Week 2 Flashcards by Lani Manners

discharge begins when

admission

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neonatal peroid

birth to 28 days

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first peroud of reactivity

30 mins: HR increases to 160-180 and infant is alert
60-100 min: peroid of decreased responsiveness, infant is tired

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second peroid of reactivity

2-8 hours after birth
10 min to several hours
tachycardia and pnea, increased muscle tone, improved skin color, meconium passed

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what is responsible for gas exhange

placenta

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ductus arteriosus

pulmonary artery to aorta

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foramen ovale

door between atrial

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ductus venosus

bypasses the liver

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fetal Po2

20-30 mmHg

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ducuts arteriousus and venous are converted to what in 2-3 months

ligaments

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3 vessels in cord

AVA

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what is oxygenated in the cord

vein

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few first breaths do what to fetal lung fluid

air moves in and pushes the fluid in the lungs out

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what happens in the atriums after delivery

pressure in left atrium increases and closes the door

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most critical physiologic change

initiation of breathing

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labor induces what changes in Co2, O2, and pH and what does that stimulate

mild hypercapnia
hypoxia
acidosis
stimulate the respiratory center

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4 stimuli

chemical
mechanical
thermal
sensory

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chemical stimuli

flow through umbilical and CO2 and pH and O2

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mechanical stimuli

squeezed through pelvis

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thermal stimuli

warm to cold

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sensory stimuli

handling, talking, rubbing

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what system is the last to develop

respiratory

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fetal lungs secrete how much of fetal lung fluid

25-30ml/kg

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fetal lung fluid helps develop what

alveoli

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at term infants should hold how much of air

20mL

surfactant relating to age

increased surfactant with increased gestational age

why might C section have wetter lungs

because the decrease the squeezing

what to do if infant is not breathing

positive pressure ventilation

heart rate sleeping and awake

sleep 80-100 awake 120 to 160

BP (map)

equals weeks 40 MAP = 40 weeks

delayed cord clamping pros and cons

increase BV and BP decrease risk of necrotizing enterocolitis and intraventicular hemorrhage increase risk of jaundice

ductus arteriousus closes

24 hours

RBC

higher since the PO2 is lower the fetus needs additional RBC for oxygen transport

what is the best thing for a cold baby

skin to skin

4 heat loss modes

convection radiation evaporation conduction

convection

air/draft

radiation

solid objects not touching

evaporation

fluid to aircon

conduction

2 objects touching

what is non shivering thermogenesis

brown fat metabolism

brown fat amount related to gesation

increase with gesation

what does the baby need for brown fat metabolism

O2 and glucose

what baby might have a hard time with brown fat metabolism

hypoxic hypoglycemic

meconium passed within

24 hours

should void by

24 hours

general rule of thumb for urine and stools

age in days = how many

can moms sugar cross placenta

yes

can moms insulin cross placenta

no baby needs to make own

why might gestational diabetes be at risk for hypoglycemia

increase sugar and increase insulin and when cord is clamped, still making insulin and then at risk for hypoglycemia

preterm babies at risk for hypoglycemia

decrease glycogen storage

when is glucose the lowest

2 hours after birth

hypoglycemia s/s

jitter apneic feeding problems seizures lethargy

jitter vs seizure

jitter stops when you hold hand, seizure doesnt

jaundice is peak for term baby

3-5 days

jaundice is peak for preterm baby

5-7 days

if someone tells you a baby is in jaundice what is the first question

age

causes of jaundice

increase bill production ineffective breast feeding = dehydration composition of breast milk mom and baby blood incompatibility sepsis brusing premature delayed mec passing

if a baby has an infection where does the temp go

hypo

is vernix good or bad for babies

good

acrocyanosis

blueish in hands normal due to immature circulatory system

mongolian spots

above butt

erythema toxic

normal newborn rash

what do we need to do for male genetialia exam

ensure both testes have descended

seizure activity

eyes deviating staring apnea tachycardia increased salivation

for HR and we are palpating the cord we should count for how long

6 sec and x by 10

when is APGAR preformed

1 5 10 min and every 5 until 20

is APGAR an indicator of how well they will do in rest of life

where do babies start to struggle with APGAR

under 7

do we get head circumference

yes

where do we inject babies

vastus lateralis

vit K does what

prevents vit K hemorrhagic disease

sugar inhibits what production

surfactant

why do we get bigger babies due to sugar

sugar acts as a growth hormone

AGA

appropriate for gestational age 10-90

LGA

large for gestational age 90

SGA

small for gestational age 10

gestational age is an important predictor of

survival

morbidity and morality have a ________ relationship with gestational age

inverse

Ballard exam

exam that estimates gestational age

vernix caseosa

fetal protective skin film that acts as a barrier in uteri and facilitates postnatal adaptation to dry extrauterine enviornment

stork bites/nevus simplex

red spot at base of skull

relfexes

root moro palmar plantar babinski tonic neck

why do we measure head circumference

brain growth

anterior fontanel closes

18 months

caput

crosses suture line

cephalohematoma

does not cross line

smbgaleal hemorrhage

severe anemia, shock bleeding into head high morbidity and mortality

hydrocephalus

increase in fluid in ventricles

low set ears

syndrome

apnea lasts how long

>20 sec

what is abnormal in respiration

grunting flaring retractions

normal heart rate

120-160

capillary refill is checked on

chest

3 vessel cord

2 arteries 1 vein

do we want cord in or out of diaper

yes

hydrocele

extrafluid in testicles

evidence of fistula of anus

stool from vagina or penis

treatment of hyperbilirubinmeia

phototherapy exchange transfusion

at risk infants for hypoglycemia

preterm late preterm SGA/LGA IDM (infant of diabetic mom) perinatal stress

newly circ infant

check for bleeding and urination check for infection penis is covered in yellow exudate in 24-48 hours, this is normal

most common response to pain

vocalization or cry

sucrose

nonpharm releases bodies opioid

safe sleep position

ABC

safe sleep prevents

SIDS

mothers who breastfeed decreased risk for

PPH

LATCH scoring tool

Latch audible swallowing type of nipple comfort level of mother hold (positioning)