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88 Cards in this Set

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Transitional period
first 6-8 hours after baby is born in wich the newborn stabilizes respiratory and nursing functions (nurse provides direct care)
Continuing care
continued evaluation of baby at intervals (mom and baby)
Airway and respirations-TP
is the baby crying
Warmth-TP
prevent hypothermia (depletes glucose stores)
Ensure safety-TP
a. injury/ sides up on crib/not sleeping on abdomen
b. infection
ID actual/potential problems-TP
prbs c feeding, temp reg
Continued protection-CC
against injury/infection
Id actual/potential probs-CC
with mom and baby
Facilitate bonding-CC
talking, cuddling
Education-CC
newborn care, parenting
Factors affecting newborn adaptation
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.
Normal gestational period
40wks
Ways to warm a newborn
Radiant warmer
swaddle
skin to skin contact
hats
Newborn
from time of birth through 28 days
Umbilical cord
2 arteries which remove waste, 1 vein which brings in nutrients
Are murmurs something to worry about? Why
90% of all murmmurs are transient. No
Periodic breathing
pauses lasting 5 to 15 seconds
Normal breaths per minute for a newborn
30-60
How are babies different than adults in regards to breathing?
Obligatory nose breathers.
Is it normal for babies to be coughy/gagggy form mucous?
Yes, for 12 to 18 hours after birth it can be normal, esp if it is a cesarean section.
What is a normal babies BP?
Can crying affect it?
80/46, yes, it may result in an inc of 20 mm Hg.
What is the normal pulse rate? In utero?
120-160 bpm for both
What is wet baby?
It is the time after birth(post delivery) that the blood vessels are closer to the skin and they can lose body heat quickly.
Cold stress results in what state of being?
acidosis
If a child is having tremors, what do you do?
accucheck to check for hypoglcemia
In what direction does a babies neurodevelopment move?
Head to toe, and proximodistal. (Cephlacaudal)
When should we see a babies first void?
at least once in the 1st 24 hrs. Document!!!!
May be brick red or cloudy with mucous.
Is a brick red urine normal? What is it?
Yes. it is due to urates.
After the first day, how many urines should we expect?
Day 1-2=2-6 per day
Day 5+=5-20 " "
What is the first stool passed called?
Mecoinium stool
What is the easiest for the baby to absorb? Hardest?
Carbs/protiens are easy
starches and fats are hard
Physiologic jandice
jaundice appearing > 24 hours after birth, RBC destruction, normal
Pathological jaundice
Jaundice appearing < 24 hours after birth, ABO compatabilites, abnormal.
Is the babies immune system fully mature at birth? What does this indicate?
No, cant limit invading organisms, inc risk for infection, inc risk for mortality.
Normal Weight?
6 to 8 lbs, 2500-4000g
Normal length?
18-22 inches
Skin appearance?
thin, dry, ruddy, translucent, poss some hair (lanugo)
Vernix
mainly found on preterm baby
Lanugo
fur, dec as gestational age inc, born preterm, have more
When do we do newborn assessments?
immediately after birth, within the first 4 hours, prior to discharge.
Wha is the nb head circumference? Is it larger that the chest?
12.5 to 14.5 inches (32-37cm)
> than chest by 2-3 cm. Usually out of shape form delivery.
What is the condtion of the feet in a nb?
loose and wrinkly skin, increase sole creases with inc gestational age
How much of the foot should have sole creases?
2/3
What are normal findings on the trunk of the nb?
folds in neck, small shoulders, swollen breasts, big abdomen, umbilical stump, slender pelvis. Chest is usu 12-14 inches.
Eyes? Color?
blue gray, sometimes crossed, sclera can be blu tinged
NB normal finding for Ears?
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.
Legs in the nb
Flexed and bowed, use ortolanis mauever to check for click, ind. congenital hip dysplasia.
What is given at birth to help prevent bleeding in the nb?
Vitamin K (IM)
What is the cold point for a new born temp?
97.7, axillary.
Why do we check the clavicle for crepitus?
To make sure they were not broke during delivery
What is different about the genitals of a newborn after birth?
Both have swollen genitals, females may ahve psedumenstruation, males have rugae, have a sac, and have testicles, Which need to be checked for descent.
Face of a nb?
puddgy, broad nose, receding chin (helps c sucking)
Hands of nb
clenched fist, loose skin, nails extend beyond fingertips in posterm
Skull has two major fontanells. What are they?
Anterior, diamond shaped
Occipital, triangle shaped
Harlequin sign
one half of the nb body truns red while the other stays pale
Whitchs milk
breastmilk of baby from mothers hormones
SGA
small for gest age
Does size ind gest age?
no
Does gest age ind the size?
no
What is normal behavior for nb right after birth?
Alert for approx 1-2 hours, then sleeps, responds to stimuli, such as noises, touch light, sounds, feeding, and to pain.
Whata are teh nb developmental tasks?
Trust vs mistrust, E
Oral, F
Sensorimotor, P
When is the very first assessment done?
In utero, c fetal monitor strips.
What is the first extrauterine assessment called?
APGAR
What does the APGAR measure?
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
How often do you do an apgar?
at 1 and 5 minutes, and again at 10 min if score is < than 8.
Who does the apagars on a c-section baby
neonatology.
Who gets what wrist bands?
2 on baby, 1 on mom.
When is the second assessment? Where is it done?
1 to 4 hours after delivery, in the NN.
What is assessed at the 2nd assessment?
Physical assessment (systems)
Gest age assess
TPR
Apical pulse for 60 sec
Resp for 60 sec
What is assessed in a behavior assessment?
Bonding
Parental repsonses
Auditory patterns and responses of infant
Motor activity
Social behavior
what is assessed with bonding?
the mother infant dyad, the nurse reassures, teaches, has mom redemonstrate, gives praise and support.
What parental responses are we looking for in the asessessment?
Are they bonding with the infant or freaking out?
What motor activity are we looking for in the assessment?
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.
How long should a baby have the startle reflex?
they loose it at 3 mos.
IF a preme does not suck very well, than how can we feed it to ensure energy conservation?
NG tube.
What is meant by the social behavior of the infant?
Is it smiling or grimacing
What are some nursing diagnoses for the newborn?
Respiration
Nutrition (Effective/Interrupted breastfeeding)
Temperature(Too warm, not warm enough)
Infection
what are some delivery room goals?
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)
What are some nursery goals?
Promote comfort
maintain safety(ID, physical)
stabilize regulatory functions
promote nutrition, fluid balance
facilitate bonding
demonstrate caring
educate
reduce parental fear
Newborn education
Infant care
Sleep patterns
Signs of illness
Infant care
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.
What routine screenings are done as part of infant care?
Blood type and Rh factor
Hearing
PKU
Glucose
Bilirubin
Hepatitis B
What education is req in regards to sleep patterns?
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.
What education is req in regards to signs of illness?
taking temp, refering to doctor with questions. Whst signs to look for, like inconsoleable crying, becomes lethargic, dec eating, jitteriness.
What is normal nb blood glucose?
40-60
What places a nb at a hi risk ?
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.
Why is GBBS so harmful?
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.
Why doe the Rh factor matter?
if mom in neg and baby is pos, mom will develop antibodies against next baby, need RoGham to prevent atb develoment.