-N
1.DRY THE BABY
2. SKIN-TO-SKIN CONTACT
3. DELAYED/PROPERLY TIMED CORD CLAMPING & CUTTING
4.NON-SEPARATION & BREASTFEEDING

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4
Q

Dry the baby

A

Dry the baby:
Immediate: 30 seconds

Thorough: Face, Head, Body, Extremity

Purpose:
-Stimulation: crying
-Prevents hypothermia: Evaporation

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5
Q

SKIN-TO-SKIN CONTACT

A

Time: Next 30 secs; within 1 minute
Prone with head turned to side to the mother’s chest/abdomen

Purpose:
-promotes bonding, B.F., Baby’s sucking reflex.
-Prevents hypothermia, hypoglycemia, infection

Nudging: Crawling of the baby to breast.
-Montgomery’s: produces oil :pheromones.
Vision (10 in)
-delays crede’s prophylaxis until baby finds breast >1hr.

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6
Q

What do u call when the manner of crawling of the baby to breast.

A

Nudging

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7
Q

BEST TIME FOR DELAYED/PROPERLY TIMED CORD CLAMPING & CUTTING

A

When the pulsation stops
Rationale: Prevents ANEMIA

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8
Q

DELAYED/PROPERLY TIMED CORD CLAMPING & CUTTING

A

Time: 1-3 minutes
Best time: when the pulsation stops
-Prevents ANEMIA

*Observe aseptic technique.
-Breech: Tetanus Neonatorum

*No milking of the cord
-Can cause intracerebral
hemorrhage

Umbilicus –2cm—C1–3cm–C2
-5cm from umbilicus to c2
-cut near clamp 1

Observe: A-V-A
-Lacking: complication
-Heart defects
-Renal agenesis: Dysfunctional kidneys
-Down syndrome: Trisomy 21 (translocation)
After cord clamping & cutting
-give 10 u of oxytocin (IM)
-To stimulate uterine contraction

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9
Q

No milking of cord, otherwise:

A

Can cause intracerebral hemorrhage

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10
Q

CLAMPING DISTANCE!!!

A

1st clamp: 2cm; From umbilicus
2nd clamp: 3cm; from: near 1st clamp
overall= 5cm

Umbilicus –2cm–C1—3cm—C2

*CUT NEAR THE 1ST CLAMP!!!!

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11
Q

After clamping/cutting of cord, Observe for:

A

Observe: A-V-A
-Lacking: complication
Heart defects
-Renal agenesis: Dysfunctional kidneys
-Down syndrome: Trisomy 21
(translocation)

After cord clamping & cutting
-give 10 u of oxytocin (IM)
-To stimulate uterine contraction

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12
Q

NONSEPARATION & BREASTFEEDING

A

Nonseparation: 90 mins (1 1/2 hrs)

Breastfeeding: start within 60 minutes
Duration: 20 minutes;
10 mins & 10 mins
1st 10 minutes: Nourishment
2nd 10 minutes: Sucking pleasure
***5 mins per breast

Interval: B.F. per demand/ 2-4 hrs

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13
Q

late sign of hunger:

A

CRYING
*dont wait until bby cry

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14
Q

Feeding cues:

A

-Opening mouth
-Licking
-Rooting
-tonguing
-Crying: late sign of hunger

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15
Q

EYE OINTMENT

A

DELAYED IN 1 HOUR

CREDE’S PROPHYLAXIS
DRUG: Antibiotic (erythromycin)
APPLICATION: 1-2 cm; inner to outer canthus

Prevent: Opthalmia Neonatorum
Chlamydial conjunctivitis,
Gonorrheal conjuctivitis,
Newborn Blindness.

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16
Q

Manner of Applying Crede’s Prophylaxis:

A

1-2 cm; inner to outer canthus

17
Q

Causes of opthalmia Neonatorum:

A

-Gonorrhea: Neisseira Gonorrhea
-Chlamydia: Treponema Pallidum

***Syphilis: baby will have IUFD

18
Q

90 MINUTES- 6 HOURS

2 vaccines are given:
1 vitamin

A

BCG
HEPA B
Vitamin K

19
Q

BCG

A

-ID
-Right deltoid
-0.05 ml
-Prevents: TB

20
Q

HEP B

A

-IM
-Right Vasus Lateralis (outer middle aspect of thigh)
-0.5ml

21
Q

Vitamin K AKA?

A

Phytomenadione/ Aquamephyton

22
Q

Vitamin K

A

Phytomenadione/ Aquamephyton

-IM
-Left Vastus Lateralis
-0.5 mg (preterm); 1.0 mg (term)
-Prevents: bleeding

23
Q

ANTHROPOMETRICS:

Height

A

Normal: 18-22 inches; 45-55cm
Average: 20 inches; 50cm

Height gain:
1 mon-6 mon: 1inch/month
6mon-12mon: 1.5 inch/month

24
Q

ANTHROPOMETRICS:

Weight

A

Normal: 2,500-4,000 grams
2.5-4 kg
5.5-8.8 lbs

*1st 10 days/ within 10 days
Weight loss (10% max wt loss)
Physiologic weight loss: Extrauterine life.

After 10 days: Progressive weight gain
Doubles (2x) 6 months
Triples (3x) 12 months
Quadruople (4x) 24 months

25
Q

ANTHROPOMETRICS:
CIRCUMFERENCE

A

Head Circumference
13-14 inches; 33-35 cm
Chest circumference
12-13 inches; 31-33 cm
Abdominal Circumference
12-13 inches/ 31-33 cm

***if HC is < CC: Abnormal microcephaly (Low IQ, M.R.)
Cause:
-Hereditry
-Viral infection: Zika, Rubella (forchheimer’s spot: discrete rose-colored spot soft palate; rubella)

26
Q

6 HOURS AFTER

A

Bathe the baby
-Bathe 1 part at a time
-test & feel temperature of water
(using elbow)
-never remove vernix caseosa
-For insulation & Infection
Prevention
-Craddle cap/Seborrhea
-Remove by bathing

WOF: hypothermia

27
Q

PREVENT HEAT LOSS:
-Contact with Cold object/Surface.
-Touching wall, Weigh scale w/o cloth

A

Conduction

28
Q

PREVENT HEAT LOSS
-proximity/near cold object;
-Near wall

A

Radiation

29
Q

PREVENT HEAT LOSS
-Wet body parts

A

Evaporation

30
Q

PREVENT HEAT LOSS
-Room air drafts (Window doors)
-Thermostat
-Ideal room tempt: 25-28 C

A

Convection
-Ideal room tempt: 25-28 C

31
Q

WITHIN 24-72 HOURS (1-3 DAYS)

A

NEWBORN SCREENING
-Heel prick blood
-Med tech: Collect specimen
Trained RN
-Diagnose metabolic congenital diseases
Basic Newborn screening
-6 diseases
Expanded/ Advance N.S.
-28 diseases
-results are available in 1 week

32
Q

Things to avoid/ Obsolete practices:

A

-Bathing within 6 hours
-no foot printing
-slapping, spanking, turning upside down
-application of anything in cord stump

33
Q

APGAR SCORE

A

-Conduct twice: 1 & 5 minutes

1st: within 1 minute
-Determine the need for resuscitation

2nd: 5 minutes
-check for the adaptation to extrauterine life
-Basis for FDAR

34
Q

Apgar score: 0-3

A

SEVERELY DEPRESSED

Management:
-Cpr
-Intubation
-Mechanical Ventilator
-Manual ventilation (ambubag)
-Treat the cause

35
Q

Apgar score: 4-6

A

FAIR/GUARDED

Management:
-Suction: withdrawal; 10 secs max
-Hyperoxygenation before & after intermittent
-Gentle and rotating motion
-O2: high flow

WOF: Retrolental Fibroplasia
-Blindness caused by ↑ o2
-Drop light

EXTENDED SKIN-TO-SKIN CONTACT:
KMC (Kangaroo-mother-care)
-can be done by father, grandmother, relatives.

36
Q

↑ o2 exposure to neonates will lead to:

A

Retrolental Fibroplasia
-Blindness caused by ↑ o2
-Drop light

37
Q

Apgar score: 7-10

A

Routine Newborn care

38
Q

ASSESSMENT: Head to Toe
VITAL SIGNS

A

HR: 120-160 bpm

RR: 30-60 cpm

BP: Sytole: 60-80 mmhg
Diastole: 40-50 mmhg

Temperature: 36-5- 37.2
-1st rectal: imperforated anus
-2nd axillary

SaO2: >95%

NP 2- TOP 8 (12 decks)

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