Unit 16 Flashcards
What are the normal vital signs of a newborn?
R: 30-60
HR 110-160
BP: 80/40
T: 97.7-99.5 or 36.5-37.5
What is the intial care of a newborn?
Initiation of respirations
Assess APGAR - HR through the cord
Suction mouth and then nose
Dry the baby to prevent evaporated heat loss
Skin-to-skin
Breastfeed within 30 minutes
Place ID bracelets on
What is the respiratory system of a newborn?
Distress s/s: nasal flaring, retractions, seesaw respirations
Apneic = caused by rapid increase in temperature, hypothermia, hypoglycemia, or sepsis
Tachypnea = indication of RDS; 1st sign of respiratory, cardiac, metabolic, or infectious illnesses
Acrocyanosis = normal finding in the first 24 hrs
What is transient tachypnea?
Caused from c-section and lungs are retaining fluid
What is a newborns cardiovascular system like?
RBC and WBC increased at birth, then decrease rapidly
Closure of foramen ovale within 24hrs; permanently after 3-4 weeks
Heart rate can go as low as 80 during sleep or up to 180 during crying; PMI is visible
Heart sounds like a murmur isn’t pathologic and 50% will disappear by 6 months
BP = 80/40
What are benefits of delayed cord clamping?
expands the blood volume to 100 mL
increases BP
reduces risk for intraventricular hemorrhage and NEC
NEGATIVE = can cause jaundice
What are signs of heart problems?
persistent tachycardia associated with anemia, hypovolemia, hyperthermia, or sepsis
persistent bradycardia indicates heart block or hypoxemia
Perform critical congenital heart disease screening (compare O2 levels in limbs)
What is the thermoregulation like for a newborn?
Hypothermia: no fat, large body-surface; important to dry; cold stress = hypoglycemia
Hyperthermia: skin-to-skin is important for thermoregulation
What is the integumentary system like in a newborn?
Vernix is emollient
Peeling of the skin after birth
Mongolian spots - bluish/black spots on dark-skinned babies
Nevi - commonly on face and neck, no treatment required
Erythema - rash appearing 24-72 hrs after birth; no treatment required
Problem signs: petechiae, central cyanosis, face presentation with bruising
What is the gastrointestinal system like for a newborn?
Small stomach capacity (<10mL at birth, increases to 90mL by day 10)
Feeding should be done about every 3 hours
Position head to side and burp after feeding
Observe for stool
Perform PKU after 24hours of feeding
What is the hepatic system like in a newborn?
Feed early to stimulate intestinal activity and to keep bilirubin levels low
Watch for stool and bleeding
Jaundice is common and should resolve by itself
What is the renal system like in a newborn?
weight loss 5-10% due to water loss and limited intake
Weigh newborn daily
Monitor I/Os
1st voiding within 24 hours; contact provider if not
What is the immune system like in a newborn?
Administer erythromycin 1hr after birth
Handwashing important
Breastfeeding decreases risk of infection
Infection is the leading cause of death
What is the neurological system like in a newborn?
Reflexes - rooting, swallowing, moro (fall back and extend arms), plantar (grasping), babinski (foot)
Fontanels are open to allow for brain growth
Assess head size, lethargy, and pitch of cry
What is the purpose of phototherapy?
Reduce the level of circulating unconjugated bilirubin by converting it into a conjugated form that can be excreted through urine and feces
