Care Of The Normal Newborn

Front 1

_ are newborns during the first 28 days of life

Back 1

Neonates

Front 2

What is the most critical time for the neonate?

Back 2

the first 24 hours

Front 3

Neonates

The first few breaths set into process events that will __

Back 3

1. Assitst with the conversion from fetal to adult type circulation

2. Empty the lungs of liquid

3. Establish neonatal lung volume and function in the newborn.

Front 4

How long before the baby's respirations stabilize after birth?

Back 4

The baby's respirations may not stabilize for about 2 hours after birth

Front 5

After 2 hours of birth, the baby's respiratory rate should be less than _ breaths per minute.

Back 5

less than 60

Front 6

How does the circulatory system abruptly change when the umbilical cord is clamped and then cut?

Back 6

the foramen ovale, ductus arteriosus, and ductus venosus must close to allow blood to flow to the heart, lungs, and liver.

Front 7

The first breath expands the air passages and the _A_. The healthy newborn has enough _B_ to allow the sacs to remain open, rather than collapsing after each breath. This means the next breath will not require as much effort.

Back 7

A- alveoli

B. surfactant

Front 8

_ is a chemical that stabilizes the walls of the alveoli.

Back 8

surfactant

Front 9

_ are grape-like sacs where gas exchange occurs in the lungs.

Back 9

alveoli

Front 10

The changes in the neonates respiratory system is _ with the changes in the circulatory system.

Back 10

interrelated

Front 11

What are the three ways the baby maintains temperature?

Back 11

shivering (which is not very efficient); muscle movements (which has only little benefit); and production of heat caused by using stored brown fat.

Front 12

What ways can heat loss occur in an infant?

Back 12

conduction, convection, evaporation, and radiation

Front 13

What are the four main nursing goals for a newborn?

Back 13

1. Establish and maintain an airway and respirations

2. Provide warmth and prevent hypothermia

3. Provide a safe environment and routine preventive measures

4. Promote maternal- infant attachment

Front 14

What are the five criteria of the Apgar score?

Back 14

Appearance

pulse

grimace

activity

respiratory effort

Front 15

What is the purpose of the Apgar score?

Back 15

it provides a quick and accurate means to assess the newborn's physical condition at time of birth.

Front 16

When is the Apgar score determined?

Back 16

1 minute and again at 5 minutes after birth

Front 17

Apgar Score

If the total score is 10, what?

Back 17

the newborn is in the best possible condition

Front 18

If the total score is 7 to 9, what?

Back 18

the newborn usually does not need resuscitation

Front 19

If the total score is 4 to 6, what?

Back 19

the newborn is in danger

Front 20

If the total score is 0 to 3, what?

Back 20

the newborn needs emergency resuscitation

Front 21

Permanent brain damage can occur if the newborn is without oxygen for __

Back 21

more than approx. 4 minutes

Front 22

Because the baby emerging from the mother's warm body may lose a lot of heat (going into a cold room and still wet from amniotic fluid), what is a good intervention that will not only help maintain the neonates warmth, but also encourage bonding?

Back 22

Lifting the newborn onto the mother's bare stomach or chest, perhaps even before the cord is clamped or cut, lets the heat of the mother's body transfer to the newborn.

Front 23

What other measures do you do after the baby's birth to help maintain warmth?

Back 23

-quickly dry the baby and replace wet towels with dry towels

-place a cap on the head

-use radiant warmer, pre-warmed mattress, and warm instruments while doing your assessment

Front 24

How many Kelly clamps are placed on the umbilical cord?

Back 24

2

Front 25

After the cord is clamp, what happens to the infant?

Back 25

the infant must obtain oxygen through its own respiratory effort.

Front 26

What portion of the cord is a blood sample usually obtained from?

Back 26

the portion of the cord still attached to the placenta

Front 27

Where do you apply the plastic clamp?

Back 27

1 to 2 cm above the umbilicus then you remove the Kelly clamp

Front 28

What will happen if you remove the Kelly clamp before you put the plastic clamp on?

Back 28

the infant will lose blood through the cord stump

Front 29

Where are the bands placed on the mother and infant after birth and what do they each have in common?

Back 29

-One band is placed around the mother's wrist, two on the infant (wrist and ankle)

-The each have the same exact info

Front 30

-creates and alarm if the baby is taken off the obstetrical unit without being deactivated by hospital personnel.

Back 30

Electronic Bracelet

Front 31

Some hospitals use maternal _ and newborn _ as means of identification and they become part of the permanent record.

Back 31

fingerprints and footprints

Front 32

What items must be documented before the newborn leaves the delivery room?

Back 32

sex, hour of birth, condition, and type of delivery, identifying marks, care of the eyes, vitamin K administration, and mother's Rh status

Front 33

What type of precautions are used during delivery?

Back 33

standard precautions

Front 34

What ointment is used to protect the newborn from blindness due to gonorrhea or chlamydia infection?

Back 34

Erythromycin Ointment

Front 35

How is Erythromycin ointment applied to the neonates eyes?

Back 35

applied along the conjuctival sac from inner to outer canthus

Front 36

Why is Vitamin K administered to neonates?

Back 36

The lack of intestinal bacterial flora means the newborn is unable to produce adequate amount of vit K, and is at high risk for bleeding problems during the first week of life.

Front 37

What is the first vaccination the newborn receives?

Back 37

hepatitis B

Front 38

T or F

It is safe for the mother to breastfeed, even if she is a hepatitis carrier.

Back 38

True if the baby has been immunized

Front 39

_ is when the mother and baby heads align as they look at each other.

Back 39

en face position

Front 40

What is the average wt of a healthy newborn?

Back 40

5.5 to 9.5 lbs

Front 41

What is the avg length of a health newborn?

Back 41

18 to 22 inches, boys are usually 1/2in longer

Front 42

The avg newborn head circumference?

Back 42

13 to 14 inches

Front 43

The avg newborn chest circumference?

Back 43

10 to 12

Front 44

Which is bigger on a newborn chest or head?

Back 44

The head is usually 1 to 2 inches larger than the chest

Front 45

If the newborn was delivered vaginally, the head may show temporary _

Back 45

molding (elongation)

Front 46

What causes molding?

Back 46

overlap of skull bones during the birth process

Front 47

_results from an accumulation of fluid within the newborn's scalp.

Back 47

Caput succedaneum

Front 48

_is an accumulation of blood between the bones of the skull and the periosteum, the membrane that overs the skull.

Back 48

Cephalohematoma

Front 49

What causes Caput Succedaneum?

Back 49

Swelling causes by pressure to the head during delivery. The fluid causes the scalp to be puffy and edematous, and the edema crosses the midline of the baby's scalp.

Front 50

How long does Caput Succedaneum normally last?

Back 50

The condition normally disappears within a few days

Front 51

What is an important teaching you should do for the parents of a neonate with Cephalohematoma?

Back 51

reassure them that the fluids will eventually reabsorb

Front 52

AKA "soft spots"

Back 52

fontanels

Front 53

_are formed at the junction of the individual skull bones. The bones do not infuse completely before birth, so that the head can mold to fit through the mother's birth canal.

Back 53

fontanels

Front 54

During the first several weeks, why aren't baby's able to produce tears?

Back 54

bc the lacrimal glands aren't yet functioning

Front 55

T or F (newborn)

Engorgement of the breasts is uncommon for the first 2 or 3 weeks of life in both boys and girls.

Back 55

False

It's common and is the result of no longer being under the influence of hormones from pregnancy

Front 56

What is "witch's milk" and an important nurse teaching for the family?

Back 56

When the baby's breast produce a small amount of fluid

--Teach the family that it's common and trying to express the milk may result in the complication of infection

Front 57

_ is when the genitals of the female infant may be enlarged and have a mucoid, white, or blood-stained discharge.

Back 57

Pseudomenstration

Front 58

another name for "foreskin"

Back 58

prepuce

Front 59

If the opening of the foreskin is so small that it cannot be pulled back at all, the condition is called _

Back 59

phimosis

Front 60

If it is located on the underside of the penis (near the scrotum), it is termed __

Back 60

hypospadias

Front 61

A less common location is on the upper side of the penis; this is called

Back 61

epispadias

Front 62

because of slowed peripheral circulation, the newborn's arms and legs may appear cyanotic; this condition is called -

Back 62

acrocyanosis

Front 63

Another word for "peel"

Back 63

desquamate

Front 64

The nose and cheeks may have pinhead-sized white spots, caused by unopened oil and sweat glands. These spots are called __

Back 64

milia

Front 65

White or gray bumps on the mouth's hard and soft palate are known as

Back 65

Epstein's Pearls

Front 66

A mark that often appears on the newborn's eyelid or forehead is called __

Back 66

stork bite

Front 67

A __ is a flat, purple -red area with sharp borders; this is a permanent birthmark.

Back 67

port-wine stain

Front 68

The skin of some newborns is sensitive; many newborns develop a red raised rash known as _

Back 68

erythema toxicum

Front 69

_ are small purplish dots on the skin and are due to pressure caused by labor and will fade.

Back 69

petechiae

Front 70

__ are dark blue areas of discoloration on the buttocks, lower back, or upper legs of nonwhite babies.

Back 70

Mongolian spots

Front 71

How should the ears of a newborn set?

Back 71

The top of the ear should be at or above an imaginary line drawn from the inner canthus of the eye to the outer canthus.

Front 72

Fine, downy hair that may be seen on the face, shoulders, and back, is called

Back 72

lanugo

Front 73

A white, thick, cheesy material may cover the skin,called

Back 73

vernix caseosa

Front 74

What is the vernix composed of?

Back 74

it is composed of epithelial cells and the secretions of glands.

Front 75

What is the purpose of vernix caseosa?

Back 75

It protects the skin from the drying effects of amniotic fluid in utero

Front 76

How is the neonates physical maturity assessed?

Back 76

the birth attendant observes the infant's posture, tests flexibility and reflexes, and identifies specific physical characteristics to determine the newborn's physical maturity. If the scores are too low, the newborn is treated as premature.

Front 77

When stroked on the lip or cheek, the newborn reacts by turning the head toward the direction of the stimulus.

Back 77

Rooting reflex

Front 78

The newborn tightly grasps a finger or other object placed into his or her hand. this reflex disappears as the newborn grows older.

Back 78

palmar grasp reflex

Front 79

Sudden noises or jarring movements cause the newborn to throw out the arms and to draw up the legs

Back 79

Moro's or startle reflex

Front 80

When the newborn is lying ton the back and turns the head to one side, the leg and arm of that side extend, and those of the opposite side flex.

Back 80

Tonic neck reflex

Front 81

Hold the newborn's foot and stroke up the lateral edge and across the ball of the foot. The big toe fans out and hyperextends in a positive response.

Back 81

Babinski's reflex

Front 82

The newborn steps with one foot, and then the other, when held upright with the feet touching a surface.

Back 82

Stepping reflex

Front 83

As the newborn grasps the nipple with the lips, sucking should be automatic.

Back 83

Sucking reflex

Front 84

How often do you take v/s after birth?

Back 84

an hour or two immediately after birth and then every 4 hours for the first 24 hours.

Front 85

what is the normal hemoglobin in a newborn is _-

Back 85

15 to 18 g/100 ml blood

Front 86

what is the normal hematocrit for the newborn

Back 86

45% to 60%

Front 87

If the hemoglobin and hematocrit results are lower than the normal rate, what could it mean

Back 87

it may indicate anemia

Front 88

What is the newborns normal glucose

Back 88

40 to 45 mg/100ml

Front 89

_ is an inherited disorder caused by the body's inability to digest protein normally.

Back 89

PKU (phenylketonuria)

Front 90

_ a hereditary disease in which the newborn cannot digest galactose, a certain type of sugar.

Back 90

galactosemia

Front 91

What is the normal newborns blood pressure?

Back 91

50 to 80 mm Hg- diastolic/ 30 to 50 mm Hg- systolic

Front 92

excess secretions and dead skin cells that collect beneath the foreskin

Back 92

smegma

Front 93

when part or all of the foreskin is removed

Back 93

circumcision

Front 94

When the opening of the foreskin (prepuce) is very small, a condition know as

Back 94

phimosis

Front 95

prepuce

Back 95

foreskin

Front 96

What should be placed over a new circumcised baby's penis?

Back 96

a sterile dressing for the first 24 to 48 hours so the diaper doesn't stick

Front 97

How often should you check a newly circumcised penis?

Back 97

every 15 minutes for the first 4 hours for excess bleeding