Nursing Care Of The Newborn And Family (Tb 26 / Sg 24)

Front 1

Apgar score: what are the 5 signs indicating newborn's physiologic state?

Back 1

heart rate, respiratory rate, muscle tone, reflex irritability, color

Front 2

Automatic sensor usually placed on the upper quadrant of the abdomen immediately after birth and when needed

Back 2

thermistor probe

Front 3

Inflammation of the newborn's eyes from gonorrheal or chlamydial infection contracted by the newborn during passage through the mother's birth canal.

Ointment usually instilled into newborn's eyes within 1-2 hrs after birth to treat infection (2)

Back 3

ophthalmia neonatorum

erythromycin and tetracycline

Front 4

Scale used to assess and estimate a newborn's gestational age at birth; initial assessment should be performed within the 1st 48 hrs of life to ensure accuracy and assesses physical and neurologic maturity

Back 4

New Ballard scale

Front 5

Infant born before the completion of 37 wks of gestation, regardless of birth weight

Back 5

preterm

Front 6

infant born at 34-36 wks of gestation; this infant has risk factors d/t his or her physiologic immaturity that require close attn by nurses

Back 6

late preterm

Front 7

infant born between the beginning of wk 38 and the end of wk 42 of gestation

Back 7

term

Front 8

infant born after the completion of 42 wks of gestation

Back 8

postterm

Front 9

infant born after the completion of 42 wks of gestation and showing the effects of progressive placental insufficiency

Back 9

postmature

Front 10

device used for noninvasive monitoring of bilirubin via cutaneous reflectance measurements; it allows for repetitive estimation of bilirubin and works well on both dark and light skinned newborns

Back 10

transcutaneous bilirubinometry (TcB)

Front 11

infection characterized by white plaques on cheeks or tongue that bleed if touched

Back 11

thrush

Front 12

postoperative pain scale for newborns

The 5 signs ?

Back 12

CRIES
crying, requires oxygen for saturation of 95%, increased vital signs, expression, sleepless

Front 13

Assessment finding for a 12-hour newborn in a quiet alert state (Normal or potential problem?)

episodic apnea lasting 5-10 seconds

Back 13

normal

Front 14

Assessment finding for a 12-hour newborn in a quiet alert state (Normal or potential problem?)

Slight bluish discoloration of hands and feet

Back 14

normal

Front 15

Assessment finding for a 12-hour newborn in a quiet alert state (Normal or potential problem?)

Blood pressure 86/44

Back 15

normal

Front 16

Assessment finding for a 12-hour newborn in a quiet alert state (Normal or potential problem?)

Temperature 36 degrees Celsius

Back 16

potential problem

Front 17

Assessment finding for a 12-hour newborn in a quiet alert state (Normal or potential problem?)

pink-tinged stains on diaper with first 2 voidings

Back 17

normal

Front 18

Assessment finding for a 12-hour newborn in a quiet alert state (Normal or potential problem?)

2 small white cysts at gum margins and on palate

Back 18

normal

Front 19

Assessment finding for a 12-hour newborn in a quiet alert state (Normal or potential problem?)

Boggy, edematous swelling over occiput

Back 19

normal

Front 20

Assessment finding for a 12-hour newborn in a quiet alert state (Normal or potential problem?)

Overlapping of parietal bones

Back 20

normal

Front 21

Assessment finding for a 12-hour newborn in a quiet alert state (Normal or potential problem?)

Regurgitation of small amount of milk following 1st 2 feedings

Back 21

normal

Front 22

Assessment finding for a 12-hour newborn in a quiet alert state (Normal or potential problem?)

Spine straight with dimple and small tuft of hair at the base

Back 22

potential problem

Front 23

Assessment finding for a 12-hour newborn in a quiet alert state (Normal or potential problem?)

Hematocrit 36% and hemoglobin 12 g/dl

Back 23

potential problem

Front 24

Assessment finding for a 12-hour newborn in a quiet alert state (Normal or potential problem?)

White blood cell count (WBC) 20,000/mm3

Back 24

normal

Front 25

Newborn male designated LGA, mother with gestational diabetes late in pregnancy. Nurse should be alert for hypoglycemia. Which findings are consistent with hypoglycemia?

a. high-pitched cry
b. jitteriness
c. hyperthermia
d. laryngospasm

Back 25

b. jitteriness

other signs are apnea, respiratory distress, poor feeding, lethargy, hypotonia, hypothermia, and seizures

laryngospasm and high-pitched cry are signs of hypocalcemia

Front 26

What is this baby's Apgar score? (baby boy at 1 minute)
HR - 160
Respiratory effort - good, crying vigorously
muscle tone - active movement, well flexed
color - body pink, feet and hands cyanotic

Back 26

Score = 9 (7-10 = not having difficulty adjusting to extrauterine life)
HR - 1
Respiratory - 2
muscle tone - 2
reflex irritability - 2 (crying with stimulus)
color - 1

Front 27

What is this baby's Apgar score? (baby girl at 5 minutes)
HR - 102
respiratory effort - slow, irregular with weak cry
muscle tone - some flexion of extremities
reflex irritability - grimace with stimulus to soles of feet
color - pale

Back 27

Score = 5 (4-6 = moderate difficulty adjusting to extrauterine life)
HR - 2
Respiratory - 1
muscle tone - 1
reflex irritability - 1
color - 0

Front 28

Parents are concerned cause their breastfed son, who weighed 8 lbs 6 oz at birth, now 2 days later weighs 7 lbs 14 oz. They wonder if they should stop breastfeeding, "maybe my breast milk is not enough for the baby to grow." How should you respond?

Back 28

Calculate the % weight loss - make sure it doesn't exceed 10%
Explain the % is 6% which is in the expected normal range for weight loss after birth
discuss the cause of the loss and feeding measures
inform them that the weight should be regained within 2 weeks

Front 29

Parents of a newborn (30 hrs old) who develops hyperbilirubinemia, very concerned about the color of their baby, "a relative was yellow just like our baby and later died of liver cancer!" How should you respond?

Back 29

explain in simple terms that their newborn is experiencing physiologic jaundice, explain why it occurs, what effect it will have on the baby's health, and how it will be resolved
emphasize that their baby's form of jaundice is common and naturally occurs as a newborn adjusts to extrauterine life

Front 30

What are some nonpharmacologic pain relief measures after a circumcision? (7)

Back 30

swaddle, nonnutritive sucking, take to parent, distract, apply Vaseline, change diaper promptly, avoid pressure on site when holding or positioning

Front 31

State of purpose of administering vitamin K to newborns

Back 31

to prevent and treat hemorrhagic disease in the newborn

Vitamin K is necessary because the newborn does not have the intestinal flora to produce this vitamin in the 1st wk after birth

It promotes formation of clotting factors (II, VII, IX, X) in the liver