Unit 1 - Newborn Assessment Flashcards
What is the foramen ovale? What causes it to close?
Connects R and L atria to allow blood to bypass pulmonary system. Closes after birth d/t increased systemic pressure.
What is the ductus arteriosus? When does it close?
Duct from Pulmonary Artery to Aorta. Closes hours after birth.
What is the ductus venosus?
Causes blood to bypass liver
What is the approximate O2 sat of a fetus?
Approximately 10%
What should capillary refill time be for a newborn?
< 2 seconds
Describe newborn cardiac findings
- Heart beat may be irregular at first, and murmurs are common for the first 24 hours
- Heart rate 110-160, but can be 180s initially
- Volume 80-85 mL/kg
How long could it take for PO2 to reach 95%+?
Within 24 hours
Describe taking BP on a newborn assessment? What is a major concern?
Take BP at R arm and L calf to check for CCHD (critical congenital heart disease).
Report systolic >= 10 on arm vs leg or PO2 > 3% difference
(This is checked at 24 hours @ ProHealth, but varies by policy)
What stimulates newborn respirations? What characteristics would you expect? What about limbs?
Respiration is stimulated by pressure changes, increased CO2 and decreased O2.
Normal resp rate is 30-60 breaths/min. Breaths will be shallow and irregular, possible apnea (less than 15 seconds is normal).
Peripheral cyonosis is normal
What is RDS? Which newborn is most susceptible? What is the main reason this occurs?
Respiratory distress syndrome. It is most common in premature infants, mainly due to the fact that the respiratory system the last system to develop.
What specific group of ‘stress hormones’ does fear and anxiety trigger?
Catecholamines
What does APGAR measure? What does it stand for? When is it performed? What does the score mean?
APGAR - Appearance, Pulse, Grimace, Activity, Respirations. It is performed at 1 min and 5 min. It measures the newborn’s response to the birthing process.
>7 = Healthy 5-7 = Re-check <5 = emergency
What newborn vitals would you expect to see?
HR: 110-160 bpm
Resp: 30-60
BP: 50-85/30-55
Temp: 97.7 - 99.7
What condition does cold stress lead to in a newborn?
Acidosis
What vitamin is given to newborns? Route? Why is this necessary?
Vitamin K is given IM in the vastus lateralis. They are deficient d/t a sterile gut.
What are average measurements (head, chest, weight, length) for a newborn? What is the newborn growth rate?
Head: 32-37 cm (2 cm greater than chest)
Chest: ~32 cm (measured at nipples)
Weight: 5 lb 8 oz - 8 lb 13 oz
Length: 18-22 inches
- Low weight < 5.5 lbs
- Grow 7 oz/week for 6 months (double by 5 mo and triple by 1 year)
What is a low birth weight?
< 5.5 pounds
What is a regular pregnancy term? What happens after this time frame?
37-42 weeks. After 42 weeks, the placenta slows down.
What are abnormal pregnancy terms?
Preterm: < 37 weeks
Post-term: > 40 weeks
Post-mature: >40 weeks and placenta aging
What is SGA and what are the associated complications?
Small gestational age, less than 5.5 pounds.
Hypoxia, hypothermia, hypoglycemia, hyper-bilirubinemia
What is LGA and what are the associated complications?
Large gestational age, greater than 9 pounds.
Placental deprivation –> hypoxia
Oligiohydramnios –> cord compression
Macrosomia –> difficult delivery
Hypoglycemia –> (mom DM) d/t cessation of high glucose blood supply
Hyperbilirubinemia –> d/t polycythemia (increased hematocrit)
Describe what you would expect to find with the newborn urinary system
- Wet diaper within 24 hours
- Light and odorless, but may be “rusty” at first
- No of diapers = days old
- Until day 4, at which point should be 6-10
What are the fontanelles? How long do they last?
Posterior fontanelle = 4-6 weeks
Anterior fontanelle = 4-6 months
What is a hypospadias?
Abnormal urethral opening
Term for the first 28 days of newborn’s life? (Or birth to one month)
Neonatal period
What are the four key areas of the neonatal period?
Circulation, respiration, thermoregulation, glucose regulation
What are the names of the major catecholamines and what do they do?
Epi and Nor-epi (also dopamine). Stimulate cardiac, surfactant, fluid clearance
What is HR at birth and what does it decrease to?
110-160 decreasing to 120-130
What is early clamping? Late clamping?
Early is 30-40 seconds, late is 3-4 minutes
What is TTN? What causes it? Which type of birth can lead to this?
Transient tachypnea of the newborn, caused by fluid retention in the lungs. C-sections can lead to TTN due to the lack of vaginal thoracic compression.
** May require thoracic compression after delivery
When should APGAR be rechecked? What score would require a recheck?
Rechecked @ 10 minutes if score is 5-7
What are the typical characteristics of a postterm newborn?
- Dry, cracked, peeling, wrinkled skin
- Vernix caseosa and lanugo are absent
- Long, thin extremities
- Plantar creases covering soles of feet
- Wide-eyed, alert expression
- Abundant hair on scalp
- Thin umbilical cord
- Long fingernails
- Limited vernix and lanugo
- Meconium-stained skin and fingernails
Why is erythromycin put on a newborn’s eyes? What causes this?
Prevents ophthalmia neonatorum (conjuctivitis) caused by chlamidia or gonorrhea
How often would you take a newborn’s temperature?
Every 30 min for two hours (or until stable)
What three conditions are hypoglycemia risk factors?
- Pre-mature
- FGR (Fetal growth restriction)
- Maternal diabetes
