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NURS 372 > Week 10 - Newborn Nursing > Flashcards

Week 10 - Newborn Nursing Flashcards

1
Q

Newborn period

A

birth to 28 days of life

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2
Q

Main physiological adaptations (5)

A

1) establishing and maintaining respirations

2) adjusting to circulatory changes

3) regulating temperature

4) nutritional intake and digestion

5) regulating weight

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3
Q

Apgar scoring purpose

A

rapid assessment of the newborn’s transition to extrauterine at 1 and 5 mins of life

out of 10

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4
Q

When to repeat Apgar scoring

A

repeat at 10 and 20 mins if less than 7 at 5 mins

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5
Q

Apgar score of 3 or less

A

severe distress

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6
Q

Apgar score of 4 to 6

A

moderate distress

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7
Q

Apgar score of 7 to 10

A

normal transitioning

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8
Q

How long do you assess the HR for the Apgar scoring?

A

10 seconds

auscultate with stethoscope

the ONE day you do it within 10 seconds***

or palpate the cord for 10 second

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9
Q

APGAR mneumonia

A

A = appearance (colour)

P = pulse (HR)

G = grimace

A = activity (muscle tone)

R = respirations

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10
Q

What should the nurse promote right after birth

A

skin to skin

do as many assessments as possible during skin to skin

only interrupt if unstable

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11
Q

Benefits of skin to skin for baby

A

physiological stabilization (HR, RR, and O2 stable)

improved blood glucose

thermoregulation

more effective sucking

comfort, less crying

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12
Q

What helps to stabilize blood glucose levels?

A

ideal thermoregulation

cold = stressed = use up glucose

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13
Q

Benefits of skin to skin for mom

A

breastfeeding

less anxiety

less chest engorgement/pain

higher satisfaction with birthing experience

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14
Q

Benefits of skin to skin after C-section

A

better temp regulation

less jaundice

breastfeeding

contact between mom and baby

reduced postpartum depression

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15
Q

T or F: Only mom can participate in skin to skin

A

mom AND father can partake

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16
Q

Sudden Unexpected Postnatal Collapse (SUPC)

A

sudden collapsewithin the first week of life

infant becomes rapidly unstable

appears initially healthy but ofteninternal health problem

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17
Q

When do most cases of Sudden Unexpected Postnatal Collapse occur?

A

within first 2 hours

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18
Q

Risk factors for Sudden Unexpected Postnatal Collapse

A

baby lying FACE down

parents alone with baby

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19
Q

What nurse can do to help prevent Sudden Unexpected Postnatal Collapse

A

do frequent assessments and vitals

nurse providing care to dyad during the first 2 hours after birth

elevate head bed between 35-80 degrees

if leaving the room, make sure that someone takes over

teach parents re abnormal appearances

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20
Q

Other baby positioning considerations

A

mouth and nose not blocked

sniffing positioning

can slide 1 finger in between

straight spine

chest to chest

legs well flexed in M position

mom not distracted

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21
Q

Normal newborn HR

A

110 - 160 bpm

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22
Q

Normal newborn RR

A

30 - 60 resps/minute

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23
Q

Normal newborn axillary temp

A

36.5 - 37.5 C (WHO, AAP)

36.3 - 37.2 C (ACoRN)

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24
Q

Consideration when taking temperature accurately

A

needs to be dry

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25
Normal BP at birth
systolic: 60 - 80mmHg diastolic: 40 - 50mmHg
26
Normal BP at 10 days
systolic: 95 - 100mmHg diastolic: 40 - 50mmHg
27
Oxygen saturation at 1 minute
60s%
28
Oxygen saturation at 5 mintues
80s%
29
Oxygen saturation at 10 minutes
85 to 95%
30
Respiratory system changes
shift from intrauterine oxygenation via transplacental gas exchange to extrauterine oxygenation via lungs
31
Things that help initiation of respirations (4)
1) chemical 2) mechanical 3) thermal 4) sensory
32
Chemical
normal for a bit of respiratory acidosis during labour sends signal to medulla to initiate respirations vaginal birth helps with this
33
Mechanical
compression on lungs in the birth canal after birth, there is an increase in interthoracic pressure then recoil change in pressure helps baby expel fetal lung fluid and replace with air, expanding the alveoli
34
Thermal
colder air compared to intrauterine environment temp receptors on skin send signal to medulla
35
Sensory
sensory stimulation crying increases their positive pressure, helping to expand alveoli
36
Normal respiratory findings
nose breathing shallow and irregular apnea (< 20 seconds) 30 - 60 resp/min abdominal breathing loud, clear breath sounds, equal bilaterally
37
Pauses in breathing are significant over....
20 seconds
38
Causes of apnea in newborn
medications given to mother - CNS depressants (narcotics, mag sulf) meconium aspiration syndrome - and related pneumonia pneumonia
39
Signs of respiratory distress in a newborn
nasal flaring intercostal or subcostal retractions crackles, wheezing, grunting, stridor or grasping diminished or absent air movement seasaw or paradoxical respirations RR <30 or >60bpm central cyanosis pulse oximetry <95%
40
When should transient tachypnea of the newborn resolve by?
within 1-2 hours after birth as bit expected as they're expelling fetal lung fluid but resolves quickly
41
Changes in the cardiovascular system
Warton's jelly contracts artery and vein clamping of the cord capillaries in lung begin to expand less vascular resistance in the lungs pressure in R heart and pulmonary arteries DECREASES pressure in L heart and aorta INCREASES
42
What causes the ductus arteriosus to close?
prostaglandins
43
Where to auscultate heart sounds on a newborn
4th intercostal space full minute
44
Murmurs in newborns
open ductus arteriosus can be heard as heart murmur most are insignificant should disappear by 6 months
45
Sources of heat loss (4)
1) convection 2) radiation 3) evaporation 4) conduction
46
Convection
flow of heat from the body to cooler air e.g. draft
47
Radiation
loss of heat from the body to a cooler surface not in direct contact but relative proximity e.g. cement wall near crib
48
Evaporation
loss of heat when liquid is converted to a vapour e.g. why you dry off a baby covered in amniotic fluid
49
Conduction
loss of heat from the body surface to cooler surfaces e.g. why you put a pad on a scale when weighing the baby
50
Things to do to minimize heat loss
dry off baby skin to skin cover back of neck with warm blanket hat on head get rid of wet blanekts only expose areas you need to put blanket/pad on scale
51
Reasons for below normal temperature
preterm infection dehydration environment
52
Reasons for above normal temperature
infection dehydration chemical dependence (withdrawal) environmental
53
Thermogenesis
increased muscle activity (crying, restless) to generate heat in response to a cooler environment
54
T or F: Babies can shiver
FALSE cannot shiver to warm themselves
55
Nonshivering thermogenesis
metabolism of brown fat and increased metabolic activity of the brain, heart and liver
56
Why we want to prevent baby from getting cold
increased expiratory rate use more oxygen using fat using glucose stores can develops hypoglycemia and hypoxia
57
T or F: Neonates will always cry in response to pain.
FALSE might cry grimacing turning away very red clenched fists
58
Neonate pain tools
Premature Infant Pain Profile (PIPP) Neonatal Infant Pain Scale (NIPS)
59
Comfort measures for pain
skin to skin breastfeeding sucrose swaddled pharmacological pain control
60
Average birth weight
2500 to 4000 g
61
T or F: Term infants may lose and regain up to 10% of their birthweight within the first 2 weeks
TRUE
62
What can you use to moisturize baby's skin?
vernix breastmilk
63
Jaundice occurs due to
elevated unconjugated bilirubin
64
Cephalhematoma
does NOT cross over suture lines** often localized to one side collection of blood often from prolonged labour or trauma not present initially at birth, take a few hours to appear takes a few weeks to resolves
65
What does a cephalhematoma increase the risk of?
jaundice
66
Caput Succedaneum
present initially crosses suture lines resolves on its own in a few days does NOT increase risk of jaundice
67
If you see skin tag on baby's ear, would also want to assess the....
kidneys
68
Thrush discharge will not....
wipe away in baby's mouth
69
Umbilical cord care
watch for signs of infection, bleeding keep it outside of diaper
70
What colour is urine initially?
peach-coloured due to uric acid crystals
71
Rooting reflex
infant turns head towards stimulus and opens mouth
72
Sucking stimulus
infant opens mouth and begins to suck on breast
73
Moro (Startle)
symmetrical abduction and extension of arms followed by return to the relaxed flexion
74
Grasp reflex
infant’s finger curl around examiner’s finger (palmer), toes curl downward (plantar)
75
Tonic neck reflex
infant facing left side, arm and leg on that side extended opposite arm and leg flex
76
Babinski reflex
stroke sole of foot upwards and all toes hyperextend with dorsiflexion of the big toe
77
Vitamin K prophylaxis
up to 6 hours IM injection in vastus lateralis 90 degree angle 25 gauge
78
How long to delay initial bath
24 hours
79
How long to delay initial bath if it it done for cultural reasons
6 hours
80
Which bath is preferred a) full immersion bath b) sponge bath
a) full immersion bath less chance for heat loss

NURS 372 (12 decks)

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