Unit 2 - Part 2 - Newborn Care Part 1 Flashcards
Pulse of a newborn
110-160 bpm
sleep: low is 70
cry: high is 180
BP of a newborn
birth: 70-50/45-30
day 10: 90/60
RR of a newborn
30-60 breaths per minute
Normal Temp. for newborn
36.5-37.5 C (97.7-99.4 F)
Axillary Temp for newborn
36.5-37.2 C (97.7-99 F)
Skin Temp for newborn
36-36.5 C (96.7-97.7 F)
Rectal Temp for newborn
36.6-37.2 C (97.8-99 F)
What does the APGAR scoring include?
- Heart Rate
- Resp. Effort
- Muscle Tone
- Reflex Irritability
- Color
What is a good APGAR score
7-10
What to do if APGAR is less than 7 at 5 minutes
- repeat every 5 minutes up to 20 minutes
- resuscitative measures
What to do it APGAR is less than 3 at 5 minutes
correlate with neonatal mortality
When are umbilical clamps placed
after identification of vessels
Where are umbilical clamps placed
0.5-1 inch from abdomen
When do you remove the umbilical clamp
24 hours after the cord has dried
_____ _____ is the blood that remains in the umbilical cord and placenta following birth. This blood is usually discarded. However, _____ _____ _____ utilizes facilities to store and preserve a baby’s cord blood (can help if child were to develop cancer)
Cord Blood, cord blood banking
T/F: To maintain life, the lungs must function immediately after birth.
T
Two changes necessary for the lungs to function immediately after birth:
- Pulmonary ventilation must be established through lung expansion following birth.
- A marked increase in the pulmonary circulation must occur.
The first breath of life—the gasp in response to mechanical and reabsorptive, chemical, thermal, and sensory changes associated with birth—initiates …
the serial opening of the alveoli
What happens to a newborn when air enters the lungs
- triggers decreased pulmonary vascular resistance
- blood distributed throughout lungs
Fetal hgb has a _____ affinity for oxygen than adult hgb
greater
First two things you do as immediate care of newborn
1: Respiratory/Cardiac Assessment
2. Temperature Assessment
What is part of the Respiratory/Cardiac Assessment
- mouth THEN nose suctioned
- infant placed on mother’s abdomen
How will a baby lose heat
- evaporation: dry them off quickly
- conduction: warm towels (not room temp.)
- radiation: neutral thermal environment
- convecton: worry about wind drafts (skin to skin)
How to count newborn’s pulse
Use apical pulse! Count for full minute!
Are a newborn’s respirations regular or irregular
irregular = count for full minute!
T/F: Anything that sedates mother, sedates the baby too
T (takes a lot longer to get out of baby’s system)
Grunting respirations are an indication of _____ _____
respiratory distress
Infants should produce _____ wet diaper within the first 24 hours of life
one
Describe hct values in Newborn
may rise above fetal levels
Describe hgb values in Newborn
fall
Describe Lueokocytes in newborn
normal
Describe Blood Volume in newborn
85 mL/kg (varies)
____ stored in liver until needed for new RBC’s
iron
When do newborns start producing vitamin K
when they start producing ecoli
Definition: conversion of lipid-soluble pigment into water-soluble pigment
Conjugation of Bilirubin
3 things that happen after bilirubin conjugated, bound
- can be changed back to unconjugated bilirubin
- newborn liver less able to conjugate bilirubin
- more susceptible to jaundice
How to assess physiological jaundice
by pressing skin on forehead, nose, with finger (50% full-term, 80% preterm)
if jaundice becomes apparent….
keep newborn well-hydrated
Newborn kidneys are _____ able than adult kidneys to concentrate urine
less
initial bladder volume of a newborn
6-44 mL (cloudy, high specific gravity)
T/F: newborns have pseudomenstruation
T, because they still have some hormones from mother
How big is a newborn’s brain compared to adult’s
1 quarter
- myelination of nerve fibers incomplete
Characteristics of newborn neurological function
- partially flexed extremities
- purposeless, uncoordinated bilateral movements
Describe how a newborn’s cry should be
lusty, vigorous
How do newborns grow
cephalocaudal (proximal-distal)
- abdominal
- babinski
- blinking
- grasping
- moro
- plantar (toe grasping)
- puillary
- rooting
- startle
- sucking
- tonic neck
- walking
- withdrawal
Common specific reflexes of the Newborn
When is a newborn alert
First 30-40 minutes after birth
- tends to be shorter after first 2 days after birth
Definition: they can turn you off and ignore you
Habituation
T/F: we want parents to be apart of assessments of newborns
T
3 Times for assessment of newborn
- birthing area immediately after birth
- admission to nursery
- before discharge
What is included in an initial physical assessment of a newborn
observes the nares for flaring and, as the newborn cries, inspects the palate for cleft palate.
- inspect skin
- inspect chest for respiratory rate, presence of retractions
Two gestational age assessment stage:
- external physical characteristics
- Neurological or neuromuscular development
is the baby really the age that they look
What will the ear form be like if the baby is premature
won’t spring back, stay folded over for a while
What will the ear form be like if the baby is older and mature
springs back quickly
How can you tell if a female is older and mature
Clitoris is not as easily seen, labia majora is more present
How can you tell if a male is older and mature
wrinkles in scrotum
what is vernix
cheesy substance covering skin of baby at birth
Will there be a lot or a little vernix on a premature baby
a lot
Definition: fine, soft hair, especially that which covers the body and limbs of a human fetus or newborn
lanugo
What is a supplementary method for determining gestational age
view vascular network of cornea
Gestational age determination, birth weight:
Below 10th percentile =
small for gestational age (SGA)
Gestational age determination, birth weight:
Between 10th and 90th percentile =
appropriate for gestation age (AGA)
Gestational age determination, birth weight:
Above 90th percentile =
large for gestational age (LGA)
A weight loss of up to 10% for term newborns is considered to be _____ during the first week of life.
normal
This weight loss is the result of limited intake, loss of excess extracellular fluid, and passage of meconium
T/F: Birth weight is usually regained by 2 weeks if feedings are adequate.
T
Weight for a normal, full-term white newborn
3,405 g
70%-75% of newborn’s weight is _____
water
Newborn’s head is _____ size of adult’s head
1/3
Average chest circumference for newborn
32 cm
How many pounds is considered large for a newborn
> 8.8 lbs
How often do we monitor newborn’s temperature
every 30 minutes until stable
Immediately after birth, and for approximately the next 2 hours, respiratory rates of 60–70 breaths/minute are _____. Some cyanosis and acrocyanosis are _____ for several hours
normal, normal
thereafter, the infant’s color improves steadily
Definition: A deep red color develops over one side of the newborn’s body while the other side remains pale, so the skin resembles a clown’s suit
Harlequin sign
What is the color change in Harlequin sign a result of?
a vasomotor disturbance in which blood vessels on one side dilate while the blood vessels on the other side constrict
How long does the Harlequin sign last
1-20 minutes
(Affected newborns may have single or multiple episodes, but they are transient and clinically insignificant. The nurse should document each occurrence. )
Definition: an eruption of lesions in the area surrounding a hair follicle that are firm, vary in size from 1 to 3 mm,
and consist of a white or pale yellow papule or pustule with an erythematous base.
Erythema Toxicum (“newborn rash” or “flea bite” dermatitis)
rash may appear suddenly, usually over the trunk and diaper area, and is frequently widespread
Describe shape of head of a breech-born
well-shaped, round
