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NSG 432 - OB > T6: Nsg Care of Newborn > Flashcards

T6: Nsg Care of Newborn Flashcards

1
Q

respiratory adaptations of the newborn

A

o Increase pressure blood pressure in the baby, it activates the respirations and increased perfusion to the lungs

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2
Q

Delay cord clamping…

A

increases blood volume to the baby and it decreases premature baby chances of having to do a blood transfusion

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3
Q

Mechanism’s baby uses to clear fluid from alveoli are

A

GRUNTING, NASAL FLARING, AND RETRACTIONS

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4
Q

Chemical factors for respirations

A

activation of the chemoreceptor in the carotid arteries

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5
Q

mechanical factors for respirations

A

as baby comes through the birth canal, the baby chest is squeezed and helps get out extra secretions

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6
Q

sensory factors for respirations

A

temperature lower on the outside, stimulates the receptors in the baby skin and the respiratory center in the brain (medulla oblongata)

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7
Q

what do c-section babies have more respiratory secretions

A

· because they do not go through the birth canal so there is no mechanical factor to get out extra secretions

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8
Q

what happens when the baby cries

A

opens up the alveoli and keeps the lungs open

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9
Q

premature babies do not have ..

A

surfactant

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10
Q

surfactant

A

substance that lines the alveoli and allows it to remain open

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11
Q

Betamethasone (Celestone)

A

a steroid given to mom to help with surfactant development in fetus

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12
Q

what do we suction first in the newborn

A

suction MOUTH FIRST

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13
Q

signs of respiratory distress

A

nasal flaring, intercostal retraction or if RR is <30 or >60

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14
Q

Acrocyanosis

A

hands and soles of feet are cyanotic for 24 hours

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15
Q

Central cyanosis

A

entire body looks cyanotic, this is not normal

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16
Q

cardiovascular adaptations of the newborn

A

o Increase of BP from clamping of cord, it increases pulmonary flow from left side of the heart and causes CLOSURE OR FORAMEN OVALE, closed at birth

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17
Q

What is the foramen ovale?

A

in utero it is used as a shunt between left and right atrium CLOSED RIGHT AFTER BIRTH

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18
Q

when is ductus arteriosus closed

A

closes in 24 hours

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19
Q

when is ductus venosus closed

A

§ closes in 2-3 months along with the umbilical 2 arteries and 1 vein (dry up and becomes ligaments)

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20
Q

hematopoirtic adaptations of the newborn

A

Higher concentration of hemoglobin because liver produces and stores hemoglobin in uterine

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21
Q

Coombs test

A

a test for the presence of anti-Rh factor antibodies in the blood (this is often given to pregnant women that are Rh- to see if they will mount an immune response against the blood of their fetus)

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22
Q

thermogenic adaptations of the newborn

A

o Baby doesn’t have shiver mechanism, so we have to help baby do that they don’t use O2, glucose and brown fat to maintain their temperature

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23
Q

what does a newborn use to maintain their temperature

A

O2, glucose and brown fat

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24
Q

during cold stress what does the baby use

A

brown fat

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25
Q

convection

A

when heat flows from body surface to cooler ambient air

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26
Q

intervention for heat loss through convection

A

Keep baby wrapped and with a hat on in an open bassinette keep away from an open window to help maintain temperature; shield baby from drafts

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27
Q

radiation

A

lost of heat from body surface through nearby object

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28
Q

intervention for heat loss through radiation

A

Keep baby away from cold objects and outside walls; don’t keep baby near window

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29
Q

evaporation

A

liquid converted to vapor

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30
Q

intervention for heat loss through evaporation

A

§ Dry baby completely and wrap in a blanket

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31
Q

conduction

A

loss of heat form body surface through direct contact

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32
Q

intervention for heat loss through conduction

A

§ Turn on warmer on bed

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33
Q

Normal infant temperature

A

36.6-37.5

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34
Q

If umbilical cord only has 1 artery and 1 vein…

A

INDICATES KIDNEY DEFECT

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35
Q

GI adaptations of the newborn

A

o Missing pancreatic amylase and lipase enzymes at birth, at 3 months salivary gland produces it and then at 6 moths the pancreas takes over
o First stool is meconium color is due to occult blood (brown/greenish color)
-Healthy baby passes it in 12-24 hours of life

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36
Q

Liver significance

A

role is break down bilirubin (when RBCs are breaking down)

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37
Q

baby becomes jaundice if

A

the liver cannot breakdown the RBC waste product (bilirubin)

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38
Q

jaundice

A

yellow color of skin

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39
Q

Physiological jaundice

A

· appears after 24 hours of age and DOES NOT REQUIRE TREATMENT

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40
Q

Pathological jaundice

A

within 24 but can last for over 2 weeks, REQUIRES TREATMENT

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41
Q

what should be initiated early to keep bilirubin level low

A

o Feed early to stimulate intestinal activity and keep bilirubin level low

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42
Q

what happens if pathological jaundice is not treated

A

irreversible BRAIN DAMAGE
-Acute bilirubin encephalopathy
-Kernicterus

43
Q

Acute bilirubin encephalopathy

A

bilirubin is so high that is caused toxicity and they baby will exhibit signs like lethargy, hypotonia, irritability, seizures, coma, and death

44
Q

Kernicterus

A

can cause delay in motor skills, hearing gloss and cerebral palsy if jaundice is not fixed (!!!)

45
Q

vernix caseosa

A

cheesy substance covering the skin of the fetus

46
Q

erythema toxicum

A

NORMAL RASH of neonate; pink rash that appears suddenly anywhere on the body of a term newborn during the first 3 weeks.

47
Q

Caput Succedaneum

A

Swelling under the skin due to coming through the birth canal (mainly over occiput- back of head), CROSSES THE SUTURE LINE, NORMAL FINDING

48
Q

Cephahematoma

A

o collection of blood between the skull bone, does not cross suture line

49
Q

Amniotic bands

A

as placenta develops it wraps around the limb of baby, it prevents the development of wherever it is wrapped around (hence why baby is born without digits or limbs)

50
Q

Oligodactyly

A

missing digits

51
Q

Polydactyly

A

extra digits

52
Q

Syndactyly

A

Fusion of digits

53
Q

female newborn reproductive adaptations

A

o may be born with mucoid vaginal discharge (smegma) it is normal, it is because of the high levels of estrogen during pregnancy
- Can also be born with pseudomenstruation (spotting)
- Labia minor and majora can be swollen especially if they are breach presentation

54
Q

male newborn reproductive adaptations

A

o hydrocele (fluid around the testes), undescended testes
- Foreskin; covers glans penis

55
Q

Breast feeding is highly encourage during

A

during first 30 minutes of birth: this period is called FIRST PERIOD OF REACTIVITY (baby is awake, best time to breast feed)

56
Q

first period of reactivity

A

Period beginning at birth in which newborns are active and alert. It ends when the infant first falls asleep. first 30 minutes

57
Q

APGAR score is done at

A

1 minute and 5 minutes after birth

58
Q

what does the first APGAR tell us

A

tells you how baby did during labor

59
Q

what does the second APGAR tell us

A

tells you how baby is transitioning from inuterine to extrauterine life

60
Q

If APGAR score is <5, then

A

they will repeat it 10 minutes after

61
Q

Most babies have score of 9/10 i=on APGAR because

A

because 1 is taken out for color (acrocyanosis: cyanosis of hands and feet, usually resolves in 24 hours)

62
Q

APGAR

A

activity, pulse, grimace, appearance, respiration

63
Q

normal HR of newborn

A

110-160bpm

64
Q

normal RR for newborn

A

30-60

65
Q

newborn measurements include

A

head, length, chest

66
Q

ballard chart

A

tells you if the baby is large, average, or small for gestational age

67
Q

LGA

A

large for gestational age

68
Q

AGA

A

average for gestational age

69
Q

SGA

A

small for gestational age

70
Q

molding

A

asymmetry of the head resulting from pressure of the birth canal, disappears after 72 hours

71
Q

Mongolian spots

A

bluish purple spots of pigmentation; o must document and show it to the parents, it can be mistaken for abuse

72
Q

Average weight of a newborn

A

2500-4000g

73
Q

Average length of a newborn

A

45-55cm

74
Q

Average head of a newborn

A

33-35 cm

75
Q

Average chest of a newborn

A

30-33cm

76
Q

Moro reflex

A

refers to an involuntary motor response that involves the infant suddenly splaying their arms and moving their legs before bringing their arms in front of their body.

77
Q

Babinski reflex

A

plantar reflex; start at sole of foot and go up, you will see the baby FLEX their toes

78
Q

sucking reflex

A

happens when the roof of a baby’s mouth is touched, baby will begin to suck when this area is stimulated, which helps with nursing or bottle feeding

79
Q

rooting reflex

A

when the corner of the baby’s mouth is stroked or touched the baby will turn his or her head and open his or her mouth to follow and root in the direction of the stroking.

80
Q

Palmar-plantar grasp

A

o finger is placed in newborn’s hand and the fingers will cirl around examiners finger

81
Q

preterm

A

reached 20 weeks gestation but before complete 37 weeks

82
Q

late preterm

A

between 34 weeks 0 days and 36 weeks 6 days

83
Q

term

A

37 weeks

84
Q

post term

A

reached 42 weeks 0 days gestation

85
Q

postmature

A

born after 42 weeks

86
Q

IUGR: intrauterine growth restriction

A

Born at term but they weren’t receiving nutrients because of what mom was doing (this is what makes it different from preterm)
o Can happen to someone who mom is on illicit drugs, cigarrete smoking, or alcohol

87
Q

ERYTHROMYCIN OINTMENT

A

o Protects baby against gonorrhea if mom delivers vaginally and wasn’t screened

88
Q

Vitamin K prophylaxis: IM injection

A

o Baby is born they don’t have vitamin K so it helps with clotting mechanism to prevent hemorrhage

89
Q

Hepatitis B Vaccine

A

o CONSENT IS REQUIRED
o 3 shots: one done at hospital, 2-3 months later 2nd dose is given, 6-10 months 3rd dose is given

90
Q

IF MOM IS HEP B POSITIVE

A

o then baby needs to get Hep B Immune Globulin (HBIG)

91
Q

Vaccine needle for newborn

A

25 gauge, 5/8 inches

92
Q

Umbilical cord care

A

keep area clean and dry
o Within 7 days cord will dry up and fall off

93
Q

therapy for jaundice

A

· Prevention is best therapy
· PHOTOTHERAPY is treatment (bilirubin light)

94
Q

nursing considerations for jaundice

A

o PROTECT BABY EYES, cover the eyes
o Baby must be WITHOUT clothing so light is directly on skin
o KIDNEYS CAN HELP TO GET RID OF BILIRUBIN so make sure baby is well hydrated

95
Q

Hypoglycemia

A

abnormally low level of glucose (<45mg/dL)

96
Q

normal BG in newborn

A

45-60 mg/dL

97
Q

prevention of hypoglycemia in newborns happens through

A

early feedings

98
Q

GBS POSITIVE MOM; if mom did not receive 2 does on antibiotics then

A

o CBC and blood cultures will be done before getting antibiotics

99
Q

PKU (phenylketonuria) Test

A

o Blood in each circle from HEEL STICK
o Newborn has to be 24-48 hours old
o Arizona screens for 31 conditions

100
Q

Heel Stick Location

A

lateral surface of heel

101
Q

CRIES Neonatal pain scale

A

Crying
Requiring increased oxygen
Increased vital signs
Expression
Sleeplessness

102
Q

Management of neonatal pain

A

o Swaddling, non-nutritive sucking, kangaroo care

103
Q

non-nutritive sucking

A
  • Infant’s chief pleasure
  • Using fingers, thumb, or pacifier
  • Excessive pacifier use
  • Pacifier use and decreased SIDS
104
Q

Feeding patterns

A

o Feed on demand or every 2 hours

NSG 432 - OB (14 decks)

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