Week 2 Flashcards
discharge begins when
admission
neonatal peroid
birth to 28 days
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
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
what is responsible for gas exhange
placenta
ductus arteriosus
pulmonary artery to aorta
foramen ovale
door between atrial
ductus venosus
bypasses the liver
fetal Po2
20-30 mmHg
ducuts arteriousus and venous are converted to what in 2-3 months
ligaments
3 vessels in cord
AVA
what is oxygenated in the cord
vein
few first breaths do what to fetal lung fluid
air moves in and pushes the fluid in the lungs out
what happens in the atriums after delivery
pressure in left atrium increases and closes the door
most critical physiologic change
initiation of breathing
labor induces what changes in Co2, O2, and pH and what does that stimulate
mild hypercapnia
hypoxia
acidosis
stimulate the respiratory center
4 stimuli
chemical
mechanical
thermal
sensory
chemical stimuli
flow through umbilical and CO2 and pH and O2
mechanical stimuli
squeezed through pelvis
thermal stimuli
warm to cold
sensory stimuli
handling, talking, rubbing
what system is the last to develop
respiratory
fetal lungs secrete how much of fetal lung fluid
25-30ml/kg
fetal lung fluid helps develop what
alveoli
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
no
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)