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