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42 Cards in this Set

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CHAPTER TWENTY-FOUR
(Ignore this card)
When should the newborn's VS be checked?
on admission/birth and every 30 minutes x 2, every 1 hour x 2, and then every 8 hours
Describe the first period of reactivity
the newborn is alert and exhibits exploring activity, makes sucking sounds, and has a rapid heartbead and respiratory rate. Heart rate may be as high as 160-180/min, but will stabilize at a baseline of 100-120/ min that lasts 15-30 minutes after birth
Describe the period of relative inactivity
Lasts from 30 minutes to 2 hours after birth, the newborn becomes quiet and begins to rest and sleep. The newborn's heart rate and respirations decrease.
Describe the second period of reactivity
the newborn reawakens, becomes responsibe again, and often gags and chockes on mucus that has accumulated in the mouth. This period usually occurs 2-8 hours after birth and may last 10 minutes to several hours.
A capillary heel stick should be performed when?
24 hours after birth
If a newborn is discharged before 24 hours of age, what should be done regarding a capillary heel stick?
should be repeated in 1-2 weeks
Why is it important to test for PKU?
Because Tx in the first 2 months of life can prevent retardation
When performing a capillary heel stick, how deep should the lancet go and why?
No more than 2.4 mm to prevent necrotizing osteochondritis resulting from penetration of the bone
Neonatal bradypnea
< 25 breaths/min
Neonatal tachypnea
> 60 breaths/min
Describe newborn surface-to-weight ratio, metabolism per unit area, blood vessels, and insulation
Relatively large surface-to-weight ratio, reduced metabolism per unit area, blood vessels closer to the surface, and small amounts of insulation
When the newborn is chilled, this can result in a higher demands for
oxygen
List the four mechanisms of heat loss
conduction, convection, evaporation, radiation
Conduction
loss of body heat resulting from direct contact with a cooler surface
Convection
flow of heat from the body surface to cooler environmental air
Evaporation
loss of heat as surface liquid is converted to vapor
Radiation
loss of heat from the body surface to a cooler solid surface that is close to, but not in direct contact
The newborn's temperature should stabilize at what, when?
at 37 C (98.6 F) within four hours of birth if chilling is prevented
When can the newborn be bathed?
once the temperature has stabilized to at least 36.5 C (97.7 F)
A complete sponge bath should be given to the infant when?
within the first 1 to 2 hours after birth, under a radiant heat source to prevent heat loss
Should gloves be worn when handling the infant?
gloves should be worn until the newborn's first bath to avoid exposure to body secretions
Formula feeding is usually started when?
at about 2-4 hours of age
List the six sleep-wake states from heaviest to lightest
deep sleep, light sleep, drowsy, quiet alert, active alert, extreme irritability (crying)
How much do newborns sleep?
17 hours/day, an average of 4 hours at a time
How should newborns be positioned to sleep?
supine, "back to sleep," to decrease SIDS
After the 4th day, how often should newborns void?
6-10 times a day
After the first day, how often should newborns defecate?
3-4 times/day
What is the difference between the stools of breastfed infants and formula-fed infants?
lighter in color and looser
What diaper wipes should be avoided
those with ETOH
Which medication is given to prevent ophthalmia neonatorum
erythromycin (Romycin)
Which organisms cause ophthalmia neonatorum?
Neisseria gonorrhoeae, Chlamydia trachomatis
What can ophthalmia neonatorum lead to?
blindness
How should erythromycin be applied?
from the inner canthus to the outer canthus
What is a possible adverse reaction to erythromycin in the newborn's eye? What is characterized by and what results?
chemical conjunctivitis - may cause redness, swelling, drainage, and temporarily blurred vision for 24-48 hours; a normal response to the medication
Aquamephyton
= Vitamin K injection for the newborn; 0.5-1 mg IM into vastus lateralis within 1 hour of birth
Vitamin K is not produced in the GI tract of the newborn until
around day 8
Hep B vaccine is given to the newborn
at birth, 1 month, 6 months
If cold stress occurs for the newborn…
warm slowly over a period of 2-4 hours
Which infants are at risk for hypoglycemia?
Mother with DM. SGA, LGA, < 37 weeks gestation, > 42 weeks gestation
For infants at risk for hypoglycemia, when should blood glucose be drawn?
within the first 2 hours of life
Signs of hypoglycemia in the newborn
jitteriness, twitching, weak and high-pitched cry, irregular respiratory effort, cyanosis, lethary, eye rolling, seizures, blood glucose by heel stick of < 40 mg/dL