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OB > Week 4 > Flashcards

Week 4 Flashcards

Neonatal Care

1
Q

Normal temp for a baby in Celsius?

A

36.5-37.2

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2
Q

Normal temp for a baby in Fahrenheit?

A

97.7-99

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3
Q

What pain scale is done for the baby in postpartum?

A

NIPS scale

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3
Q

What pain scale is done for the baby in NICU?

A

N-PASS scale

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3
Q

where might you find IgG Immunoglobulins?

A

Blood and extracellular fluid

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4
Q

which immunoglobulin crosses the placenta to provide passive immunity when you born

A

IgG

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4
Q

where might you find IgA?

A

External secretions such as tears, saliva, mucus

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4
Q

what is the function of IgG?

A

Crosses the placenta to provide passive immunity for newborns
Provides long term immunity after recovery or vaccine

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5
Q

what is the function of IgA?

A

Present in breast milk to provide passive immunity for breastfed infants

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6
Q

what type of immunoglobulin is present in breast milk to provide passive immunity for breastfed infants?

A

IgA

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6
Q

what type of immunoglobulin is found in secretions of all mucous membranes?

A

IgA

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7
Q

where is IgM found?

A

Blood

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8
Q

what immunoglobulin is produced first during an infection and what follows?

A

IgM and then IgG

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9
Q

what immunoglobulin is first produced by the maturing immune system of infants

A

IgM

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10
Q

What type of immunoglobulin is found on receptors of B lymphocytes?

A

IgD

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10
Q

What type of immunoglobulins are important in allergic reactions?

A

IgE

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11
Q

what are two types of active humoral immunity?

A

Vaccines and natural immunity from antigens

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12
Q

What are two types of passive immunity?

A

Natural passive immunity from placental transmission of antibodies
Artificial passive immunity of gamma globulin

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12
Q

What are the four mechanisms of heat loss?

A

Conduction, convection, evaporation, radiation

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12
Q

what are some physiologic ways the neonate response to cold?

A

Increase in metabolic rate
Increase of muscle activity
peripheral vascular constriction
metabolism of brown fat

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13
Q

what can overheating or over bundling an infant at sleep cause?

A

SIDS

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13
Q

what are some ways to prevent hypothermia in infants? *cold stress?

A

Parent infant skin to skin contact with warm blanket
Remove wet blankets
Place a stocking cap on the baby
*Wrap neonate and warm blankets
*If the temperature remains below 97.7°F place the neonate under a preheated warmer unwrapped
Monitor blood glucose levels so it doesn’t lead to hypoglycemia
Delay baths
Maintain a NTE
Place neonate away from walls and windows
*Monitor temp every five minutes when rewarming

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13
Q

why are neonates at higher risk for thermoregulatory problems? (3)

A

Higher body surface area to body mass ratio
Higher metabolic rate
Limited and immature thermoregulatory abilities

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14
Q

loss of heat due to cold hands is called______?

A

Conduction

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14
Q

loss of heat due to air currents such as air conditioners or oxygen masks is called______?

A

Convection

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14
Q

loss of heat due cold walls of isolette or cold equipment near neonate is called______?

A

Radiation

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14
Q

what is it called when there is loss of heat that occurs when water on the neonates skin is converted to vapors?

A

Evaporation

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15
Q

what is it called when there is a transfer of heat to cooler surfaces by direct skin contact?

A

Conduction

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15
Q

what is it called when there is loss of heat from the neonates warm body to cooler air currents?

A

Convection

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15
Q

What are some factors that negatively affect thermoregulation?

A

Decrease subcutaneous fat
Decreased BAT in preterm neonates
Large body surface
Loss of body heat from convection, radiation, conduction, and or evaporation

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15
Q

loss of heat during bathing or directly after birth is called______?

A

Evaporation

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15
Q

where is BAT located in a neonate?

A

Neck, thorax
axillary area
Interscapular area
Around adrenal glands and kidneys

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16
Q

what are three things that BAT promotes?

A

Increase in metabolism
heat production
Heat transfer to the peripheral system

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16
Q

What is a passing pulse or CCHD screening?

A

95% or greater in more than one extremity and less than a three percent difference in the post and preductal

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16
Q

what is it called when there is loss of heat from the neonate to cooler objects that are not in direct contact with the neonate?

A

Radiation

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16
Q

what is another name for nonshivering thermogenesis?

A

Brown adipose tissue

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17
Q

when are brown adipose tissue reserves most rapidly depleted?

A

During periods of cold stress

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18
Q

preterm neonates have abundant or limited BAT?

A

Limited

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19
Q

Pulse ox reading are taken where?

A

In either foot post ductal
Right hand -preductal

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19
Q

what are some physiologic responses to cold stress?

A

Increased caloric consumption which leads to hypoglycemia
metabolic acidosis which leads to decreased surfactant production and respiratory distress

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19
Q

What is the level for hypoglycemia in infants?

A

Less than 40-45 mg/dL

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19
Q

Why is erythromycin given?

A

As a prophylactic treatment for gonococcal and chlamydial eye infections

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19
Q

what is the term that describes excessive heat loss that leads to hypothermia and results in utilization of compensatory mechanisms to maintain any unique body temperature?

A

Cold stress

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20
Q

what are some signs and symptoms of cold stress?

A

Axillary temperature below 97.7°F
cool skin
Lethargy
Pallor
Tachypnea
Grunting
Hypoglycemia
Hypotonia
Jitteriness
Weak suck

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20
Q

what are risk factors of cold stress?

A

Prematurity and small gestational size
hypoglycemia
Prolonged resuscitation efforts
Sepsis
Neurological, endocrine, or cardiorespiratory problems

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20
Q

Risk factors for hypoglycemia

A

Macrosomic babies, LGA, SGA
Infection
Respiratory distress
Trauma from birth
Hypothermia
Neonatal resuscitation
Infants of diabetic mothers
Post term and preterm

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21
Q

what are signs and symptoms of hypoglycemia in infants? (HITJAL)

A

Jitteriness
Apnea
Lethargy
Hypotonia
irritability
Temperature instability

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21
Q

how are vitamin K shots given?

A

Intramuscularly in the vastus lateralus muscle to prevent hemorrhage

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21
Q

what are nursing actions for hypoglycemia in infants?

A

Monitor for signs and symptoms
Assess blood glucose level
Assist women with breastfeeding
Feed neonate either formula or dextrose water per protocol
Maintain NTE to decrease cold stress risk

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21
Q

when are hepatitis B vaccines given?

A

One dose before discharge
Second dose 1-2 month
3rd dose between 6 and 18 months

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21
Q

If the mom is HepB positive, what would you do for the baby?

A

Give Hepatitis B immune globulin (HBig) within 12 hours with the hep B vaccine

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21
Q

where are hepatitis B vaccines given?

A

IM Vastus lateralis

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21
Q

What would you do if the circumcision wound starts to bleed?

A

Hold pressure

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21
Q

What are the three types of circumcision?

A

Gompco clamp
Plastibell
mogen

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22
Q

What gauge needle would you use for infants?

A

25 g or 5-8 needle

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22
Q

What are contraindications for circumcision?

A

Preterm neonate
Neonates with genitourinary defect
Bleeding problems
Compromising disorder such as respiratory distress syndrome

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23
Q

What are benefits of circumcision?

A

Decreased incidence of UTO and STI

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23
Q

What are preop procedures for circumcision?

A

Consent
Verify that neonate has voided
Ensure that neonate does not eat 2-3 hrs before procedure
Administer acetaminophen 1 hr before procedure

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23
Q

when should parents notify the physician after circumcision?

A

Bleeding larger than the size of a quarter is present
signs of infection
unit has not voided within 24 hours

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24
Q

what is the normal excretion rate for full term neonates?

A

15 to 60 milligrams per kilogram of urine per day when the first few days and increases to 250 to 400 milliliters by the first month

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24
Q

what are some ways to manage pain for a circumcision?

A

Administering acetaminophen in one hour to procedure
Applying topical anesthetic cream prior to procedure
Positioning newborn in semi recumbent position on padded infant
administering oral Tylenol for at least 24 hours post procedure

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24
Q

what is the normal excretion rate Of a neonate by the end of the first month of life?

A

250 to 400 milliliters kilogram

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24
Q

Blood on the diaper of newborn girls is referred to as

A

Pseudomenstruation

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24
Q

typically neonates pass _____ stools a day but by one month it is normal for breastfed infants to pass is one every _____due to breast milk being more easily digested, while bottle fed infants continue to pass ___ stools per day

A

Several, other day two

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25
Q

what might a pink to rust stain on two or more diapers indicate?

A

Presence of urate crystals and dehydration

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25
Q

what drug given to the mother can delay or decrease urinary output in neonates?

A

Magnesium sulfate

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25
Q

some parent teachings for circumcision care?

A

Watch for bleeding and signs of an infection
inform parents that the gospel fall off on its own
Instruct parents to fasten diapers loosely

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25
Q

for which type of circumcision would you apply a protective lubricant over the circumcision site?

A

Gomco or mogen clamp

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25
Q

for which circumcision method is lubricant not recommended?

A

Plastibell

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25
Q

Why might preterm neonates have a higher risk for kidney problems?

A

the GFR is initially low and can cause dehydration, and toxicity of drugs

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26
Q

when is transitional stool usually?

A

Starts on the third day and continues for three to four days

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26
Q

what color is transitional stool?

A

Black to greenish black, to greenish brown, to greenish yellow

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27
Q

greenish black to greenish yellow stool is a phase of stool characteristics that occurs in what type of neonates?

A

Transitional that occurs in both breast fed and formula fed neonates

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27
Q

how might formula fed stool look and smell?

A

Dry, and more formed than breastfed stools. Pale yellow or brownish yellow and has an unpleasant odor

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28
Q

how might breastfed stool look? And smell?

A

Yellow to golden yellow and semi formed with a pasty consistency and sour odor

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29
Q

____ neonates tend to have more stool per day than_____ neonates

A

Breastfed, formula-fed

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29
Q

on day four what type of stool would you expect?

A

Yellow, soft, and watery

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29
Q

how many stools would you expect breastfed neonates to pass in a day?

A

4-8

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29
Q

on day three what type number and number of wet diapers should you expect in a neonate?

A

Transitional, loser greenish, black greenish, or brown with three stools and 5-6 wet diapers

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29
Q

why might neonates appear uninterested in feedings during the first few days?

A

They are in a quiet sleep state

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30
Q

what are characteristics of meconium?

A

This is the first stool eliminated and is sticky, thick, black, and odorless

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30
Q

what is the neonatal stomach emptying rate?

A

Once every two to four hours

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30
Q

what are some signs of Down syndrome?

A

Spacing of the eyes are wide, the outer canthus of the eye is higher than the ears

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31
Q

when is transitional stool usually?

A

Starts on the third day and continues for three to four days

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31
Q

Why would you stick your fingers in the newborns’ mouth?

A

Check for suck/swallow reflex
Cleft palate
Epstein pearls on the gums
Frenulum check

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31
Q

when is meconium stool first passed usually?

A

24 to 48 hours

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32
Q

what is caput succedaneum?

A

Localized soft tissue edema of the scalp that can cross the suture line
This results within the first week of life

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32
Q

what is cephalohematoma?

A

A hematoma within the periosteum and skull that appears within the first few hours of birth and can increase in size over the next few days
Does not cross suture lines

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33
Q

why is a tight frenulum on infants considered bad?

A

It can affect breastfeeding

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33
Q

what are the causes of cephalohematoma?

A

Trauma to the head during prolonged labor
Forceps delivery
Vacuum extractor

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33
Q

what should you check in male infants?

A

The urethral meatus location

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34
Q

low set ears and palmar crease are signs of what condition?

A

Down syndrome

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34
Q

If the labia ____ covers the labia ____, the baby is closer to ____, and if it is exposed the baby is more____

A

Majora, minora, term, minora

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34
Q

what should you check in an infant’s nose?

A

Check for patency by including one nostril and looking for flaring

34
Q

what are extra digits in either finger is called?

A

Polydactyly

34
Q

what is it called when there’s webbing of the fingers?

A

Syndactyly

34
Q

what might hip clicks be a positive sign for?

A

Ortolani

dislocation

34
Q

how long after a cord is clamped should you remove the clamp?

A

After 24 hours or right before discharge

35
Q

what is the sacral dimple?

A

It is a dimple that might be closed or open and if open can signal an abnormality or get infected later

35
Q

uneven gluteal folds may signal what?

A

Hip dysplasia

36
Q

In infants, the more rugae them more ___ baby is.

A

term

37
Q

might skin tags on an ear be related to?

A

Kidney problems

37
Q

When should murmurs disappear?

A

Within 2 days of birth

37
Q

A displaced PMI might indicate what?

A

Cardiomegaly

37
Q

What are some normal skin conditions of a newborn?

A

Acrocyanosis
Newborn rash
Mongolian spot
Lanugo
Milia
Vernix caseosa

37
Q

What can cause thrush in newborns?

A

Formula fed baby

37
Q

What constitutes microcephaly?

A

Head circumference below the 10th percentile

38
Q

When are tears produced in infants?

A

Two months

38
Q

what might cause bradypnea in infants?

A

Maternal analgesia or anesthesia

38
Q

jaundice within the 1st 24 hours is____ usually related to problems of the_____

A

Pathological, liver

39
Q

what might happen to the fontanelles if a baby is crying?

A

Bulging

39
Q

the more term an infant is the____ the amount of vernix

A

Less

39
Q

In what position should a newborn’s extremities be?

A

Flexed position with rapid recoil of the extremities to a flexed position

40
Q

Blue sclera might be an indicator of what?

A

Osteogenesis imperfecta

brittle bone disease

41
Q

how would you elicit the moro reflex?

A

let the head drop back slightly

42
Q

what would you expect from a moro reflex?

A

Symmetrical abduction and extension of the arms and legs and legs flex up to the trunk with the neonate making a “c” shape with a thumb and index finger

43
Q

what kind of response would the startle response be similar to?

A

Moro, but Signal partial or possible deafness

43
Q

what position would a baby assume if they are being tested on the tonic neck?

A

Fencing

43
Q

in which reflex with the neonate turn his head towards the direction of the stimulus and open his mouth?

A

Rooting

43
Q

how would you elicit a rooting response from a baby?

A

Brush the side of the cheek near the corner of the mouth

43
Q

when would you expect the rooting reflex?

A

From birth and disappearing between three and six months

44
Q

when would you expect the sucking reflex?

A

Present at birth to 10 to 12 months

45
Q

when would you expect the Palmer grasp?

A

From birth to three to four months

45
Q

What might it mean if a baby does not present a sucking response?

A

Recently fed or premature or neurological defects

46
Q

when would you expect the plantar grasp?

A

From birth to three to four months

47
Q

what would you expect in the babinski response?

A

Hyperextension and fanning of the toes when the soul of a foot is stroked upward

47
Q

what would you expect with a plantar grasp?

A

toes flexing down in a grasping motion

47
Q

when would you expect the stepping or dancing reflex?

A

From birth to three to four weeks

47
Q

what would you expect in the stepping or dancing reflex?

A

The new unit stepped up and down in place when their feet are a flat surface

48
Q

Where should you do a heel stick?

A

The lateral or medial aspect of the heal to decrease the risk of nerve damage

48
Q

in which reflex would you turn the head of the neonate to the side so that the chin is over the shoulder?

A

Tonic neck

48
Q

when would you expect the tonic neck reflex?

A

Between birth and six weeks disappearing by four to six months

48
Q

What is test conducted when the neonate Is asleep or lying still, and electrodes electrical activity of the cochlea, auditory nerve

A

Automated auditory brain stem response

48
Q

What are some newborn screenings?

A

PKU, Hearing

49
Q

Otoacoustic emissions records what response

A

Response of outer hair cells of the cochlea to clicking sounds

50
Q

When should the umbilical cord stump detach?

A

In about 2 weeks

51
Q

How tall should babies be?

A

18-20.5 in

52
Q

Weight of infants should be?

A

5lb5oz to 9 lbs

53
Q

what should the head circumference be?

A

12.5 to 14 inches

54
Q

What is Phenylketonuria?

A

Error of metabolism where the body is unable to metabolize foods such as breast milk

55
Q

What is harlequin sign?

A

One sign of the body is pink and the other is white

56
Q

What might harlequin sign indicate?

A

Vasomotor instability

57
Q

Pulse ox reading are taken where?

A

In either foot post ductal
Right hand -preductal

58
Q

What is a passing pulse?

A

95% or greater in more than either extremities with 3% or less difference in both pre and post ductal reading

59
Q

How often should a newborn be bathed?

A

Routine cleansing with water at each diaper change but not daily

60
Q

what kind of soap should you use for a baby?

A

Mild soap with a neutral pH

61
Q

what part of the body should you not soap?

A

The face

62
Q

when is the best time to bathe a baby? Why?

A

Before a feeding to decrease the risk of emesis

63
Q

What order should you Clean the baby?

A

The eyes to the buttocks, the dirtiest

63
Q

What is it called when health infants younger than 5 months cry uncontrollably?

A

Colic

63
Q

What might be prescribed for diaper rash?

A

Zinc oxide

63
Q

Should the babies belly button with the cord attached be submerged in water?

A

Controversial but should follow the institutions policy

64
Q

what are some methods for soothing colicky infants?

A

Sway the baby and walk around
Pacifier
Swaddle
Place the infant abdomen facing down over the knees and pat the back
Baby bouncer
Joy ride in the car
Put the infant in a car seat on top of a running clothes dryer
Walk in a stroller

64
Q

What babies are considered colicky?

A

Healthy infants who cry 3 hours for 3 or more week and for at least three weeks

64
Q

What are interventions to promote and support breastfeeding?

A

Formal breastfeeding education
Direct support of mothers during session
Training of primary care staff and breastfeeding techniques for support
Peer support

64
Q

what is the composition of human milk?

A

Proteins, carbohydrates such as lactose, and cholesterol, vitamins and minerals, antibodies

64
Q

what are the 3 stages of human as the body establishes the lactation process?

A

Colostrum
Transitional milk consisting of colostrum and milk
Mature milk consisting of foremilk and hind milk

65
Q

What is the yellowish breast fluid that is present for two to three days after birth?

A

Colostrum

65
Q

which type of breast milk has higher levels of protein and lower levels of fat, carbohydrates, and calories then other types of milk?

A

Colostrum

66
Q

What type of milk is composed of 20% solids and 80% water?

A

Mature milk

66
Q

what type of milk consists of colostrum and milk?

A

Transitional milk

66
Q

what stage human milk last from day 3 to 10?

A

Transitional milk

67
Q

what is the difference between foremilk and hind milk?

A

Foremilk is produced and stored between feedings end hind milk is produced towards the end of a session and has higher fat content.

67
Q

which has a higher water content foremilk or hind milk?

A

Foremilk

67
Q

In which part of the breast is milk produced?

A

The alveolar glands

68
Q

success in breastfeeding depends on what five factors?

A

Women’s desire to breastfeed
Proper positioning
Latching on
Supply
Transferring of milk

69
Q

what are some ways to position the breasts to assist with latching on?

A

Mother placing one hand around the breast several inches behind areola
the newborn is brought to the breast

69
Q

what is the position called when the newborn is held off to the side?

A

Football or clutch

69
Q

what is the newborns ability to grasp the breast and to effectively suckle called?

A

Latching-on

69
Q

what are the steps to get a baby to latch?

A

Align nipple with baby’s nose
place the baby’s mouth one to two inches beyond the base of the nipple
to remove the baby insert a finger into the corner of the baby’s mouth to break the seal

69
Q

What happens if you prop bottles?

A

Choking, otitis media, tooth decay

69
Q

At what angle should you hold a bottle to feed a baby?

A

As much as you can to fill the nipple full of milk

70
Q

what are signs of successful breastfeeding?

A

When the woman a tugging sensation when the newborn suckles
latch on pain is no longer than 10 seconds otherwise pain is a sign of poor latch
newborn’s tongue is between the lower gum and breast
swallowing can be heard

70
Q

What should you do with unused formula from the bottle at the end of the feeding?

A

discard

71
Q

what is the most critical and immediate physiological change that occurs in the transition from fetus to neonate?

A

Establishment of extra uterine respirations

71
Q

What type of water should you used for formulas?

A

Distilled or boiled non-fluoride

71
Q

what are two factors that negatively affect the transition to extrauterine respirations?

A

Decrease surfactant levels related to immature lungs
Persistent hypoxemia and acidosis that leads to constriction of pulmonary arteries

71
Q

What are some signs of respiratory distress?

A

Cyanosis
Retractions of the chest wall
Abnormal respiration patterns such as apnea and tachypnea
Nostril flaring
Grunting
Hypotonia
tachypnea

71
Q

What are the three factors that initiate extrauterine respirations?

A

Sensory, Mechanical and chemical stimuli

71
Q

during the delivery process what is ejected out of the baby’s lungs?

A

About 30 milliliters of amniotic fluid

72
Q

what phospholipid is responsible for peeping the alveolar sac partially open at the end of exhalation?

A

surfactant

73
Q

what are two physical abnormalities of a chest?

A

pigeon chest and funnel chest

73
Q

what are the respirations that define apnea?

A

Cessation of breathing or more than 20 seconds

73
Q

What are the babies that get mechanical stimuli?

A

Those that pass through the vaginal canal

74
Q

____ ______can be a sign of normal fluid which will be absorbed through the lymphatics

A

scattered crackles

75
Q

What is it called when the chest wall sinks when breathing?

A

Chest retractions

76
Q

when does the ductus venosus usually close?

A

Closes permanently within two weeks

77
Q

under what condition does the foramen ovale close?

A

When the left atrial pressure is higher than the right atrial pressure

78
Q

when does the ductus arteriosus close?

A

Within 15 hours but can sometimes be heard as a murmur upon auscultation

79
Q

Which circulatory shunt can sometimes be heard a murmur?

A

Ductus arteriosus

80
Q

What intervention causes the closure of ductus venosus shunt?

A

decreased blood flow and pressure through the shuntvia clamping of the cord

81
Q

What development of the fetus completes the transition from fetal to neonatal circulation complete?

A

Functionally closed shunt

82
Q

how long does it take for lung fluids to be cleared in most term infants?

A

Within the 1st four hours of life

83
Q

Where in the refrigerator should breast milk be stored

A

in the back of the fridge

83
Q

what are the steps to express milk manually?

A
  1. Wash hands
  2. massage each quadrant
  3. form the letter C with the thumb at the 12:00 position and forefinger at the 6:00 position
  4. push the thumb and finger towards the chest wall
  5. lean over and direct the spray of milk into a clean container
  6. repeat several times
  7. occasionally massage distal areas
  8. reposition fingers at 3:00 and 9:00 and repeat
84
Q

when is a good time to express milk?

A

At the end of a feeding session

85
Q

How long can you store breast milk at room temperature?

A

6 to 8 hours

86
Q

how long can you store expressed milk in a refrigerator?

A

Up to five days

87
Q

how long can you store expressed milk in a freezer Attached to a refrigerator?

A

Three to six months

88
Q

how long can you store expressed milk in a deep freezer?

A

6 to 12 months

88
Q

How should you thaw breast milk?

A

Bottle or bag in the refrigerator overnight
placing it under warm running water or bottle warmer
setting it in a container of warm water

89
Q

how should you not thaw breast milk?

A

In a microwave oven or stove top

90
Q

what are advantages of formula feeding?

A

Anyone can feed that invent
autonomy for the mother
decreases the frequency of feedings since digestion of formula is slower than that of human milk

91
Q

what are some disadvantages to formula feeding?

A

Need for increased:
time to prepare formula
cost
risk of infection from lack of antibodies
risk of childhood obesity and insulin-dependent diabetes

91
Q

What type of flow rates would you use for a newborn infant?

A

Slow flow

91
Q

What is the composition of manufactured formulas and what is it missing?

A

50% more protein than human milk
Uses veggie oils that are easier to digest than animal fat but devoid of cholesterol, essential for brain development

92
Q

What type of nipple flow rate is good for infants under 6 months?

A

Medium flow

92
Q

What type of nipple flow is good for older infants?

A

Fast

92
Q

Prolonged underdilution of formulas can cause what?

A

Constipation and eventually dehydration

92
Q

How long can prepared formula bottles be kept in the fridge?

A

48 hrs max

92
Q

What feeding position can decrease the risk of otitis media?

A

Head slightly higher than the trunk of the body

92
Q

How much formula should newborns take in?

A

½-1 oz per feeding during the first few days of life to 2 ½-3oz per feeding by day 4 and gradually increases to 32 oz

93
Q

How often can newborns be fed?

A

On demand or every 3-4 hours

94
Q

Why is the liver important in blood coagulation?

A

Coagulation factors II, VII, IX, and X are synthesized in the liver

95
Q

if a neonate misses a vitamin K shot then what is it at risk for?

A

Delayed clotting and hemorrhage

95
Q

the decline of maternally acquired vitamin K levels is greater in _____ neonates, neonates with a history of _____ _____, and neonates of mothers who are on __.

A

breastfed, perinatal asphyxia, warfarin

96
Q

where is vitamin K synthesized in the body?

A

Intestinal flora

96
Q

what can cause need newborns skin to be jaundiced?

A

Indirect and direct and hyperbilirubinemia

96
Q

difference between indirect and direct bilirubin

A

indirect is a fat soluble substance from RBC breakdown which is converted to direct bilirubin a water soluble substance from liver enzymes

96
Q

what type of bilirubin can be excreted in urine and stool?

A

Direct bilirubin

96
Q

what is the pathophysiology of jaundice?

A

There is an increase in the neonates RBC turnover and an increased RBC count at birth leading to a proportionately greater amount of bilirubin production that shows up in the skin

97
Q

what are some common side effects of vitamin K injection?

A

Arrhythmia, pain, swelling at the injection site

97
Q

Why is vitamin K needed in surgery and for blood coagulation?

A

Vitamin K is required for the hepatic synthesis of blood coagulation factors, II, VI, IX, X

97
Q

how soon should a neonate get a vitamin K shot?

A

IM within one hour of birth

98
Q

how does liver function affect blood coagulation?

A

It stores fat soluble vitamins a comma D, E, K, and iron

99
Q

What are the normal parameters for bilirubin?

A

Ok if less than 6 at 24 hrs
Less than 11 at 48 hrs

100
Q

What are some causes of jaundice?

A

ABO incompatibility and birth trauma

101
Q

Where are some areas to press on to assess for jaundice?

A

Nose, forehead, or sternum

102
Q

Why is it important for a jaundiced baby to eat?

A

So they can poop out the bilirubin

103
Q

what does the Coombs test detect in neonates?

A

The antiglobulin or other hemolytic diseases related to RH or ABO incompatibility with a positive test of the baby

104
Q

What are some common steps taken to prevent abduction?

A

Footprints and photo ID of infant
Arm bands of mother, father, and neonate, checked when entering or taking or returning
Never leave the baby unattended
Put the baby on the far side of the room away from the door to the hallway

105
Q

What are the safe levels for bilirubin at 24 and 48 hours?

A

less than 6 and less than 11

106
Q

What are normal respirations for a newborn?

A

30-60 bpm

107
Q

What is a normal pulse for a newborn?

A

110-160

OB (8 decks)

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