Study Guide Test 3 Flashcards
At birth the stomach holds __ml/kg
6ml/kg
Peristalsis in newborns is _______
rapid - twice as fast
Initial feedings should be about ____ ml and then increase very slowly
20 - 25ml
What is the main defining factors between Physiologic Jaundice vs Nonphysiologic Jaundice?
Nonphysiologic (pathologic) jaundice may occur in the first 24 hours while physiologic Jaundice never occurs before 24 hours
Which jaundice is considered normal.
Physiologic jaundice, also called nonpathologic or developmental jaundice, is a transient hyperbilirubinemia (excess bilirubin in the blood) and is considered normal.
The most common cause of jaundice in breastfed infants is _____________.
Insufficient intake
What kind of bilirubin can move into the tissues and cross the blood-brain barrier.
unconjugated
Bilirubin needs to be _______ by the liver in order to be excreted
conjugated
Assess for jaundice by ….
- blanching the infant’s skin on the nose or sternum.
- Assessment should be done in natural light
- Assess for jaundice every 8 to 12 hours along with vital signs.
- Determine how far down the body the jaundice extends.
- obtain transcutaneous or serum bilirubin measurements in any jaundiced infant.
Instruct parents to contact their care provider if they see an increase in jaundice when they are at home or if the infant is not eating well, voiding at least __times daily by the __ day, and producing stools appropriately (at least one stool per day for formula-fed infants and at least four stools daily for breastfeeding infants).
- 6
- 4
Jaundice becomes visible when the bilirubin is greater than __mg/dL
5
How can elevated fatty acids in the blood from Metabolism of glucose in the presence of insufficient oxygen or the metabolism of brown fat increasing the risk of jaundice?
Elevated fatty acids in the blood can interfere with transport of bilirubin to the liver, increasing the risk of jaundice
What 4 things can lead to hemolysis of RBC’s thus increasing the risk of increased bilirubin (jaundice)
- Bruising
- Cephalhematoma
- Physiologic destruction of RBCs
- Pathologic destruction of RBCs
________ is a very rare type of brain damage that occurs in a newborn with severe jaundice
Kernicterus
Physiologic jaundice is caused by ________ _____________
transient hyperbilirubinemia (excess bilirubin in the blood)
Factors that increase risk for increased bilirubin?
- Excess production
- Red blood cell life
- Liver immaturity
- Intestinal factors
- Delayed feeding
- Trauma can result in increased hemolysis of
red blood cells. - Fatty acids are released when brown fat is used
Methods of heat loss
- Evaporation
- Conduction
- Convection -
- Radiation
_________ is air-drying of the skin that results in cooling.
Evaporation
How does CONDUCTION work in heat loss
Movement of heat away from the body occurs when newborns have direct contact with objects that are cooler than their skin.
What occurs in convection?
Transfer of heat from the infant to cooler surrounding air
- NO DRAFTS
__________ is the transfer of heat to cooler objects that are not in direct contact with the infant.
Radiation
Thermoneutral zone in healthy, unclothed, full-term newborns, an environmental temperature of ______________ provides a thermoneutral zone. When the infant is dressed, the thermoneutral range is ___________
- 89.6° to 92.3°F
- 75.2° to 80.6°F
Manifestations of hyperthermia?
- metabolic rate rises, causing an increased need for oxygen and glucose and possible metabolic acidosis.
- peripheral vasodilation leads to increased insensible fluid losses.
- Tachypnea
What is Non shivering thermogenesis?
Metabolism of brown fat to produce heat
When should the hearing test be performed?
How do pain and anxiety affect a woman's already high metabolic rate.
-FHR is assessed for at least one full minute - quantity, color and odor of amniotic fluid are charted - the woman's temp should be assess at least every 2-4 hours after the membranes rupture - provide comfort
- induce labor - augment labor - allow internal fetal monitoring
Induction and Augmentation of Labor: Risks