T3 - Newborn Nursing Care (Josh) Flashcards
What are the Four Conditions for maintaining an adequate O2 supply?
Clear airway
Establishment of respirations
Adequate circulation, perfusion, and cardiac function
Adequate thermoregulation
Which order do we suction the neonate?
mouth before nose
**M comes before N
Nursing Interventions for Neonatal Respiratory System
Support baby w/ head to side
Compress bulb syringe and suction SIDE OF MOUTH first
**avoid touching center back of mouth (gag reflex)
Suction each side of NOSE
Deeper suction w/ DeLEE x 5 secs or less
How much Vit K do we give to newborn?
0.5 - 1mg
***5/8 in needle w/ a TB syringe
How often is neonate body temp assessed?
q30 minutes until stable
Nursing actions to maintain body temp?
Position crib away from wall/windows
Perform exams under heat panel
Delay bath until temp stable
Which temp source?
axillary (book)
rectal (in real life sometimes)
Which med do we give in newborn eyes?
Erythromycin
***may also use Tetracycline 1% or Silver Nitrate 1%
***prevents inflammation r/t gonorrhea infection
Which med should be injected within 1 hr of birth?
Vit K (0.5 - 1 mg)
***helps w/ clotting factors
How long should mom wait to give a tub bath?
until cord separates (10-14 days)
Clean cord w/ —.
water
***no evidence that antiseptic/antimicrobial agents help
Which scale is used to classify neonates based upon maturity and intrauterine growth?
Ballard Scale
Ballard Scale:
What constitutes preterm?
Ballard Scale:
What constitutes early term?
37-38.6 wks
Ballard Scale:
What constitutes full term?
39-40.6 wks
Ballard Scale:
What constitutes late term?
41-41.6
What does PKU test look for?
Kenicterus
***ketones in urine
Ballard Scale:
What constitutes post term?
42 wks or more
Ballard Scale:
What constitutes post mature?
over 42 wks w/ placental insufficiency effects
What info is needed for Ballard Scale assessment?
weeks gestation
length
weight
had circumference
When would the Gestational Age Assessment be done?
after transition period (~ 4 hrs)
***based on neuromuscular and physical maturity
Common lenght and weight of neonate?
length = 17.7 - 21.7 in
weight = 5.5 - 8.8 lb
What is difference b/t a Cephalhematoma and a Caput Succudanum?
Cephalhematoma – collection of blood
Caput Succudanum – collection of fluid
What are some common soft tissue injuries in neonates?
Cephalhematoma
Caput Succudanum
Bruising
The – fontanel is diamond shaped.
The — fontanel is triangle shaped.
Anterior
Posterior
What will newborn chest look like?
~ 1/2 inch smaller than head
Breast tissue present
Nipple Discharge
What is syndactaly?
webbing of digits
What will the ears be in line with?
pinna in line w/ outer canthus of eye
***low set ears a sign of Down’s Syndrome
Genitalia assessment in neonates:
Enlarged
Discharge may be present in female neonates (pseudomenses)
Testicles descended in male neonates
Treatment for Hypothermia
Swaddle in double warm blankets
If temp does not respond –> return to radiant warmer per protocol
Observe for respiratory distress (cold stress increases O2 need)
Observe for signs of hypoglycemia – cold stress uses up glucose on board
Which plasma glucose level in full-term infant requires intervention?
Before circumcision, we should hold —
feeding
Which type of clamp used in circumcision makes procedure bloodless?
Yellen (Gumco) Mogen clamp
***apply petroleum jelly or antibiotic ointment afterwards
Which type of circumcision procedure requires no ointment?
Plastibell
No – until circumcision heals.
tub baths
***do NOT clean off yellow exudate
Urine assessment
Usually 6-8X day if getting enough to eat
Urine pale; poorly concentrated
Document all voiding especially post circumcision
No voiding documented first 24 hours –> MD notified
Place neonate on which side to encourage stomach emptying?
right side
***never place on stomach (ASPARATION)
Conditions in which breastfeeding should be avoided?
Active TB
Hep B or Hep C
HIV
Cancer
Maternal drug use
Why would a drug addict mom be asked to pump?
1) they may have to use it to aid in DTs Only a very small amount will be given to the baby and ONLY if the baby is experiencing sever withdrawals and other measures have not worked.
2) other reason is to see if the mother is continuing drug use.
Storage of breast milk.
Rigid plastic containers
Refrigerate (48-72 hrs)
Frozen (1 mth)
***6-12 mths if deep freezer
How should frozen milk be thawed?
fridge
under running water
Type 1 DM mom will likely have a — baby.
big
***all that sugar is transferred to baby in utero
***baby will be hypoglycemic postpartum
Which newborn tests are required by all states?
PKU
Hypothyroid
Hearing Screen
When should PKU and Hypothyroid screens be performed?
24 hrs from 1st good feeding
To test for PKU, infant needs to have ingested —
milk in adequate amounts
Accumulation of PKU result in —
mental retardation
***can be prevented if treatment stared early
What is PKU test looking for?
phenylalanine (essential amino acid) in the urine
What is Galactosemia?
absence of an enzyme that metabolzes galactose and that results in damage to liver, brain and eyes
***galactose is “milk sugar”
Treatment of Galactosemia?
eliminate breast milk
***baby cannot be safely breastfed b/c lacks the enzyme to break down galactose (milk sugar)
Signs of a sick infant
Lethargy
Temp > 100F
Vomiting or Green Liquid stools
Refusal of 2 feedings in a row
Depressed fontanels
Dry mucous membranes
