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OB > The Normal Newborn (1) > Flashcards

The Normal Newborn (1) Flashcards

1
Q

what is necessary for fetus lung compliance?

A

surfactant (lecithin and sphingomyelin)
(open alveolar sacs in lungs so oxygenation can take place)

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2
Q

what is the ideal ratio of lecithin adn sphingomyelin (surfactant)

A

2:1 or greater lecithin:sphingomyelin

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3
Q

what are fetal breathing mvmts

A

breathing mvmt in the amniotic fluid

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4
Q

describe a babys first breath

A

inspiratory gasp from CNS response to mechanical, reabsorptive, chemical, thermal, and sensory changes

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5
Q

what are the mechanical events of respiration before/during birth

A
  • lung fluid decreases prior to onset of labor
  • chest compression during labor
  • higher intrathoracic pressure leads to absorption of lung fluid
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6
Q

what do chemical stimuli do for the resp system

A

stimulate chemoreceptors that stimulate the respiratory center

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7
Q

what are examples of cemical stimuli

A
  • transitory asphyxia (HR decelerations, less o2=inc. resp)
  • elevation of PCO2 (inc. co2=inc. resp)
  • decrease in pH
  • clamping umbilical cord, dec. prostaglandins
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8
Q

what is thermal stimuli

A

cold stimulates sensory receptors

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9
Q

what is sensory stimuli

A

tactile, auditory, visual, and painful stimuli stimulate receptors

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10
Q

what is the normal respiratory rate for newborns?

A

30-60

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11
Q

describe newborn breathing

A
  • irregular breathing pattern
  • obligatory nose breathers
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12
Q

what are some potential signs of respiratory distress?

A
  • inc. resp rate
  • grunting
  • retracting
  • flaring
  • color change
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13
Q

what part of fetal circulation allows blood from the umbilical vein to bypass the liver and enter the right atrium

A

ductus venosis

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14
Q

what part of fetal circulation allows blood flow from right atrium to left atrium

A

foramen ovale

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15
Q

what part of fetal circulation allows blood flow from pulmonary artery to aorta

A

ductus arteriosis

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16
Q

when will the ductos venosis close?

A

when blood supply from umbilical venous return is closed off

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17
Q

when will closure of the extra fetal circulation pathways take place?

A

when blood starts going to the lungs

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18
Q

how long does it take for the ductus venosis to close

A

4 weeks

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19
Q

how long does it take for the foramen ovale to close

A

30 months

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20
Q

how long does it taje for the ductus arteriosis to close

A

2 months

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21
Q

normal newborn heart rate is ____ following delivery, ____ in full term newborn, and ____ during deep sleep

A

180, 110-160, 80-100

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22
Q

what is turbulent blood flow through narrow opening

A

presence of murmur

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23
Q

what can happen if the cardiovascular ducts don’t close?

A

-mix of oxyegnated and nonoxygenated blood, can lead to color changes and poor feedings

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24
Q

what is a normal fetal pulse ox?

A

50%

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25
Q

describe hemoglobin levels in newborns

A

levels rise initially , get additional hgb from placenta, atransient dehydration

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26
Q

describe physiologic anemia of the newborn

A

cell life is shorter, cells die off faster than they can reproduce, peaks @ 3 mo., iron supplements given

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27
Q

what patients does Rh incompatibility effect?

A

people that are Rh- (negative blood type)

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28
Q

describe Rh incompatibility

A

rh- mother is not effected during the first pregnancy, but antibodies are made that will attack subsequent pregnancies

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29
Q

what works to prevent antibody (rh) formation against subsequent pregnancies

A

rhogam

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30
Q

when is rhogam given

A

-during pregnancy
-postpartum
-after abortions

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31
Q

what blood type does Rh incompatibility effect?

A

-

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32
Q

what is heat loss from air current

A

convection

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33
Q

what is heat lost when the surface around baby is colder

A

radiation

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34
Q

what is heat lost when the body is moise with dry air?

A

evaporation

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35
Q

what is heat lost when baby loses heat to a cold surface (like a scale)

A

conduction

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36
Q

what is a normal baby temp

A

36.4-37.2

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37
Q

describe relation of gestation/brownfat/flexed position

A

full-term babies have more brown fat and can flex better

38
Q

what allows for optimal oxygen use, metabolism, and internal temp because of thermal balance?

A

neutral thermal environment

39
Q

what helps thermogenesis

A

increased BMR, muscular activity, nonshivering thermogenesis

40
Q

what are interventions for baby hypothermia

A
  • verift reading
  • double wrap and hat
  • kangaroo care (skin/skin)
  • warmer or isolette
41
Q

what is the role of the liver in a newborn

A

iron storage, carbohydrate metabolism, conjugation of bilirubin

42
Q

is jaundice a normal biologic response?

A

yes

43
Q

what is jaundice from?

A

increased bilirubin levels

44
Q

physiologic jaundice occurs after low long?

A

after the first 24 hours

45
Q

interventions for physiologic jaundice

A

-notify pediatrician
-well hydrated
-phototherapy (maximum skin, exposure cover eyes, monitor diapers)

46
Q

where does bilirubin go if theres too much?

A

brain

47
Q

what is long term irreversible permanent brain damage

A

kernicterus

48
Q

what is breast feeding jaundice associated with

A

poor feeding and inadequate fluid intake

49
Q

what are interventions for breast feeding jaundice

A

frequent feedings and lactation support

50
Q

when does breast milk jaundice begin

A

after day 7

51
Q

what is breast milk jaundice r/t

A

breast milk itself

52
Q

what results from breastmilk causing reabsorption of bilirubin from the intestine. free fatty acids from BM comoete for binding sites on albumin and inhibit coagulation

A

breast milk jaundice

53
Q

when is swallowing and peristalsis initiated?

A

in utero

54
Q

when does the first BM normally occur, and what is the goal time

A

within 48 hours, goal of 8-24 hr

55
Q

what is 1st BM called?

A

meconium

56
Q

what is the implication and function of vitamin k in newborns

A

since the GI tract is sterile, there is limited vitamin k. it is used for clotting

57
Q

what is the normal BM frequency

A

vary, 1 BM every 2-3 days up to 10 per day

58
Q

what kind of stool is greenish “raspberry seed” appearance, lasts 1-2 days

A

transitional stool

59
Q

is breastfed or formula stool more formed?

A

formula

60
Q

how long does it take for most babies to void, and nearly 100% void by when?

A

most within 24 hr, 100% 48 hr

61
Q

do babies have a higher or lower GFR than adults

A

lower

62
Q

when can babies fully concentrate urine?

A

3 months

63
Q

pain relief for circumcision

A

lidocaine @ site prior tylenol after

64
Q

what is the pain assessment tool for newborns?

A

NIPS (neonatal infant pain score)

65
Q

what pain meds are used in infants?

A

local, emla (cream numb), tylenol, sweetease (sucrose solution)

66
Q

what is the normal appearance of the penis after circumcision?

A

beefy red and raw (no swelling/active bleeding)

67
Q

should petroleum jelly be used after circumcision?

A

yes!!!! liberally

68
Q

what kind of immunity is where the pregnant woman forms antibodies from exposure

A

active acquired immunity

69
Q

what kind of immunity is where IgG antibodies are transferred to teh fetus? (fetus gets from mom)

A

passive acquired immunity

70
Q

between IgG and IgM, which crosses the placenta?

A

IgG

71
Q

where is IgA found?

A

colostrum

72
Q

what is seen in the first period of reactivity in newborn neurological function

A

Hr and RR are elevated
alert from time of birth-30 mins

73
Q

what is seen during the period of inactivity in newborn neuro function

A

Hr and RR decrease
may sleep up to 4 hours

74
Q

what is seen in the second period of reactivity in newborn neuro

A

HR and RR may increase
awake/alert for 4-6 hr

75
Q

what sleep state for newborns has eyes closed, no eye movement, regular resps, and HR 100-120

A

deep sleep

76
Q

what sleep state in newborns has irregular resps, rapid eye mvmt, irregular sucking

A

light sleep (REM)

77
Q

what newborn alert state has open/closed eyes w/ fluttering eyelids

A

drowsy/awake

78
Q

what newborn alert state has the baby alert, may fixate on attractive object

A

quiet alert

79
Q

what newborn alert state has eyes open and motor activity quite intense

A

active alert

80
Q

what newborn alert state is an intense state

A

crying

81
Q

what is the visual capability of newborns

A

faces, bright colors, and patterns

82
Q

what is the auditory capability of newborns

A

can hear, conduct hearing test

83
Q

what is the olfactory capability of newborns

A

identify people through smell

84
Q

what is the taste capability of newborns

A

can respond to taste

85
Q

describe the grasping reflex

A

holding a placed finger

86
Q

describe the rooting reflex

A

stroke face, it turns with attempt to suck

87
Q

when does teh rooting reflex disappear

A

4 mo.

88
Q

when does the stepping reflex disappear

A

4-8 weeks

89
Q

describe the babinsky reflex

A

stroke sole of foot, fans/extends toes

90
Q

describe the tonic neck reflex

A

turns head to one side when laying on back, arm extended on baby side faces, flexed on opposite side

OB (15 decks)

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