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129 Cards in this Set
- Front
- Back
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Reflexes I "• Involuntary movements or actions. Some movements are spontaneous
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occurring as part of the baby's usual activity. Others are responses to certain actions. Reflexes help identify normal brain and nerve activity. Some reflexes occur only in specific periods of development"
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Suck Reflex Rooting helps the baby become ready to suck. When the roof of the baby's mouth is touched
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the baby will begin to suck. This reflex does not begin until about the 32nd week of pregnancy and is not fully developed until about 36 weeks. Premature babies may have a weak or immature sucking ability because of this. Babies also have a hand-to-mouth reflex that goes with rooting and sucking and may suck on fingers or hands.
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Moro Reflex The Moro reflex is often called a startle reflex because it usually occurs when a baby is startled by a loud sound or movement. In response to the sound
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the baby throws back his/her head
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Tonic Neck Reflex When a baby's head is turned to one side
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the arm on that side stretches out and the opposite arm bends up at the elbow. This is often called the "fencing" position. The tonic neck reflex lasts about six to seven months
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Babinski Reflex When the sole of the foot is firmly stroked
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the big toe bends back toward the top of the foot and the other toes fan out. This is a normal reflex up to about 2 years of age
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• Soft spots on a baby’s head which during birth enables the bony plates of the skull to flex
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allowing the child’s head to pass through the birth canal. Allows space for brain to grow
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• Pressure interferes with blood flow from area
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causing localized edema @ birth
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Cephalhematoma "• Bleeding between the skull and the periosteum (membrane that lines the outersurface of all bones
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bet. Scalp & blood/bone)
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• Not present @ birth
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develops within 1st 24 hrs-48 hrs
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• Occur in sacral area but may appear on buttocks
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arms
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• Normal engor.. due to accumulation of milk
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enlarged lymph glands & increase blood flow
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• Meds- acetaminophen
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ibuprofen
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Milia "• White cyst
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1-2mm in size
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• Occurs on face over forehead
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nose
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• As fetus nears term
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the lanugo becomes thinner
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• Small amt. seen on shoulders
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forehead
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Vernix (Caseosa) "• A thick
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white substance that resembles cream cheese
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Nevus Simplex Flat
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pink or reddish discoloration from dilated capillaries that occur over eyelids
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Nevus Flammeus (Port Wine Stain) permanent flat
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dark
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Nevus Vasulosus (Strawberry Hemangioma) has enlarged capillaries in outer layers of skin. Dark red & raised w/ a rough surface
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strawberry appearance. Located on the head. May grow larger for 5-6 mths but disappears by the early school years. No tx necessary.
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Erythema Toxicum "• Benign rash of unknown cause in newborns
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with blotchy red areas that may have white or yellow papules or vesicles in the center
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• Appears during the 1st 24-48 hrs after birth
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occasionally not until 1-2 wks. Common over face
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Application of Alcohol (optional)- (a)swabbing the umbilical cord stump with alcohol helps the site heal faster (b) Dampen a cotton ball with rubbing alcohol
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gently swab
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Application of Bacitracin Apply around the umbilical cord to treat infection
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use it one time a day
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Observations "• Evaluate pain with one of the pain scales (before
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during
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Frequent Diapering "• At each diaper change
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you will want to apply a small amount of petroleum jelly. Make sure that the petroleum jelly is pure
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• Redness
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pain
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Caring for Uncircumsized Infant "• You do not need to retract (pull back) the foreskin to clean it for the first year of life. After 1 to 2 years of age
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you can retract the foreskin partially for cleaning. However
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Stooling (p 459) "Meconium (first stool)
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which is greenish black with thick
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Formula fed infant excretes pale yellow to light brown stools. They are firmer in consistency. The infant may excrete several stools daily
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or only one or two. The stools have the characteristic odor of feces.
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Voiding (p 492) ): the newborns bladder empties as little as once of twice during the first two days
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although more frequent voiding is common. By the 4th day of life
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Signs of Diarrhea (p 580) watery stools indicate diarrhea. It may be absorbed into the diaper with little or no solid material left at the surface. A "watery ring" remains on the diaper
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showing where the liquid was absorbed. Diarrhea stools occur more frequently than the infants normal stools and are greenish from bile moving quickly through the intestines. Diarrhea can be serious because life-threatening dehydration develops quickly.
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Brick Dust Staining (p 492) ): the newborn's urine may contain urate crystals that cause a reddish or pink stain on the diaper. This is known as "brick dust staining" and may be frightening to parents
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who may think the infant is bleeding. It does not continue beyond the first few days as the kidneys mature.
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Importance of Breast Milk (p 540) breastfeeding has many advantages. Recent evidence has shown that not only the certain illnesses decreased during breastfeeding
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but the mortality rate is lowered as well.
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Anatomy and Physiology of Milk Production (p 543) milk is produced in the alveoli of the breasts through a complex process by which materials from the mother's blood stream are reformulated into breast milk. The milk is ejected from the secretory cells of the alveoli into aleolar lumen by contraction of the myoepithelial cells. From there it travels into the lactiferous ducts
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which lead from the alveoli to the nipples. The ducts are compressed during nursing to eject a stream of milk through pores in the nipple.
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Initiation & Maintenance (p 543) at birth
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loss of progesterone
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Colostrum (p 538) the major secretion of the breasts during the first week of lactation is colostrum - a thick
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yellow substance. Colostrum is higher in protein
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Positioning (p 546) make the mother as comfortable as possible before she begins nursing. Pain or an awkward position may interfere with the let-down reflex and cause her to tire. The "cradle"
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"football"
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Latching On (p 547) after positioning the infant to face the breast
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the mother holds her breast so that the nipple brushes against the center of the infant's lips. A hungry infant usually opens the mouth
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Nipple Rolling/Stimulation (p 544) the use of creams
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nipple rolling
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Amount of Time and Frequency (p 582) breastfeeding mothers should be taught not to set a strict time-tale but to feed the infant when signs of hunger are present. This will be more often than if the infant is formula fed
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about every 2 to 3 hours. The feeding concludes when the infant falls asleep or after a short period of non-nutritive suckling. The total time varies with individual infants and from feeding to feeding. It may be as short as 20 minutes to as long as 40 minutes. Infants may experience growth spurt. It can happen at approximately 10 days
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Switching Breasts (p 582) generally
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feedings should last 10 to 15 minutes on each breast.
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Burping (p 564) for the first few days the infant should be burped or "bubbled" after every half ounce. Gradually
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the infant is able to take more milk before burping and should be burped halfway through feeding. Demonstrate placing the infant over the shoulder or in a sitting position with the head supported while patting or rubbing the infant's back.
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Nutritional Needs of Mother (p 540) although the fatty acid content of breast milk is influenced by the mother's diet
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malnourished mothers have about the same proportions of protein
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Engorgement and Nipple Integrity (p 555) many woman have a temporary swelling or fullness of the breast when the milk begins to "come in" or change from colostrum to transitional breast milk. This usually occurs on the second or third day after birth but may begin earlier in a woman who have nursed before. This normal engorgement is the result of accumulation of milk
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enlarged lymph glands
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Manual Expression and Breast Pump (p 559) hand expression can be performed without other equipment but is not as effective as a breast pump. Hand expression or manual pumps are useful for mothers who want to save milk for another feeding or whose areola is so engorged that the infant can not grasp it. The mother who wants to pump her milk for a prolonged time may prefer using a battery-operated or electric breast pump. Use of the breast pump should begin within the first 24 hours after birth for the woman who cannot breastfeed her infant. She should pump her breasts as often as the infant would nurse
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approximately every 2 to 3 hours during the day and once or twice at night when prolactin levels are elevated. Pumping sessions should last approximately 15 to 20 minutes. A total of eight or more sessions in each 24 hours is best to maintain milk supply.
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Weaning (p 561) no one "right" time to wean the infant exists. Explaining that even a short period of breastfeeding offers the infant many advantages is reassuring. Gradual weaning process helps avoid engorgement
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and infants can get used to a bottle or cup over a period of time. Omitting one breastfeeding session a day and waiting several days or a week before omitting another will allow the mother and infant to adjust to the change more easily.
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Hunger Cues (p 563
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p 545-box 22-2) hungry infants show the same behaviors whether breastfeeding or formula feeding. They may fuss or cry
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Supplementing Water/Formula (p 549
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p 583) both formula and breast milk contain enough water for infants who are eating well. Additional water is not needed. Some mothers give water to formula fed infants who are fussy and do not respond to other interventions. Sips of water can also be given to infants with hiccups. Hiccups go away shortly
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Amount and Type (p 563-64) bottle-fed infant takes only 1/2 to 1 oz per feeding during the first day of life but gradually increases to 2 to 3 oz per feeding by the third to fifth day. The infant who is satisfied often goes to sleep. Ready-to-use formula is available in bottles to which a nipple is added or in cans to be poured directly into a bottle. It should not be diluted. Although expensive
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it is practical when there is difficulty in mixing or the water supply is in question. An open can should be refrigerated and used within 48 hours. Concentrated liquid should be diluted according to directions. Equal part of concentrated liquid and water and mixed in a bottle to provide the amount desired for each feeding. Open cans should be refrigerated and used within 48 hours. Powdered formula is more economical and particularly useful when a breastfeeding mother plans to give an occasional bottle of formula. Usually one scoop of powder is added to each 2 oz of water in a bottle. Packets with enough powder formula for one feeding are convenient when away from home. Formula should be well mixed to dissolve the powder and make the solution uniform. Once mixed
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Preparation (p 563) mothers can prepare a single bottle or a 24 hours supply. If the water supply is safe
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sterilization is not necessary for normal newborns. Bottles and nipples can be washed in hot
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Burping (p 564) for the first few days the infant should be burped or "bubbled" after every half ounce. Gradually
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the infant is able to take more milk before burping and should be burped halfway through feeding. Demonstrate placing the infant over the shoulder or in a sitting position with the head supported while patting or rubbing the infant's back.
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Regurgitation (p 583) infants often regurgitate because they may eat more than their stomach can easily hold and because their immature lower esophageal sphincter allows the stomach contents to flow easily. "Wet burps" result when air is trapped under stomach content. As the air is expelled
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a small amount of milk comes with it. Regurgitation may occur frequently
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Signs to Notify MD (p 586) "an infant from birth to 3 month of age should not have a sustained respiratory rate above 60 breaths per minute. If retractions
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cyanosis
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Vomiting (p 583) vomiting may involve the entire feeding versus regurgitation of a small amount. It is expelled more forcefully. Parents should always seek treatment for the infant with projectile vomiting
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in which the vomitus is expelled with such force that it travels some distance. This is a sign of pyloric stenosis
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Changing in Feeding Behaviors (p 582) mothers may be concerned when an infant suddenly becomes seems fussy and wants to feed much more often than previously. It is usually due to a growth spurt. It can happen at approximately 10 days
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2 weeks
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Equipment "o Soft wash cloth or cotton squares
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infant tub
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Sponge and Tub "o Use a small plastic tub lined with a bath sponge for security. Set up the plastic tub in the kitchen sink or regular bathtub. If the cord is attached
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place the baby in the tub without water. No cord- fill up tub with 2-3 inches of warm water (100 degrees; always test temperature using your wrist or forearm- it should feel warm but not hot). Clean the infant with a soft wash cloth. Never leave infant unattended in tub."
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Eye Care "o Holding your baby's head
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gently wash around each eye with a cotton round or cotton square dampened with warm water. Cotton rounds or squares are good to use because they don't shed pieces of lint. Use a new cotton round or square for each eye and always wipe from the inside corner of the eye
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Care of Scalp
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Hair
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o Baby with cord clamp: Keeping your baby wrapped in a towel
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put your arm under his back and your hand behind his head. With your free hand wet your baby's hair with the washcloth. Apply a small amount of gentle baby wash which is specially formulated to not sting his eyes
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o Pay attention
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and once you find that you are getting scratched
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Use of Soaps
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Lotions
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o Baby powder is an astringent powder used for preventing diaper rash
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as a deodorant
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o Avoid using oils: Mineral oils contain hydrocarbons
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a real danger to the stomach and especially the lungs - which can stop working. A mouthful of baby oil ingested by a child is enough to cause it to vomit and if they breathe that into their lungs that is enough to cause lung inflammation which could lead to death
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Diapering: Cloth v Disposable "o Some parents prefer disposable diapers because you can simply dispose diapers into a diaper pail. Disposable diapers are useful when traveling. The positive features for disposable diapers are the highly absorbent materials used to contain wetness; the source is usually the absorbent gelling material (AGM) in the center of the diaper that contains moisture from the skin. Preventative measures for diaper rash in disposable diapers include changing the diapers frequently. Disposable diapers
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however
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o Cloth diapers have evolved and become quite efficient in that they now have Velcro straps. The positive attributes for cloth diapers are no use of materials like AGM or dyes. These materials may affect a baby with sensitive skin. Cloth diapers can be cleaned in-house or by using a cleaning service
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both options are proven more economical than disposable diapers. Although advocates of cloth diapers agree that disposable diapers negatively impact the environment
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STOOLS OF BREASTFED BABIES: are loose
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watery
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STOOLS OF FORMULA FED BABIES: are less frequent and more formed than breastfed stools. You will usually see one to three greenish-yellowish
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pasty stools. Learn what's normal for your baby. Stooling patterns and frequencies vary for every baby. Some breast and formula-fed babies normally have one large stool every three to four days. Call your pediatrician if your baby is having diarrhea or difficulty passing stools.
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o Avoid using commercial diaper wipes as they may affect skin pH. Clean all the stool and urine off the baby. Wash away urine and stool with a warm
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wet cloth
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Use of Ointments
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Vaseline
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Diaper Rash "o How diaper rashes occur: It happens frequently for babies with sensitive skin (be mindful of new materials on baby’s skin and chemicals used to clean or produce diapers)
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extended exposure to waste (urine and stool)
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Diaper Rash Prevention and Treatment "o To treat diaper rash: Change diapers frequently. Keep the area dry and clean. Check the diaper often
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every hour if the baby has a rash and change the diaper as soon as it is wet or soiled. Check at least once during the night. Good air circulation is also important for healthy skin. Babies should have some time without wearing a diaper. A cotton pad can protect the bed while the baby is diaper free. Frequent and vigorous washing with soap can strip the baby's tender skin of natural protective barriers. Wash gently but thoroughly
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Signs to See MD "o Has a fever greater than 100 degrees rectally or axillary (under arm); has diarrhea-frequent
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watery
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Temperature Taking "o Most physicians recommend taking a baby's temperature rectally
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by placing a thermometer in the baby's anus. This method is accurate and gives a quick reading of the baby's internal temperature. Axillary (underarm) temperature measurements must be held in place for 10 minutes. The tympanic (ear) type thermometers may not be accurate for newborns and require careful positioning to get an accurate reading. Skin strips that are pressed on the skin to measure temperature are not recommended for babies. Touching a baby's skin can let you know if he/she is warm or cool but you cannot measure body temperature simply by touch.
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o To take a rectal temperature: Place the baby across your lap or changing table
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on his/her abdomen
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Medication Administration "o Babies under three months of age should not get any medication that is not prescribed by a doctor. Check expiration dates and medication names. Don't use kitchen spoons when measuring medications - they are not very precise. Shake medications before use if the instructions require it. Refrigerate medications before use if the instructions require it. Don’t give medications in the dark
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you may misread the label. Give medications for the length of time they are prescribed for
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Dressing and Clothing "o When stocking up on basics before your baby arrives
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purchase very little in newborn size. Your baby will outgrow these tiny garments fast--sometimes in less than a month. It’s more practical to buy in the 3- to 6-month or 6- to 9-month size. If saving money is your mission
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Safe Sleeping: Postions "o Babies should always sleep on their backs to decrease risk of Sudden infant death syndrome (SIDS). It is commonly known as is the sudden and unexplained death of an otherwise perfectly healthy baby. A diagnosis of SIDS is given when; a peacefully sleeping baby simply doesn’t wake up. In most cases
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no cause is ever found. Most SIDS deaths occur in children who are between 2 months and 4 months old. For the first two months of a baby’s life
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Safe Sleeping- Environment "o No loose blankets
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sheets or other objects should be in the crib"
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Amount of Sleep and Awake Time "o Your newborn baby doesn’t know the difference between night and day. She needs to sleep and feed around the clock to grow and develop correctly
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so night and day don’t matter much to her anyway. In general
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Stimulation and Safe Toys "o In the first years of your baby’s life
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the brain is busy building its wiring system. Activity in the brain creates tiny electrical connections called synapses. The amount of stimulation your baby receives has a direct affect on how many synapses are formed. Repetitive stimulation strengthens these connections and makes them permanent
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Shaken Baby Syndrome "o Shaken baby syndrome (SBS) or Battered Baby Syndrome is a form of child abuse that occurs when an abuser violently shakes an infant or small child
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creating a whiplash-type motion that causes acceleration-deceleration injuries. There are often no external signs of injury.
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o SBS is accompanied by a variety of signs
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which range from mild to severe and nonspecific to obviously head trauma related. There is no single symptom that defines SBS. The characteristic injuries associated with SBS include retinal hemorrhages
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Car Seat "o The first thing you have to keep in mind before you choose a baby car seat is safety. It is pointless to buy something that cannot protect your children. Make sure the car seat you are choosing has a good quality and can 100% protect your children. Many web sites available on internet provide a customer reviews on almost every products. Please spend a little of your time do some research about each model that interested you and make sure it has positive reviews. The second important thing is the size and weight of your baby compare to the car seat. Baby car seat is designed to fix a baby in place with no movement once an accident happens. An over sized car seat is not effective to protect your child or in worst case it can hurting your child instead of protecting him. Usually every car seat model comes with a recommendation on baby s age
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size
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Growth and Development- 1st Month "o In the first month of life
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a baby's primary tasks are to eat
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o By 1 month your baby will be able to: make jerky
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quivering arm movements
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Sibling Rivalry "o Probably all children who have a brother or sister will experience sibling rivalry at one time or another. Sibling rivalry is a natural
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normal phenomenon. It can take many different forms and can have any number of different causes. Often
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Dealing with Crying Babies "o Why babies cry: Baby is wet
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hungry
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Soothing Methods for Crying Babies "o If you've tried everything you can think of to stop the baby from crying but to no avail
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here are some things that may help you cope: 1-Tag team crying duty- There's no reason why both of you and your partner have to suffer together. Have a schedule of twenty or thirty-minute shifts to do both a world of good. Getting a little exercise during your time off will also calm your nerves before your next shift starts. 2-Let the baby cry it out- If the crying has gone on for more than twenty minutes
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o Other soothing methods: Sing to your baby
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give your baby a bath
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First Visit "o This will likely surprise most parents
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but the first visit to your pediatrician may be the most important. The pediatrician can help make sure your baby is feeding well
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o `Although it depends on whether or not your baby was already jaundiced when she went home
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how well she was feeding
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Dtap- to protect against diphtheria
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tetanus
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Hepatitis A- to protect against hepatitis A
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which can cause the liver disease hepatitis.
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• Between 12 and 23 months
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two shots at least six months apart
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Hepatitis B (HBV)- to protect against hepatitis B
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which can cause the liver disease hepatitis:
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Hib- to protect against Haemophilus influenza type B
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which can lead to meningitis
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• At 6 months (If your child receives either the PedvaxHIB or ComVax vaccine at 2 and 4 months
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he won't need the 6-month shot.)
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HPV- to protect against human papillomavirus
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the most common sexually transmitted disease in the United States and a cause of cervical cancer:
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Influenza (the flu shot)
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to protect against influenza (the ""flu""):
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• Age 6 months and up
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every year in the fall or early winter
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Meningococcal- to protect against meningococcal disease. Before the vaccine came along
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meningococcal disease was the leading cause of bacterial meningitis in children in the United States:
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MMR- to protect against measles
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mumps
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Pneumococcal (PCV)- to protect against pneumococcal disease
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which can lead `to meningitis
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Rotavirus- to protect against rotavirus
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which can cause severe diarrhea
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Excessive Sleepiness during first few days after birth
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infants sleep longer than expected or fall asleep at the breast after feeding. The nurse should show mothers how to arouse sleepy infants for breastfeeding (rub baby’s hair or check gently
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Mild Tremors if tremors are present
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the blood glucose level should be checked because hypoglycemia is the most common cause
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Fractured Clavicle likely to occur in large infants
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esp when shoulder dystocia occurred. A lump or tenderness over the area of the fracture may be observed. Treatment of a fractured clavicle includes immobilization for the affected arm for a short time
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Elevated Bilirubin- "Hyperbilirbinemia" assess for jaundice watch for infant’s skin over a firm surface
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such as the end of the nose or the sternum. Infants tend to look in yellow color from the head and moves down the body. Common risk factors are prematurity
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Hypospadius abnormal placement of the urinary meatus on the ventral (underneith) side of the penis
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it can be corrected by surgery.
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Undescended Testicle when testes are not present in the scrotal sac
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it occurs on one or both sides
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Precocious Teeth – some infants are born with precocious teeth
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usually lower incisors
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Moro it occurs when infant’s head and trunk are allowed to drop back 30 degrees
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infant’s arms and legs extend and abduct
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Palmar Grasp occurs when the infant’s palm is touched near the base of the fingers
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the hand closes into a tight fist.
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Plantar Grasp similar to the palmar grasp reflex
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when the area below the toes is touched
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Sucking place nipple or finger in mouth
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rub against palate. Infant begins to suck.
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Strepping hold infant so feet touch solid surface
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infant will lifts alternate feet as if walking.
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Gallant - lightly stroke the back
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lateral to the vertebral column
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Breast Feeding "Antibodies in breast milk to protect the infant from illness
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have fewer respiratory
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• Avoid soaps
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creams
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(i.e.rubbing
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pulling
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Care for Sore Nipples "signs: cracked
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blistered
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Management of Engorgement "signs: hard
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tender
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• Express a little milk by hand or with breast pump until reola is soft
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then begin to feed
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Colostrum: 1st wk thick
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yellow substance.
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high protein
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fat
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‚Üì Ig and proteins ‚Üë calories
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lactose
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May progress to engorgement if feedings are delayed
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too short or not frequent enough.
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