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OB chapter 10,11,12
the newborn
| Question | Answer |
|---|---|
| How should you assess a newborn’s heart rate | observe the rise and fall of the abdomen |
| Normal vital signs | Pulse:110-160 bpm; RR:30-60breaths/min; T:97.7F (36.5C); BP:60-80 systolic, 40-50 diastolic |
| Vernix caseosa | thick, white, cheesy substance covering the skin of the newborn |
| Milia | pearly white pinpoint papules on the face and nose of the newborn |
| Normal circumference of head | 13-14 inches (33-35.5cm) |
| Caput succedaneum | localized swelling of soft tissues of the scalp that is caused by pressure on the head during labor |
| Newborn’s breathing pattern (full-term infant) | irregular, movement of the chest and abdomen are synchronized, periodic breathing is normal |
| Fontanelle closure | anterior by 18 months; posterior by 2-3 months |
| Newborn sight and what they like to look at | simple, highly contrasting colors and formed image |
| rooting reflex | baby turns toward touch when lightly stroked on cheek |
| Assessment findings that you would call the Dr. (crepitus in clavicles) | can be from shoulder dystocia |
| Moro’s reflex | extension and abduction of extremities in response to being startled |
| Plantar reflex | when the sole of the newborn’s foot is stimulated, the toes curl downward |
| Which is the most desirable state to test an infant | quiet alert |
| Congenital hip dysplasia | click sound when newborns’s legs are flexed and abducted laterally toward the mattres; knees not of equal length and thigh folds should are asymmetric |
| Cephalhematoma | a collection of blood between the periosteum and the cranial bone; the swelling does not cross the suture line; no treatment is indicated |
| Reason for newborn screening and testing performed before discharge | enable early intervention if a possible health problem exists |
| Mongolian spots | dark blue or slate gray discolorations most commonly found in lumbosacral area in babies of dark skinned parents |
| Reason for elongation of newborn’s head | fontanelles allow the fetal head to mold in order to fit through the birth canal causing an elongated appearance of the head |
| Depressed fontanelles is a sign of? | late sign of dehydration |
| Acrocyanosis | cyanosis of the hands and feet in the first week of life is caused by a combination of a high hemoglobin level and vasomotor instability |
| Imperforate anus | a closed anus |
| Thrush in newborn (symptoms) | gray-white patches on the tongue and mucous membranes that cannot be quickly removed |
| Vaginal discharge or blood in newborn | pseudomenstration, smegma |
| Negative tonic neck reflux and concerns | absence or asymmetry in term newborn indicates neurologic problem |
| Coarctation of the aorta | a constriction of the aortic arch or of the descending aorta; symptoms may not develop until later childhood; high BP and bounding pulses in upper extremities and weak pulses in the cool lower extremities, signs of CHF |
| Best state to check hearing | active sleep |
| Congenital cataracts | indicated by an absence of the red reflex in the retina |
| Extrusion reflex | present until 4 months of age |
| Sleep states | quiet sleep; active sleep |
| First nursing action to prevent heat loss | dry the newborn |
| Normal axillary temp | between 36.5-37.5C/97.7-99.5F |
| cord assessment within the 1st hour | assess for bleeding |
| Reasons for vit K injections | newborns cannot synthesize vitamin K due to lack of normal flora in intestines, must be given as a prophylaxis to assist in clotting |
| Infant care following circumcision | a sterile gauze with petroleum jelly or A&D ointment is applied to the penis; observe for bleeding every 15 minutes for the first hour and then every 30 minutes for the next 2-4 hours |
| what area of the newborn is most susceptible to infection | cracks in the skin, particularly on the newborn’s hands, feet, and umbilical cord |
| what is the most preventable method from spreading infection | handwashing (3 minute scrub up to elbow) or use of hand sanitizer |
| bathing until cord falls off | give sponge baths until the cord stump falls off |
| What symptoms should be taught to parents to report in a breastfeeding infant | how long and how hard infant sucks; whether spitting up occurs and if it is projectile or forceful |
| Why should the nurse have parents tell about cultural practices related to infant care | to ensure they aren’t harmful |
| changing diapers after circumcised | a sterile gauze with petroleum jelly or A&D ointment is applied to the penis |
| early indicator of infection | poor feeding, lethargy, and periods of apnea |
| proper bulb suctioning | the bulb is compressed before insertion, then released to create sufficient suction to remove mucus |
| how to properly burp infant | |
| purpose of eye ointment after birth | prevent infection |
| proper car seat safety | should not move more than 1 inch in any direction, and the harness strap should be snug at armpit level of child |
| following a circumcision when can an infant go home | after he voids |
| where are infant IMs given | thigh, middle third of the vastus lateralis muscle |
| risks of propping bottles | potential for spitting up, aspirating, choking and otitis media |
| Hep B administration | first injection within 12 hours of birth; second injection at 1 month of age; third dose at 6 months of age |
| care of uncircumcised penis | avoid forceful retraction of foreskin, clean with water during infancy, smegma is normal |
| signs to report to Dr. related to temperature | fever greater than 100.4 |
| signs to report to Dr. related to breathing | dyspnea or apnea greater than 20 seconds |
| signs to report to Dr. related to skin color | dusky appearance, blueness around mouth, or whites of eyes appearing yellow |
| signs to report to Dr. related to cord appearance | discharge, bleeding, redness or foul odor |
| signs to report to Dr. related to eyes | redness, swelling, or discharge |
| signs to report to Dr. related to feeding | more than one episode of forceful or frequent vomiting; refusal to feed for two or more consecutive feedings |
| signs to report to Dr. related to stools | two or more green, watery stools or hard and infrequent stools |
| signs to report to Dr. related to wet diapers | no wet diapers in 18 hours or fewer than six voiding in a 24 hour period |
| signs to report to Dr. related to crying | inconsolable, quieting techniques not effective or continuous high-pitched cry |
Created by:
laotracuata
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