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107 Ch. 24
Newborn Adaptations
| Question | Answer |
|---|---|
| What is the neonatal period | birth to 28th day of life |
| what are 2 phases of transition period for neonate | 1st/2nd periods of reactivity |
| what happens in 1st period of reactivity | lasts up to 30 min. after birth, HR incr to 160-180, then falls to 100-120. May have crackles, grunting, nasal flaring, retractions of chest (all signs of resp distress usually) |
| what is 2nd period of reactivity | 4-8 hrs after birth, tachy/tachypnea, meconium passed, incr muscle tone, color, spitty/gaggy |
| what are normal respirations for newborn | 30-60 b/min with periodic breathing(pauses), apnea(stop 5-15sec) nose breathers, suction mouth first |
| what are 4 causes of respiration in NB | chemical: pH more acidic, incr CO2, decr O2 mechanical:squeeze in vag canal (C-sect not, so hard to get pink) Thermal: shock stimulates to breath Sensory: lights, smells, snds, touch, gravity |
| what is surfactant and how help lungs | keep alveoli walls from being sticky and collapsing, lowers surface tension, so less inspiratory pressure needed to keep alveoli open Peaks - 35 wks |
| what is Functional Residual Capacity | Air that resides in lung to keep open |
| What happens to HR in baby | birth: 110-140 cry: 175-180 sleep: 80-90 |
| How asses NB HR | ascultate 1 min., murmurs normal if stay pink |
| Normal NB BP | NB: 60/40, 80/50 1st hour: drop 15mm 10 days: 95/45, 100/75 |
| How does circulation change to neonate | 300ml with 100ml incr. Preterm > term b/c > plasma vol. Late clamping of cord incr volume |
| what are lab values for NB | Hb: 14-24, Hct: 44-64%, then drops WBCs 1st day incr (23,000-24) then drop to 11,500 |
| what are signs of resp distress | >160, retractions, flaring of nares, cyanosis, grunting, seesaw resp, asymmetry |
| why a risk of hemorrhaging and clotting deficiency | No Vit K at birth, casue gut is sterile adn made from intestinal bacteria. Give IM of Vit. K |
| what is normal blood glucose | 40-60mg/dl adult: 70-110 |
| what is thermogenesis | non-shivering, how does baby keep warm, brown fat adn incr metabolic activity in brain, heart, liver |
| what does cold stress do to baby | vasoconstricts, decr 02 to lungs and perfusion to tissues, anaerobic glycolysis then acidosis = hypoglycemia |
| what are four methods of heat loss | conduction: heat loss w/ contact, warmed crib Convection: heat loss from air mvmt, cap/blanket radiation: heat loss, no contact, away from windows evaportation: dry after bath |
| what is TNZ, thermal neutral zone for full term | 89.6-93.2F, lower for adults, higher for preterm |
| what enzymes are not produced in NB | lipase, pancreatic amylase (6mos), amlase(3mos) |
| when is meconium seen | 1st 24-48 hours, sterile 3rd day - transitional stools 4th - milk stools |
| Sucking reflexes are coordinated wtih swallowing by when | after 33wks |
| what is jaundice | manifestation of bilirubin in tissues above 5mg/dl |
| when is iron stored for NB | stored in utero |
| what is kernicterus | yellow staining of brain cells lead to bilirubin encephalopathy. s/s: CNS depression/excite, lethargy, seizures |
| what is normal values of unconjugated bilirubin | 0.2 - 1.4 jaundice not good if before 24 hrs |
| what is caput succedaneum | swelling of scalp, cross suture line |
| what is cephalhematoma | blood underneath, not cross suture line, may cause jaundice |
| what is subaleal hematoma | Bleeding beyond bone vital to early detect, monitor LOC and decr Hct |
| what is telangiectatic nevic | stork bite, fades |
| what is erythema toxicum | newborn rash |
| what is vernix caseosa | cheese like coating after birth |
| what is milia | sebaceous glands (white pearls) |
| what is nevus flammeus | port wine, permanent |
| what is desquamation | peeling, sign of post maturity |
| what determines term infant in reproductive system | F: vag discharge, not as edematous M: rugae on scrotum, lgr, |
| what do signs of asymmetry of folds of skin in legs indicate | hip dysplagia, do Ortolani Test |
| what is polydatyly? syndactyly? | poly: xtra digits syn: fused digits |
| Know these reflexes | moro(startle), plantar grasp, Babinski(foot), rooting, suck, fencing(tonic neck), stepping when upright, crossed extension |
| These help determine term or preterm | posture: flexed/extended square window: bend hand/not arm recoil, popliteal angle, scarf sign, heel to ear: term fights plantar creases: lots/smooth ear boing! |
| what is witche's milk | baby discharge from breast |
| what is optimum awake state | quiet alert others: drowsy/active alert/crying |
| what is habituation | expose to same stimuli, decr response |
Created by:
palmerag
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