week 6 COPY Flashcards
bulb vs suction catheter after delivery?
- Mouth, then nose
- Non meconium substance
bulb suction
bulb vs suction catheter after delivery?
- Meconium plugs
- Only used when infant comes out with no tone, pale, limp, no respiratory effort
suction catheter
umbilical cord
___ arteries
___ veins
- 2 arteries
- 1 vein
kangaroo care vs radiant warmer after delivery
- ________________ – option for stable infants
- ________________ – option for c/s infants, unstable infants, infants requiring close assessment
- Kangaroo care – option for stable infants
- Radiant warmer – option for c/s infants, unstable infants, infants requiring close assessment
Neonatal resuscitation protocol
should nurse intervene?
- preterm baby, no tone, not breathing or crying
- Labored breathing or persistent cyanosis
- Apnea or gasping, HR <100
- HR <100
- HR <60
yes = intervene (warm, dry, stimulate, position airway, suction)
yes = intervene (position airway, suction, pulse ox, O2 or CPAP)
yes = = intervene (PPV, pulse ox, cardiac monitor)
yes = intervene
yes = intervene (chest compression, O2, epinephrine)
Apgar score
A –
P –
G –
A –
R –
Apgar score taken at _____ min and ___ min
Apgar score
A – appearance (color)
P – pulse (HR)
G – grimace (reflex irritability)
A – activity (muscle tone)
R – respiratory effort
Apgar score taken at 1 and 5 minutes
Apgar score
are all of these 0, 1, or 2 points?
- Pale blue color
- Absent HR/pulse
- Absent reflex irritability
- Limp muscle tone
- Absent respiratory effort
0
Apgar score
are all of these 0, 1, or 2 points?
- Body pink, extremities blue in color
- HR/pulse is slow, under 100
- Grimace with reflex irritability
- Some flexion with muscle tone
- Slow, irregular respiratory effort
1 point (everything in between 0 and 2, not absent but not great either)
Apgar score
are all of these 0, 1, or 2 points?
- Completely pink color
- HR/pulse above 100 bpm
- Vigorous cry with reflex irritability
- Active motion with muscle tone
- Good cry (respiratory effort)
2 points
Newborn vitals
Pulse
- Normally _____-______ (when is best time to assess?)
- Sleep ______
- Vigorous cry __________
- locations to check pulse _________ and ____________
Newborn vitals
Pulse
- Normally 110-160 (at rest, best time to assess)
- Sleep 80
- Vigorous cry 180
- Brachial and femoral pulse
new born Temp
- ______.7 F – _____.5 F
- location?
Temp
- 97.7 F – 99.5 F
- Axillary
new born Respirations
- First 2 hours of life RR is increased – up to ______ breaths/min
- Normal respiratory _____ - _______ breaths/min
Respirations
- First 2 hours of life RR is increased – up to 70 breaths/min
- Normal respiratory 30-60 breaths/min
- Normal = ___________ breathing – pauses in breathing up to 20 secs
- Abnormal = __________ breathing – pauses in breathing over 20 secs
- Normal = periodic breathing – pauses in breathing up to 20 secs
- Abnormal = apneic breathing – pauses in breathing over 20 secs
new born BP
- Goes up or down after birth?
- Cap refill
BP
- Goes down after birth
T/F
When crying vitals will be slightly low and that is normal?
Pulse ox reading screens for congenital heart disease in newborn?
F - Consider when crying – vitals will be slightly elevated and that is normal
T - Pulse ox reading screens for congenital heart disease in newborn – low O2 levels indicate heart issues
- newborn Weight loss
- Term babies lose _______ of birth weight
- Preterm babies lose _______ of birth weight
- Weight gain
- Double birth weight by 6 mos
- Triple birth weight by 12 mos
Measure weight
- Weight loss
- Term babies lose 5%-10% of birth weight
- Preterm babies lose 15% of birth weight
- Weight gain
- Double birth weight by 6 mos
- Triple birth weight by 12 mos
Measure length
- Head circumference
- Chest circumference
- Length head to toe
is head or chest circumference bigger in newborn?
- Head circumference bigger than chest circumference
Skin color
-Completely ________ – desired
-Acrocyanosis – blue hands/feet or body/mouth
-Central cyanosis – blue hands/feet or body/mouth
Skin color
- Completely Pink – desired
- Acrocyanosis – blue hands and/or feet
- Central cyanosis – blue body and/or mouth
newborn Resting posture
- Preterm – extended or flexed?
- Term – extended or flexed?
Resting posture
- Preterm – extended
- Term – flexed (helps preserve heat)
newborn skin
- __________ – thin, transparent, veins prominent, smooth feet (no creases)
- ___________– opaque, no vernix, creases on feet
- ____________ – dry, peeling
post term, preterm, term
Skin
- Preterm – thin, transparent, veins prominent, smooth feet (no creases)
- Term – opaque, no vernix, creases on feet
- Post term – dry, peeling
newborn Back
-Assess spine
-Sacral dimple (pilonidal dimple) - Closed/open indentation or pit at the base of spine
- If ________ must r/o
- Spina bifida occulta
- Tethered cord syndrome
Back
- Assess spine
- Sacral dimple (pilonidal dimple)
- Closed/open indentation or pit at the base of spine
- If open must r/o
- Spina bifida occulta
- Tethered cord syndrome
T/F
Lanugo decreases as gestational age increases?
true
observe umbilical for _________
hernia
Term baby expected appearance T/F
- Creases on soles of feet
- Vernix only in skin creases
- Instant recoil to ears
- Prominent breast bud tissue
- Increased lanugo
- Creases on soles of feet
- Vernix only in skin creases
- Instant recoil to ears
- Prominent breast bud tissue
X - lanugo decreases as fetus matures, term baby would have little to none