T3-Newborn Nursing Care Flashcards
What is suctioned first: mouth or nose?
Mouth before nose!
What is the respiratory interventions?
- Support baby with head to side
- Use bulb syringe and suction mouth, then each side of nose
- Deeper suction can be done with DeLeeX (5 sec or less per insertion)
When do we assess the temp of newborn baby?
Immediately after birth and q30 min till stable
What do we attach over upper quadrant of abdomen? Why?
Tranistor probe to keep infant temp 36.5-37C
Where should infants crib be away from?
Walls and windows
Where do we perform exams?
Under heat panels
When do we give newborn bath?
After temp is stable
What eye prophylaxis is done? Why?
Erythromycin eye ointment to prevent inflammation r/t gonorrhea infection
What kind of injection is Vit. K? Where is it administered?
IM -.5-1 mg w/in one hour of birth; administered in vests lateralis
What is umbilical cord care?
- Clamp cord after delivery
- Assess # of veins and arteries
- Assess for infection
- Clean cord with H20
- No tub bath till cord separates
When does the umbilical cord usually separate?
~10-14 days
What is the goal of cord care?
To prevent hemorrhage and/or infection
Preterm?
Born less than 37 weeks
Late preterm?
34.0-36.6 weeks
Early term?
37.0-38.6
Full term?
39.0-40.6
Late term?
41.0-41.6
Post term?
42.0 weeks and over
Post mature?
Over 42 weeks with placental insufficiency effects
General characteristics of neonate: Length?
17.7-21.7 inches
General characteristics of neonate: Weight?
5.5-8.8 lbs
General characteristics of neonate: Normally loses ____ of birth weight within one week of birth
5-10%
Collection of blood
Cephalhematoma
Collection of fluid
Caput succudanum
How are sutures and fontanelles?
Open and palpable
What if fontanelles are depressed?
Dehydration
What if fontanelles are bulging?
Fluid overload
Anterior fontannel is ___ cm and is ___ shape
5 cm and is diamond shaped
Posterior fontannel is ___ shaped
Triangle
What is smaller: anterior or posterior fontannel?
Posterior is SMALLER than anterior
Chest is approx ____ in smaller than head
0.5 cm
Legs and arms are normally ____
Flexed
Feet and hands may exhibit ____
Acrocyanosis
What is polydactaly?
More than 5 digits
What is syndactaly?
Webbing
Where do babies want to breath from: nose or mouth?
Nose
Ears: Pinna in line with ______
Outer canthus of eye
T/F: Genitalia may be enlarged
True
Discharge may be present in female neonates. This is pseudo menses and is hormonal. What color may discharge be?
Pink or white
Testicles are _____ in male neonates
Descended
Excess breakdown of RBC= ?
Ex?
Jaundice
Hematoma, bruising
Liver immaturity=?
Not enough of enzyme glucornyltransferase
Poor sucking ability=?
Doesnt consume enough food to introduce intestinal flora so bill is not conjugated to direct (conjugated) form that can be excreted
Can cold stress cause jaundice?
Yes
Describe what you do for phototherapy for hyperbilirubinemia.
- Under lights in mini diaper
- Cover eyes, testes, ovaries
- Monitor and maintain temp with skin probe
- Monitor insensible water loses
- Provide fluids
- Provide stimulation
Treatment for hypothermia?
- Swaddle in double warm blankets
- If temp doesnt respond go back to radiant warmer per protocol
- Observe for resp. distress
- Observe for signs of hypoglycemia
Hypothermia treatment–why do we observe for resp distress?
Cold stress increases O2 need
Hypothermia treatment–Why do we observe for signs of hypoglycmia?
Cold stress uses up glucose on board
What is prevention for hypoglycemia?
Feed early and frequently and maintain safe glucose levels
For high risk infants, when do we check glucose?
Within 2-3 hours of birth
What are symptoms of hypoglycemia?
Jittery
High pitched cry
Eye rolling
Seizures
Plasma glucose level in full term infant: Less than ___ requires intervention?
Less than 45
This is from ppt, I thought she said in class less than 43 … ?
What has a longer lasting supply of glucose?
Milk
If mom doesn’t breastfeed, what are other ways infant can get glucose?
Bottle feed D5W
NGT or IV glucose
Can infant be fed before circumcision?
No, hold feeding before procedure
Yellen and Mogen clamp procedure makes procedure ____
Blodless
Can ointment be put on after Yellen procedure? Mogen? Plastibell?
Yellen: yes
Mogen: yes
Plastibell: no
What do we document after circumcision?
First voiding past procedure
What procedure has the bell fall off in diaper?
Plastibell
If we see yellow exudate, what do we do?
DO NOT clean it off!
What should we teach about the petroleum gauze?
To watch for strings that could wrap around penis and cause necrosis
If infant is getting enough to eat, how many times should they pee? What color is urine? What if no voiding in first 24 hours?
6-8X/d
Pale; poorly concentrated
Notify MD
Breast fed babies should be offered first feeding during _____.
How can we place them after feedings to encourage stomach emptying?
Stage 4 (recovery)
Right side
Breastfeeding: What is secreted first 2-3 days?
Colostrum
Less fat and sugar; more protein and antibodies
When is there traditional milk?
3rd day of/1st week
Breastfeeding promotes ____
Bonding
What are conditions in which breastfeeding should be avoided?
- Active TB
- Hep B or C
- HIV
- Cancer
- Maternal drug abuse
- How should milk be stored?
- Refrigerated for …?
- Frozen milk attached to fridge is good for ____.
- Frozen milk in deep freezer is good for ___.
- Rigid, plastic containers
- 48-72 hrs
- 1 milk
- 6-12 months
What newborn screening test are required by all tests? How do you get it?
PKU and hypothyroid; blood sample from infant heel
What is important about PKU test.
Infant needs to have ingested milk in adequate amounts before test…done 24 hours later
What do accumulates of phenylketonuria result in?
Severe MR
Glactosemia: Absence of enzyme result in damage to ___, ___, and ___.
What is treatment?
Liver, brain, eyes
Treatment is elimination of milk from diet and you cannot safely breastfeed; work with mom to find commercial formula
What is bathing home care?
Diapering home care?
Crying?
- Sponge bath till cord falls off; clean cord with water after each diaper change and keep diaper off cord
- Diaper: clean infant with warm water after voiding and stools
- Crying will happen when hungry, wet, or bored
Signs of sick infant: how is sleep?
Lethargy or difficult to wake
Signs of sick infant:
Temp above?
100F
Signs of sick infant:
How is digestion?
Vomiting or green, liquid stools
Refusal of 2 feedings in a row
Signs of sick infant:
How ar fontanels and mucous membranes?
Fontanels: Depressed
Mucous membranes: Dry, sticky