Maternal Child Test 2

Front 1

How do you figure calorie needs for newborn

Back 1

110-120 kcal/kg

Front 2

If a mother is eating a well balanced diet, at what age will the baby need iron supplements?

Back 2

4-6 months

Front 3

Why is colostrum important?

Back 3

Source of passive immunity
lasts 3-4 days

Front 4

Advantages of Breast Milk

Back 4

--Recommened for 6-12 months
--Immuity Protection
--Considered the ideal food
--Maternal infant attachment
--oxytocin release
--skin to skin contact

Front 5

Maternal Education, what would be one of the first things to do with a breastfeeding mother?

Back 5

Assess women's knowlege of breast feeding! Always assess first

Front 6

What is prolactin?

Back 6

Hormone that causes the breast to produce milk

Front 7

What is oxytocin?

Back 7

--causes milk let down
--increases response to nipple stimulation

Front 8

What postion should baby be when breastfeeding?

Back 8

At nipple level, facing the nipple

Front 9

What can be done to prevent trauma to nipple?

Back 9

position the infant so the nipple is far back in the mouth

Front 10

What can you do to arouse baby if it falls asleep after a few minutes on the breast?

Back 10

unwrap and gently arouse the infant

Front 11

How do you break suction of baby from breast to avoid trauma?

Back 11

insert fingers into corner of the infants mouth

Front 12

What can be done if a breast feeding mother notes a tender hard area on her breast?

Back 12

Try massaging the area and apply heat, this will cause the duct to open

Front 13

What are some nursing implications to the timing of newborn feedings?

Back 13

--Supportive of the family:Facilitate rooming in, limited or no pacifiers, and encourage unrestricted breast feeding
--education of the family
--education of extended family

Front 14

How long can breast milk be stored in fridge?

Back 14

48 hours
frozen for up to 6 months

Front 15

Which women tend to continue breastfeeding?

Back 15

Women who avoid the use of bottles and formula

Front 16

Name some maternal illness and meds that would be contraindicated in breastfeeding

Back 16

--maternal breast cancer
---HIV or AIDS
--Meds (flagyl)
--medical condition of infant (Esophageal Atresia)

Front 17

State psychosocical reasons why breastfeeding may be contraindicated or problematic

Back 17

when to start breast feeding or who assits (Navajo wait until their milk comes in to start breast feeding, no colostrum)

Front 18

How would you help a mother with engorged breasts?

Back 18

--Instruct and assit the mother to massage her breasts (massage of breast cause a release of oxytocin & increase the speed of milk release)
--instruct to breast feed frequently and for adequate lenghts of time

Front 19

How much should an infant on a 4 hours feeding schedule consume?

Back 19

--3.2 to 3.5 oz
--the newborn requires appox 19-21 oz each day (6 feedings in 24h)
--3.2-3.5 oz x 6=19-21 oz

Front 20

Which type of formula is recommeded for infants?

Back 20

Iron fortified

Front 21

What is aseptic steriliztion?

Back 21

bottles are boiled separate from formula for 5 minutes

Front 22

What is terminal sterilization?

Back 22

formula is prepared in the bottles, which are loosely capped, and then the bottles are placed in the sterilizer where they are boiled for 25 minutes

Front 23

What should you tell a mother who is NOT breastfeeding?

Back 23

Avoid stimulation of the breast

Front 24

Which baby gains weight faster, bottle or breast?

Back 24

bottle

Front 25

What is an infant at increased risk for is the bottle is propped?

Back 25

Aspiration if regurg occurs

Front 26

How long is formula good for after it touches the infants lips?

Back 26

1 hour
--bacterial may grow in formula once opened--do not save from one feeding the next

Front 27

What is the chemical receptors that cause the stimulation of the resp centers in the medulla?

Back 27

hypoxia--decrease in oxygen and increase in CO2

Front 28

Name some mechanical receptors that influence respirations in the newborn

Back 28

--squeezing of chest wall
--fluid is moved into upper respiratory tract
--expelled during birth or at birth
--tactile stimulation
--noise
--light

Front 29

Name some thermal factors that are adaptation for the newborns respirations

Back 29

--temp change
--sensors in skin
--message sent to resp center in the brain; medualla
--stimulation of breath

Front 30

What are the differences in the resp tract in the infact born c section?

Back 30

--c section omits the mecahnical force of delivery
--no squeezing of chest wall
--fluid does not move from the upper resp tract
--limited fluid is expleed during birth
--may have moist lung sounds for first 24 h
--baby may spit up amniotic fluid

Front 31

At birth what happens to the pressure in the left atrium and why?

Back 31

It increases due to blood flow from the lungs

Front 32

When should you call the doc regarding circulation?

Back 32

--if a infant is dusky and turns cyanotic when crying
--the infant is howing poor adaptation to extrauterine life

Front 33

Newborns have ___________times the sure area to body mass than adults

Back 33

three

Front 34

How do newborns attempt to maintain body temp?

Back 34

by remaining in the flexed position

Front 35

What is evaporation? And what can be done right after delivery to help prevent it?

Back 35

--loss of heat via air drying and insensible water loss
--dry skin immediately

Front 36

What is conduction? And what can you do to prevent it in infants?

Back 36

--loss of heat via direct contact with cooler objects
--warm objects that will touch the infant

Front 37

What is convection? And how can you prevent it in infants?

Back 37

--heat loss to surrounding room
--provide warm draft free environment

Front 38

What is radiation? And what can be done to prevent it in infants?

Back 38

--heat loss to cooler objects that are not in direct contact with the infant
--place cribs away from windows

Front 39

What is acrocyanosis?

Back 39

infant is pink centrally and has cyanosis of extremities

Front 40

Where is the brown fat that is highly vascular located?

Back 40

--around the back of the neck
--axillae & around the kidneys & adrenals
--around sternum & b/w scapula
--along abdominal aorta

Front 41

Do preterm infants have more or less brown fat?

Back 41

less brown fat which makes them more susceptible to heat loss

Front 42

Identify hazards of cold stress

Back 42

--increased metabolic rate
--increased need for o2
--resp distress
--decreased surfactant production
--hypoglycemia
--metabolic acidosis
--jaundice

Front 43

In hypothermia the basal metabolic rate (BMR) is _________ in an attempt to compenstate, thus requiring _________glucose

Back 43

increased
more

Front 44

What needs to be assessed when an infant is in a radiant warmer, warming light, or a warmed incubator?

Back 44

monitor temp

Front 45

RBC's have a ___________life span when compared to adults

Back 45

shorter

Front 46

Excess bilirubin from breakdown of __________may lead to _____________

Back 46

RBC's
jaundice

Front 47

Newborns lack Vit K, why cannot babies synthesize Vit K?

Back 47

the bowel is initially sterile in the newborn, and vit K can't be synthesized until food is introduced inot the bowel

Front 48

Why is a newborn more likely to have regurg?

Back 48

the cardiac sphincter of the stomach is relaxed

Front 49

What is the first stool called in infants? Explain its charcteristics and when it is passed

Back 49

--Meconium
--greenish black, thick, sticky, and tar like
--usually passed in first 24h but can be up to 48h

Front 50

What is bilirubin?

Back 50

a substance that is produced from the hemolysis of RBC's

Front 51

What is unconjugate bilirubin?

Back 51

fat soluble--may be absorbed by subq fat, causing jaundice

Front 52

Where does unconjugate bilirubin change to conjugate bilirubin?

Back 52

in the liver--liver is not mature enough to prevent the development of juandice during the first week of life

Front 53

List factors that increase hyperbilirubinemia

Back 53

--hemolysis of excessive RBC
--short life of RBC
--liver immaturity
--lack of intestinal flora
--delayed feeding
--trauma resulting in bruising or cephalhematoma
--fatty acids from cold stress or asphyxia

Front 54

When does NORMAL physiologic jaundice occurs?

Back 54

--appears 24h AFTER birth and on the 2nd or 3rd day

Front 55

What mg dl is jaundice visiable at?

Back 55

5-7 mg dl and peaks on day 2-4

Front 56

When does ABNORMAL pathologic jaundice appear

Back 56

within the first 24 h of birth

Front 57

Unconjugated bilirubin is _____soluble and binds with ________ tissue that produces the yellowish discoloration of the skin

Back 57

fat
subq

Front 58

__________bilirubin is the transference of fat soulble bilirubin to _________soluble bilirubin for excretion

Back 58

conjugated
water

Front 59

What places an infant at a lower risk of developing high levels of bilirubin?

Back 59

breastfeeding within the first hour of delivery

Front 60

What is the normal temp (axillary & rectal) and normal resp for infants? What about apical pulse rate?

Back 60

--axillary--97.7 to 99.5
--rectal--97.7 to 99.7
--apical pulse 120-160 bpm
--resp 30 to 60/min

Front 61

What may severe and prolonged hypoglycemia lead to?

Back 61

brain damage--without glucose the brain is unable to function and grow

Front 62

What is the quickest and most common method to obtain a neonatal blood glucose level?

Back 62

puncture the lateral pad of the heal

Front 63

During the first peroid of reactivity what should be done?

Back 63

--bring to the breast for 1st feeding
--eye to eye contact (Face to face)
--first peroid of reactivity 30min-2 hours after delivery

Front 64

What is one thing that needs to be assessed for developmental dysplasia?

Back 64

thigh and gluteal creases are asymmetrical

Front 65

Describe the Babinski reflex

Back 65

stroking the later sole of the foot from heel to ball of the food, a postive sign is the flaring of toes outward andbig toe to dorsiflex

Front 66

What is erytherma toxicum?

Back 66

normal newborn rash (red base with white papule in center)

Front 67

An infant is considered ___________if it falls greater than 90th percentile for wt

Back 67

LGA, large for gestation age

Front 68

An infant is considered __________if it falls less than 10th percentile for wt

Back 68

SGA, small for gestation age

Front 69

An infant is considered ____________if it falls between the 10th & 90th percentile for wt

Back 69

AGA, average for gestation age

Front 70

When are gestational age assessments done? What factor of the skin may change the data?

Back 70

Soon after delivery
Drying of the skin

Front 71

Why do nurses perform gestational age assessments?

Back 71

to identify infants at risk

Front 72

What assessment of the skin can deteremine gestational age?

Back 72

peeling and cracking of the skin

Front 73

What can be indentified in an infant with an infection?

Back 73

--axiallary temp of >100
--elevated IgM level is assocaited with a recent infection

Front 74

When would you advice that a new parent call the doc?

Back 74

a 2 wk old with nasal congestion and resp of 64/min

Front 75

Why is it recommended to keep hte cord dry?

Back 75

to decrease bacteria growth

Front 76

Name some maternal illness and meds that would be contraindicated in breastfeeding

Back 76

--maternal breast cancer
---HIV or AIDS
--Meds (flagyl)
--medical condition of infant (Esophageal Atresia)

Front 77

State psychosocical reasons why breastfeeding may be contraindicated or problematic

Back 77

when to start breast feeding or who assits (Navajo wait until their milk comes in to start breast feeding, no colostrum)

Front 78

How would you help a mother with engorged breasts?

Back 78

--Instruct and assit the mother to massage her breasts (massage of breast cause a release of oxytocin & increase the speed of milk release)
--instruct to breast feed frequently and for adequate lenghts of time

Front 79

How much should an infant on a 4 hours feeding schedule consume?

Back 79

--3.2 to 3.5 oz
--the newborn requires appox 19-21 oz each day (6 feedings in 24h)
--3.2-3.5 oz x 6=19-21 oz

Front 80

Which type of formula is recommeded for infants?

Back 80

Iron fortified

Front 81

What is aseptic steriliztion?

Back 81

bottles are boiled separate from formula for 5 minutes

Front 82

What is terminal sterilization?

Back 82

formula is prepared in the bottles, which are loosely capped, and then the bottles are placed in the sterilizer where they are boiled for 25 minutes

Front 83

What should you tell a mother who is NOT breastfeeding?

Back 83

Avoid stimulation of the breast

Front 84

Which baby gains weight faster, bottle or breast?

Back 84

bottle

Front 85

What is an infant at increased risk for is the bottle is propped?

Back 85

Aspiration if regurg occurs

Front 86

Describe the etilogy of potential hemorrhage in infants

Back 86

low prothrombin levels the first few days of life (absence of gut bacterail flora) which influences the production of vit k

Front 87

Describe vit K adminstation of the newborn

Back 87

--0.5-1.0 mg within first hour of birth
--vastus lateralis
--clean site with alcohol

Front 88

Where do you insert the bulb syringe in the infants mouth and why?

Back 88

in the sides of the mouth because inserting it in the back of throat may produce a vagal response (bradycardia)

Front 89

What can be done to decrease temp loss in the infant?

Back 89

--wrap the infant with warmed blankets
--place cap on baby's head

Front 90

What are signs of complications after circumcison?

Back 90

--bleeding more than a few drops with first diaper change
--failure to urinate
--fever or low temp, purulent or fould smelling drainage (infection)
--displacement of the Plastibell

Front 91

What are nursing interventions done regarding circumcision?

Back 91

--teach circumcision care to family
--tell parents that a yellow crust will develop and should not be removed b/c it's part of normal healing process

Front 92

When is the most difficult time to teach mother about baby care?

Back 92

the day after baby birth, we need to be aware not to overload the mother

Front 93

What is the purpose for state wide screening?

Back 93

to recognize and treat newborn disorders early

Front 94

What things do we do to assure safety on maternity unit?

Back 94

--check ID bands
--daily color system
--key pad entry to secure areas
--door alarms
--code rainbow
--question anyone walking in hallway carrying an infant