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20 Cards in this Set
- Front
- Back
What is Apgar scoring?
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Scoring test performed at 1 minute then at 5 minutes. If the score is less than 8, then it is probable that some measure need to be taken
Each of the following gets a score of 0 – 2, giving a total score of 0 – 10: Heart Rate, Respiratory effort, Muscle tone, Reflex irritability, Color |
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Describe the newborn sleep cycles.
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Defined according to duration, length of cycle dependent on age of the newborn.
First period of reactivity – baby is alert, initiate breast feeding Period of inactivity / sleep phase – Baby sleeps for a few hours Second period of reactivity – Baby is bathed within 3rd and 4th hour, sometimes under a heat lamp. The baby may be submerged into water. The baby sleeps 16 to 20 hours per day for the 1st 2 weeks. |
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Describe the newborn sleep states.
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Sleep states: Deep / Quiet sleep – regular breathing, no movement except sudden body jerks, Active REM – irregular breathing, body twitching, may cry out but not awake, Quiet alert – Infant awake and involved with the surroundings, Awake / crying states
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Discuss newborns and temperature.
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Temperature regulation – babies lose heat very rapidly. When a baby is cold, there is: An increase of O2 consumption, An increase of utilization of glucose (hypoglycemia) & brown fat, An increase need for calories, An increased risk for metabolic acidosis, A decrease in surfactant production.
They lose heat by: Convection – Body heat lost to cool air flow, Conduction –Body heat lost to blankets, etc., Radiation – Body heat lost to cool temps., Evaporation – Body heat lost due to moisture from skin and lungs., Management – babies are stimulated to breath by drying action post birth. |
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Discuss the normal newborn vital signs.
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Vital signs: Temperature – per axila 36.5 – 37.0 C / 97.9 – 98.0 F ** first temperature is done rectally to check for unperferated anus. Then it is performed at the axillary. If the baby’s temp in < than 97.8, double wrap the baby and check again. Babies cannot shiver to warm their own body.
Pulse / Heart Rate – Apical: 120-140 bpm. Varies with sleep / crying Respirations – 30 – 60 breaths / minute Blood Pressure – In arm / thigh. May be higher in thigh. 65-41 mm/hg. It is important for the closing of the vessels. |
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Discuss the normal newborn weight.
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Average weight: 3400 grams or 7 lbs 8 oz. There is usually a 5 to 10 % weight loss in the first few days. It is regained within 10-14 days.
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Discuss the normal newborn length.
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Average length: 45.2 cm to 55 cm or 17.8 inches to 27.7 inches
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Discuss the normal newborn head.
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33 –35 cm / about 2 – 3 cm larger than chest. Measure right above the brow. Look at fontanels – anterior and posterior – Bulging? Sunken?
Caput succedaneum – Spongy, collection of fluid (like coneheads). It does cross the suture line, will settle down in 24 hours. – Due to edema. Cephalohematoma – Does not cross the suture line – Due to birth trauma. **Extreme size differences in head may indicate microcephaly, hydrocephaly or ICP. |
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Discuss the normal newborn eyes, nose, mouth & throat.
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Check alignment, symmetry – helix of the ear should be above the eyeline. Check for cleft palate. Check for Birthmarks, Milia – White pinhead size keratin-filled cysts. Will go away on its own. Check for newborn rash.
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What are the different types of newborn birthmarks?
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Birthmark = hemangioma. Strawberry hemangioma - bright red and sticks out of the skin, so it does look a little bit like a strawberry. Some strawberry hemangiomas go away on their own by the time a kid is about 5 years old. Almost all strawberry hemangiomas go away by themselves by the time a kid is about 9 years old.
Cavernous hemangioma - is beneath the outer layer of skin. This type of birthmark is deep beneath the outer layer of skin. This kind of birthmark is puffier than a strawberry hemangioma. It's bluish-red. Cavernous hemangiomas usually don't go away by themselves. Port-Wine Stains: This isn't puffy or raised, it's level with the outer layer of skin. A port-wine stain is an area of skin that is either maroon or dark red. Kids who have port-wine stains usually have them on the face and neck. Moles - any brown, blue, or black spots on your skin since birth. Moles are tiny collections of pigment cells -cells that contain color. Like other birthmarks, moles don't hurt and usually aren't a sign of illness in kids. |
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Discuss the normal newborn neck and body.
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Vernix – waxy substance that protects the baby in utero. More than usual = that the baby is immature. Check for skin folds, if not, baby has a web neck. Lanugo – downy, fine hair that is lost as the baby matures.
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Discuss the normal newborn chest.
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Circumference 32-33 cm. Evident xiphoid. Chest measured a the nipple line. Breast enlargement – enlarged do to hormones. Witch’s milk. Do not squeeze out this milk. Check for extra nipples. Sternal retractions. Listen for lung sounds. Lung maturation: Lung functions after 26th week gestation. Lung surfactant okay at 35 weeks gestation. Check clavical for breaks – can occur during delivery. Respiratory effort: Within the 1st minute of birth: Loud & lusty cry, No dyspnea, No retractions, Respiratory rate < 60 / min, Diaphragmatic & abdominal muscles used, Nose breather.
Mouth = circumoral cyanosis |
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Discuss the normal newborn abdomen.
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Umbilical cord – 2 arteries and 1 vein – Obtain cord blood sample in delivery room.
When cord cut, check to see the three vessles. Brachial and femoral pulses – measured at the umbilicus. |
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Discuss the normal newborn back and shoulders.
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Spine intact. Check for lanugo. Check for mongolian spots – greenish color, lower portion of the body. Run finger down the spine to assess for abnormalities. Check shoulder for break / dystocia – can occur during delivery.
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Discuss the normal newborn gastrointestinal and genitourinary.
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Listen for bowel sounds. Patent anus. Passes meconium within 24 hours. Urinate within 24 hours. Stools will transition from meconium to:
Seedy – breast fed. Pasty – formula fed. |
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Discuss the normal newborn genitalia.
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Male: Testes palpable in scrotum. Scrotum pendulous, rugae. Check for no hypo or epispadia. Check for testicle descended. Female: Check that labia & clitoris is edematous.
Pseudomentruation. Hymenal tag. If baby is premature, you may see labia minora, labia majora and clitoris all at once. |
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Discuss the normal newborn extremities.
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Check for syndactly / polydactly – check both upper and lower. Check for webbed extremities. Check ortolani’s maneuver – for hip dislocation.
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What are the newborn reflexes?
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Blink, Rooting – Aid to breastfeeding - Rub jaw, baby will turn and open mouth. Sucking – should be strong, Palmar and plantar grasp – place finger on palm, baby will grasp. Stepping – simulate walking. Tonic Neck / Fencer – Moro – Startle reflex – baby will move hands close together, Babinski – not present as normal in adults. Will fan toes when stroking bottom of foot. Trunk incurvation – Rub the side of the trunk and the baby will turn to that side.
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What is the newborn nutrition?
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Breast Milk: Colostrum – in the first 3-4 days after birth. Rich in protein, low in sugar and fat, also has minerals, vitamins and maternal antibodies. Transitional milk – Seen day 2 – 4. Mature milk – by day 10
Fore milk, Hind milk – higher in fat – allows for rapid growth of the newborn. Metabolic Screning Test (or PKU) – blood from baby done prior to 72 hours. |
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Discuss the newborn stools.
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Meconium – Sticky, tarry, blackish green appearance. Passed within the first 24 hours. Transitional – 2nd or 3rd day of life color and consistency changes to greenish brown loose stools
Breast fed stools – More liquid, seedy, yellow color – breast milk easier to digest. Bottle fed stools – Formed, pasty, brownish-yellow. |