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Exam 3 NUR113
Newborn Care
| Question | Answer |
|---|---|
| When does the fetus breath its first breath? | When the cord is cut |
| What is the neonatal transition period? How long does it last? | Period during which the newborn's body systems adapt to extrauterine life The first 6 hours after birth |
| What are primary concerns during the neonatal transition? | Cardiac and respiratory function; thermoregulation |
| What age is considered a newborn? | Birth thru day 28 |
| What respiratory adaptations occur? | lungs expand and ventilation occurs (fluid is squeezed out during delivery) increased blood circulation to lungs |
| What are some characteristics of newborn respiration? | -Diaphragmatic -Shallow -Short periods of apnea -Periodic Breathing -nose breathers -Intercostal muscle use -Acrocyanosis |
| What cardiovascular adaptations occur? | Normal BP 60-80/40-50 HR 110-160 Pressure changes cause shunts to close Cap refill on forehead or sternum |
| What hematopoietic adaptations occur? | physiologic anemia - Hgb declines over 1st 2 months |
| What GI adaptations occur? | Stomach holds 50-60mls Some reflux is normal Breastfed stool - pale yellow, more liquid, more frequent Formula stool - pale |
| What immunological adaptations occur? | Active acquired immunity; Passive immunity (IgG from mom), S/S of infection are subtle; Colostrum has IgA |
| Can newborns regulate their temperature? | No |
| What is special about temperature regulation of newborns? | Cannot regulate temperature; regular is 97.7 to 99.5 Flexed posture to keep warm; cannot shiver; don't typically sweat; Large body surface area in relation to mass |
| What Initial newborn care is performed? | Mouth then nose suctioned with bulb syringe; cut cord then skin to skin with mom; |
| What is the APGAR score? | A measure of how well a baby is doing after birth |
| What is considered a low/bad APGAR score? | 6 or below |
| What does APGAR stand for? | Appearance Pulse Grimace Activity Respiration |
| In the Appearance category of the APGAR, how is it scored? | 0 - Pale or blue 1 - blue extremities pink torso 2 - pink |
| In the Pulse category of the APGAR, how is it scored? | 0 - None/absent 1 - less than 100 2 - greater than 100 |
| In the Grimace category of the APGAR, how is it scored? | 0 -No response 1 - weak grimace/some 2 - cries/vigorous |
| In the Activity category of the APGAR, how is it scored? | 0 - None/flaccid 1-Flexion of arms/some flexion 2 - arms flexed, legs resist extension /active motion |
| In the Respiration category of the APGAR, how is it scored? | 0 - none/absent 1 - slow or weak and irregular 2 - strong cry |
| When is APGAR take on newborns? | At 1 and 5 minutes |
| What is a good APGAR score? | 7-10 |
| What is done if a newborn has an APGAR less than 7 at 5 minutes? | repeat every 5 minutes up to 10 minutes and perform resuscitative measures |
| How far from the abdomen should the umbilical cord be clamped? | 0.5-1 in |
| What collaboration occurs while caring for a newborn? | Pediatrician, neonatologist, nurse, lactation consultant, audiology specialist, additional specialists |
| What should the inital assessment of a newborn include? | Head to toe: Skin (color, folds, marks, vernix), Chest (breathing, lung sounds); abdomen & umbilical cord (1 vein 2 art) Muscle tone |
| What measurements are performed on neworns? | Weight - 2,500 to 4,000 (5.5-8.8lbs) Length- 45 to 55 cm (18 to 22 in) Head circumference- 32 to 36.8 cm (12.6 to 14.5 in) Chest circumference- 30 to 33 cm (12 to 13 in) |
| When and how is gestational age assessed? | within first 48hrs; Using external and neuromuscular characteristics; New Ballard Scale/Dubowitz |
| What are the gestational age categories? | Preterm<37wks Late preterm 34-37wks Term 37-41wks 6/7days Post term >42wks |
| What is assessed on a newborn to determine gestational age? | Posture Square Window formation Arm recoil Popliteal angle Scarf Sign Heel-to-ear extension Ankle dorsiflexion Lanugo/skin Ear cartilage Genital development |
| What are common reflexes newborns should have? | Breathing, blinking, pupillary, swallowing Tonic neck, Stepping, Babinski stroke, plantar(opposite of Babinski), palmar grasp, suckling, Moro |
| What is acrocyanosis? | cyanosis of the extremities; is normal in newborns |
| What are some normal markings that can be on new born skin? | Telangiectatic nevi/stork bite-pale pink or red marks;fade by 2nd bday Mongolian spots- bluish-purple spots, common in darker skin ethnicities, fade 1st-2ndyr, often mistaken for bruises Nevus flammeus/port wine stain-purple or red, face, doesn’t blanch |
| What is hydrocephalus? What does it look like? | excessive cerebral fluid within brain cavity; bulging fontanels |
| What is microcephaly? | less than or equal to 32cm, abnormally small head |
| What is a cephalhematoma? | collection of blood, does not cross suture lines, from trauma during birth, resolves in 2 to 3 weeks; |
| What is a caput succedaneum? | localized swelling, crosses suture lines, from pressure, resolves in 3 to 4 days |
| True or false: it is unnecessary to verify the patency of the anus. | False |
| When should meconium be passed? | within 24 to 48 hours |
| How long should newborns sleep? | 16-19hrs |
| How often should newborns void? | 6-8x/day after first 24hrs |
| True or false: Some weight loss after birth is normal | True; 5-10% weight loss that is regained within 10-14days |
| Where are most newborns given vaccinations? | Thighs, esp. tops of thighs |
| What are common newborn medications? Why are they given? | Erythromycin eye ointment - prevent infection Vitamin K - prevent bleeding disorders (clotting factor) Hepatitis B - prevention of infection Don't inject in the same muscle |
| What are some considerations for newborn circumcision? | Do not do the first day, educate patient, pain management, monitor for bleeding, keep clean |
| What is considered hypoglycemia in newborns? | BS 40 or less |
| What will a Large Gestational Age infant look like? | Assess for birth trauma- fractured clavicle, asphyxia, hypoglycemia, polycythemia, RDS; Plump, full-faced, poor motor skills, behavioral states; high jaundice risk |
| What is the Moro relfex? | Startle reflex; baby is lowered quickly and arms should extend |
Created by:
failingstudent88
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