Ob Test 1

Front 1

Transitional period

Back 1

first 6-8 hours after baby is born in wich the newborn stabilizes respiratory and nursing functions (nurse provides direct care)

Front 2

Continuing care

Back 2

continued evaluation of baby at intervals (mom and baby)

Front 3

Airway and respirations-TP

Back 3

is the baby crying

Front 4

Warmth-TP

Back 4

prevent hypothermia (depletes glucose stores)

Front 5

Ensure safety-TP

Back 5

a. injury/ sides up on crib/not sleeping on abdomen
b. infection

Front 6

ID actual/potential problems-TP

Back 6

prbs c feeding, temp reg

Front 7

Continued protection-CC

Back 7

against injury/infection

Front 8

Id actual/potential probs-CC

Back 8

with mom and baby

Front 9

Facilitate bonding-CC

Back 9

talking, cuddling

Front 10

Education-CC

Back 10

newborn care, parenting

Front 11

Factors affecting newborn adaptation

Back 11

a.antepartum experience
what affects mom affects baby
b.intrapartum experience
ow long was labor, any meds given, type of delivery?
c. Newborn transition to extrauternie life (age, genetics, nurses assessments.

Front 12

Normal gestational period

Back 12

40wks

Front 13

Ways to warm a newborn

Back 13

Radiant warmer
swaddle
skin to skin contact
hats

Front 14

Newborn

Back 14

from time of birth through 28 days

Front 15

Umbilical cord

Back 15

2 arteries which remove waste, 1 vein which brings in nutrients

Front 16

Are murmurs something to worry about? Why

Back 16

90% of all murmmurs are transient. No

Front 17

Periodic breathing

Back 17

pauses lasting 5 to 15 seconds

Front 18

Normal breaths per minute for a newborn

Back 18

30-60

Front 19

How are babies different than adults in regards to breathing?

Back 19

Obligatory nose breathers.

Front 20

Is it normal for babies to be coughy/gagggy form mucous?

Back 20

Yes, for 12 to 18 hours after birth it can be normal, esp if it is a cesarean section.

Front 21

What is a normal babies BP?
Can crying affect it?

Back 21

80/46, yes, it may result in an inc of 20 mm Hg.

Front 22

What is the normal pulse rate? In utero?

Back 22

120-160 bpm for both

Front 23

What is wet baby?

Back 23

It is the time after birth(post delivery) that the blood vessels are closer to the skin and they can lose body heat quickly.

Front 24

Cold stress results in what state of being?

Back 24

acidosis

Front 25

If a child is having tremors, what do you do?

Back 25

accucheck to check for hypoglcemia

Front 26

In what direction does a babies neurodevelopment move?

Back 26

Head to toe, and proximodistal. (Cephlacaudal)

Front 27

When should we see a babies first void?

Back 27

at least once in the 1st 24 hrs. Document!!!!
May be brick red or cloudy with mucous.

Front 28

Is a brick red urine normal? What is it?

Back 28

Yes. it is due to urates.

Front 29

After the first day, how many urines should we expect?

Back 29

Day 1-2=2-6 per day
Day 5+=5-20 " "

Front 30

What is the first stool passed called?

Back 30

Mecoinium stool

Front 31

What is the easiest for the baby to absorb? Hardest?

Back 31

Carbs/protiens are easy
starches and fats are hard

Front 32

Physiologic jandice

Back 32

jaundice appearing > 24 hours after birth, RBC destruction, normal

Front 33

Pathological jaundice

Back 33

Jaundice appearing < 24 hours after birth, ABO compatabilites, abnormal.

Front 34

Is the babies immune system fully mature at birth? What does this indicate?

Back 34

No, cant limit invading organisms, inc risk for infection, inc risk for mortality.

Front 35

Normal Weight?

Back 35

6 to 8 lbs, 2500-4000g

Front 36

Normal length?

Back 36

18-22 inches

Front 37

Skin appearance?

Back 37

thin, dry, ruddy, translucent, poss some hair (lanugo)

Front 38

Vernix

Back 38

mainly found on preterm baby

Front 39

Lanugo

Back 39

fur, dec as gestational age inc, born preterm, have more

Front 40

When do we do newborn assessments?

Back 40

immediately after birth, within the first 4 hours, prior to discharge.

Front 41

Wha is the nb head circumference? Is it larger that the chest?

Back 41

12.5 to 14.5 inches (32-37cm)
> than chest by 2-3 cm. Usually out of shape form delivery.

Front 42

What is the condtion of the feet in a nb?

Back 42

loose and wrinkly skin, increase sole creases with inc gestational age

Front 43

How much of the foot should have sole creases?

Back 43

2/3

Front 44

What are normal findings on the trunk of the nb?

Back 44

folds in neck, small shoulders, swollen breasts, big abdomen, umbilical stump, slender pelvis. Chest is usu 12-14 inches.

Front 45

Eyes? Color?

Back 45

blue gray, sometimes crossed, sclera can be blu tinged

Front 46

NB normal finding for Ears?

Back 46

Thin, little cartilage, may be filled with vernix. Should snap back into place.Every child has a hearing test, if fail, could be due to vernix in ears.

Front 47

Legs in the nb

Back 47

Flexed and bowed, use ortolanis mauever to check for click, ind. congenital hip dysplasia.

Front 48

What is given at birth to help prevent bleeding in the nb?

Back 48

Vitamin K (IM)

Front 49

What is the cold point for a new born temp?

Back 49

97.7, axillary.

Front 50

Why do we check the clavicle for crepitus?

Back 50

To make sure they were not broke during delivery

Front 51

What is different about the genitals of a newborn after birth?

Back 51

Both have swollen genitals, females may ahve psedumenstruation, males have rugae, have a sac, and have testicles, Which need to be checked for descent.

Front 52

Face of a nb?

Back 52

puddgy, broad nose, receding chin (helps c sucking)

Front 53

Hands of nb

Back 53

clenched fist, loose skin, nails extend beyond fingertips in posterm

Front 54

Skull has two major fontanells. What are they?

Back 54

Anterior, diamond shaped
Occipital, triangle shaped

Front 55

Harlequin sign

Back 55

one half of the nb body truns red while the other stays pale

Front 56

Whitchs milk

Back 56

breastmilk of baby from mothers hormones

Front 57

SGA

Back 57

small for gest age

Front 58

Does size ind gest age?

Back 58

no

Front 59

Does gest age ind the size?

Back 59

no

Front 60

What is normal behavior for nb right after birth?

Back 60

Alert for approx 1-2 hours, then sleeps, responds to stimuli, such as noises, touch light, sounds, feeding, and to pain.

Front 61

Whata are teh nb developmental tasks?

Back 61

Trust vs mistrust, E
Oral, F
Sensorimotor, P

Front 62

When is the very first assessment done?

Back 62

In utero, c fetal monitor strips.

Front 63

What is the first extrauterine assessment called?

Back 63

APGAR

Front 64

What does the APGAR measure?

Back 64

Rep- 0,1,2 no breathing, some breathing, or healthy cry.
Heart rate, 0= none, 1=0-99, 100 or more=2, listen for 6 sec, then * 10
Muscle tone, limp=0 some recoil=1, pulls away, flails arms/legs=2
Reflex irritability
Color, blue=0, pale=1, pink=2

Front 65

How often do you do an apgar?

Back 65

at 1 and 5 minutes, and again at 10 min if score is < than 8.

Front 66

Who does the apagars on a c-section baby

Back 66

neonatology.

Front 67

Who gets what wrist bands?

Back 67

2 on baby, 1 on mom.

Front 68

When is the second assessment? Where is it done?

Back 68

1 to 4 hours after delivery, in the NN.

Front 69

What is assessed at the 2nd assessment?

Back 69

Physical assessment (systems)
Gest age assess
TPR
Apical pulse for 60 sec
Resp for 60 sec

Front 70

What is assessed in a behavior assessment?

Back 70

Bonding
Parental repsonses
Auditory patterns and responses of infant
Motor activity
Social behavior

Front 71

what is assessed with bonding?

Back 71

the mother infant dyad, the nurse reassures, teaches, has mom redemonstrate, gives praise and support.

Front 72

What parental responses are we looking for in the asessessment?

Back 72

Are they bonding with the infant or freaking out?

Front 73

What motor activity are we looking for in the assessment?

Back 73

Neuro reflexes= protective, such as blinking, coughing sneezing, yawning. Feeding, such as rooting, sucking, swalowing, gagging, extrusion of tongue. Others, such as Moro reflex (startle)
, Tonic neck, stepping, palmar grasp, plantar grasp, babinski reflex, and conditional, like feeding.

Front 74

How long should a baby have the startle reflex?

Back 74

they loose it at 3 mos.

Front 75

IF a preme does not suck very well, than how can we feed it to ensure energy conservation?

Back 75

NG tube.

Front 76

What is meant by the social behavior of the infant?

Back 76

Is it smiling or grimacing

Front 77

What are some nursing diagnoses for the newborn?

Back 77

Respiration
Nutrition (Effective/Interrupted breastfeeding)
Temperature(Too warm, not warm enough)
Infection

Front 78

what are some delivery room goals?

Back 78

patent airway
warmth
safety, physical and from infection, transport in cribs
ID
APGAR
Vitamin K and erythromycin
weight and measurement
TPR at birth and q 30min
(1st temp is rectal, then ax form there on)

Front 79

What are some nursery goals?

Back 79

Promote comfort
maintain safety(ID, physical)
stabilize regulatory functions
promote nutrition, fluid balance
facilitate bonding
demonstrate caring
educate
reduce parental fear

Front 80

Newborn education

Back 80

Infant care
Sleep patterns
Signs of illness

Front 81

Infant care

Back 81

bath-mild soap sponge bath until uc falls off
temp-recta/axillary
cord care-wipe with alcohol pad with each diaper change, call ped if see drainage
circumcision- ring, mild soap and water, look for redness, infection, inability to urinate
Diapering/dressing-6-8 wet diapers daily, document stools. Bottle fed=pale yellow, formed and pasty. Breast fed=yellow gold, soft or mushy.
Feeding=Breast, on demand or set schedule, Bottle, q4 hours, both around the clock.
Sleeping-habits
Comforting, snuggle tight, rocking, bouncing.
Medical checkup, varies, usu 2 weeks
Safety, carseat, position after feeding.

Front 82

What routine screenings are done as part of infant care?

Back 82

Blood type and Rh factor
Hearing
PKU
Glucose
Bilirubin
Hepatitis B

Front 83

What education is req in regards to sleep patterns?

Back 83

position, put on back or right side, you can also lay them on their chest to ear the heartbeat, rub their back and swaddle them tight.

Front 84

What education is req in regards to signs of illness?

Back 84

taking temp, refering to doctor with questions. Whst signs to look for, like inconsoleable crying, becomes lethargic, dec eating, jitteriness.

Front 85

What is normal nb blood glucose?

Back 85

40-60

Front 86

What places a nb at a hi risk ?

Back 86

SGA, LGA, Premature. less that 37 weeks, post mature due to aspiration or hypoglycemia, if over 41 wks is post, cord can get calcified, block transmission, GBBstrep, and Rh factor.

Front 87

Why is GBBS so harmful?

Back 87

detremental to babies, doesn't harm mom, can be fatal for baby. Mom gets a antibiotic during delivery to prevent transmission, it has an early onset of respiratory distress, if late onset, see meningitis symptoms.

Front 88

Why doe the Rh factor matter?

Back 88

if mom in neg and baby is pos, mom will develop antibodies against next baby, need RoGham to prevent atb develoment.