Maternity Module 7

Front 1

ABCs immediately at birth

Back 1

airway, breathing, circulation

are airways clear, what is their color, muscle tone, respiratory distress, rapid heat loss because they are wet.

put skin to skin to warm baby up if stable.

want them to be pink, crying well, breathing well, good tone

Front 2

second assessment

Back 2

admission assessment- more indepth

head to toe physical exam. healthcare practitioner preforms full physical examination. nurses do another within first 2 hours of life (general measurements, weight, length, head circumference, chest circumference, abdominal girth) (compared against norms to see if development is going alright). gestational age assessment, attachment/ bonding assessed.

Front 3

regular weight, head circumference, chest circumference, length

Back 3

weight 2500-4000g, 7lb8oz

head 33-35 cm

chest 2 cm less than head

length- 15-22 inches

expected to loose a little weight within the first week of life because of water weight, regain it within 14 days after delivery

if head circumference is smaller than chest, this is concerning

Front 4

ballard tool

Back 4

Done within first 4 hours

-passively observing infant first before doing things that will affect the newborn

each finding given a point value

maternal conditions may affect certain components

stress can accelerate fetal maturity, but slower fetal growth. Diabetes does the opposite.

Front 5

physical maturity characteristics

Back 5

skin (peeling, transparent), lanugo (presence or absence)(presents around 24-25 weeks on shoulders and back)(more common in diabetic mothers in pinna and upper back), sole (plantar) creases (form at top and progress to sole with maturity) (premature has smooth sole, post mature have creases all over), areola and breast bud tissue (presence and size, premature will not have big, post will have well developed), eye/ ear formation (premature may have fuse eyelids, postmature has thick cartilage in ears that are stiff, premature won't have thick cartilage and can fold ear over and it will stay there), genitalia (surface should be covered by rugae, testes should have descended)(premature will have prominent clitorus and flat labia, post mature will have labia that covers clitoris)

Front 6

neuromuscular ballard tool

Back 6

posture (supine position) flaccid is 0 points, 4 points is completely flexed (hypertonic), what does the baby do passively, square window (measures wrist angle to see how far forward infant hand can go (preterm is little flexibility)), arm recoil (flexing arm up against chest, actively extend to straight position and then let go), popliteal angle (degree of knee flexion, premature can make a completely straight leg, little flexibility later on), scarf sign (extending infants arm across the body and measuring how far across the elbow falls), heel to ear (bringing heel to ear (no resistance is bad)

Front 7

order of taking vitals in new born

Back 7

don't want to take temperature first because baby will cry which will elevate other vitals

can use stethoscope to see breathing, or can watch respirations, apical pulse, temperature (axillary), blood pressure (if needed)

Front 8

normal vital signs new born

Back 8

pulse (110-160)

respirations (30-60)

blood pressure 70-50/45-30

temperature (axillary) (36.5-37.2 c) (97.7-99f)

Front 9

molding, cephalohematoma, caput succedaneum

Back 9

molding (vertex position in vaginal delivery, occurs from pressure of descending part against cervix. flattened forehead which rises to point in posterior of skull (conehead)), cephalohematoma (goose egg looking)(doesn't cross suture line, collection of blood from broken blood vessels that builds under the scalp,) caput succedaneum (at presenting part of head, cap, crosses suture line, swelling under the skin of the scalp fluid filled)

all from trauma during vaginal birth

Front 10

barlow and ortolani maneuver

Back 10

tests hip dislocation after breach position

put downward pressure on hip and feel if there is a dislocation (barlow)

ortolani is when you abduct the thigh back to regular position

Front 11

blood from vagina in females

Back 11

pseudomenstruation is possible as is uric acid crystals (pinkish blood) which is relatively normal

but can indicate that the baby is dry

Front 12

hypospadias

Back 12

meadis in males is on ventral surface of penis

Front 13

phimosis

Back 13

normal in uncircumcized infant. foreskin is unable to be retracted.

Front 14

hydrocele

Back 14

edema of genital area. fluid in testes.

Front 15

cryptorchidism

Back 15

undiscended testicle

Front 16

acrocyanosis

Back 16

cyanosis of hands and feet. normal finding up to 24 hours. poor peripheral stimulation

Front 17

mottling

Back 17

lacey pattern of blood vessels under skin

circulation fluctuations

chilly or prolonged apnea, hypothyroidism, sepsis

Front 18

jaundice

Back 18

yellowish discoloration, detected first on face, head to toe.

Front 19

erythema toxicum

Back 19

newborn rash, eruption of lesions around hair follicle, looks like acne, appear suddenly

no treatment required, reassure parents that it is normal

Front 20

facial milia

Back 20

exposed sedacious glands, raised white spots

appears as eppstien pearls in mouth

Front 21

vernix caseosa

Back 21

cheese like substance that covers newborn in utero.

reabsorbed so if they are post term, their skin might be peeling a little

Front 22

telangiectatic nevi

Back 22

stork bites, pale pink or red spots on eyelids, nose, nape of neck, common in babies with light complexions.

fade by second birthday

Front 23

mongolian spots

Back 23

dark colored spots in newborns, gray blue, black, dorsal area, asian, hispanic, african descent.

fade gradually

can be mistaken for bruises

Front 24

nevus flammeus

Back 24

port wine stain, cappillary angeoma below eppidermus, not elevated, dense capillaries, does not blanch or fade

Front 25

moro

Back 25

startle reflex, c with index finger and thumb- appears after 32 weeks gestation, disappears by six months of age

Front 26

rooting

Back 26

turn towards cheek that is being stroked, disappears around 3 weeks

Front 27

babinski

Back 27

stroke from heel to toe, responds by incurve toe, uncurl it and stretch it out.

Front 28

trunk incurvation

Back 28

gallant reflex, new born in prone position, stroke one side of vertebral column, swing buttocks toward side being stroked

Front 29

craniosynostosis

Back 29

premature closure of cranial sutures

needs to be corrected surgically

Front 30

plagiocephaly

Back 30

infants rapidly growing head attempts to expand and meets some type of resistance such as a flat surface of a crib mattress

pressure from bed causes asymmetry

molding helmets

Front 31

choanal atresia

Back 31

when they aren't breathing from both sides of nose

obligatory nose breathers

Front 32

transient stabismus

Back 32

temporarily cross eyed

Front 33

epstein pearls

Back 33

keratin containing cysts

Front 34

tongue tied baby

Back 34

short frenulum

hard to breath

Front 35

states of alertness in newborns

Back 35

deep sleep, light sleep, drowsiness, quiet alert, active alert, crying

form a continuum

best time to feed is not in crying, but in quiet alert state

Front 36

what is considered hypothermia in a newborn

Back 36

97.7 (36.5 c)