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12 Cards in this Set

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Newborn Pain Assessment
Performed during shift assessment, during procedures (circumcision, heel-sticks, IV start), and following interventions
Pain scales (NIPS, CRIES, PIPP, etc) take into account physical signs of pain
How do I know if I'm making enough breastmilk?
Infant feeds at least 15 minutes on one breast q 2-3 hours, is satisfied and sleeps between feedings, has 6-10 wet diapers q day, has multiple "mustard" BMs q day
What are some helpful hints for breastfeeding?
Infants chest toward mom
Lips flanges out
Mouth wide open
All or most of areola in mouth
If baby latches on in first half hour they will be more successful
How many wet diapers should a baby have?
Day 1-4= one wet diaper for however many days old they are
Day 5+= 6-10 wet diapers per day
If I am bottle feeding how much do I need to feed my baby?
1 oz q 3-4 hrs for first 24 hours and increase volume over the next week to about 3 oz per feeding
Newborn stomach size
Day 1= 5-7 ml
Day 3= .75-1 oz
Day 7 = 1.5-2 oz
On day 1 the newborn stomach will not stretch to hold more volume, if baby is overfed extra milk will be spit up
When should the newborn pass meconium?
First 24-48 hours
If not passed could be first sign of cystic fibrosis
What infants are at risk for hyperbilirubinemia?
Higher hematacrit
Blood incompatibility
Birth trauma
Ethnic groups
What is hyperbilirubinemia?
RBCs are broken down into bilirubin (BR). Unconjugated BR is fat soluble and bound to protein (bad). BR travels to liver and becomes conjugated, water soluble with glucuronide, excreted in the bile and then eliminated in the urine and feces. A build up of unconjugated BR moves into the extravascular tissue, skin, sclera, and brain tissue.
You will see jaundice start at the face and work it's way down the body, be very vigilant if it reaches the stomach. If BR crosses the BBB can cause irreversible neurological damage.
How do you treat hyperbilirubinemia?
Phototherapy: breaks down the biliruben. Uses bilights, fiberoptic blanket, or sunlight.
Precautions: eyes/genitals covered, regular feedings, watch for dehydration, verify lamp output with photometer (usually start out at 15)
What safety precautions should be taken when working with a newborn?
1. Wash hands before touching any baby
2. Gloves when changing diaper or coming into contact with other fluids
3. ID bands- baby will have mom's name on band
4. Do no carry the baby in the hallway, use a bassinet
What home safety issues should be discussed with parents before they take baby home?
1. Car seat: must have one to leave hospital
2. Siblings
3. Pets