Newborn Nursing 210 Exam 2

Front 1

Near term lung fluids shift to interstitial spaces. This continues through the labor process. Pulmonary resistance to blow flow is reduced. Surfactant works to keep alveoli expanded between respirations?

Back 1

Respiratory Adaptations

Front 2

A larger negative pressure is required during the first breath because?

Back 2

The alveoli are collapsed.

Front 3

Chemical chemoreceptors, in the corotids and the aorta, respond to normal birth hypoxis, the diaphragm is then stimulated by the medula to contract forcifully?

Back 3

How breathing is initiated in the newborn.

Front 4

Decreased blood oxygen (PO2) and pH and increased blood carbon dioxide (PCO2) levels?

Back 4

The chemical factors in the brain in regards to respiration initiation.

Front 5

Compression and release of the chest during birth?

Back 5

Mechanical factors of respiration initiation

Front 6

Change in temperature from the uterus to the colder air environment?

Back 6

Thermal factors in respiration initiation.

Front 7

Stimuli from handling sound, light, and pain?

Back 7

Sensory factors of respiration initiation.

Front 8

Reduces surface tension within the alveoli, and prevents collapse of alveoli with exhalation?

Back 8

Surfactant production

Front 9

Produced in adequate amounts by 34 to 36 weeks of gestation?

Back 9

Surfactant production

Front 10

Absorbed by the pulmonary, circulatory and lymphatic systems of the baby?

Back 10

Fetal lung fluid

Front 11

This is accelerated by labor and may be delayed by cesarean birth?

Back 11

Fluid absorption

Front 12

Closure of the ______ _______ causes blood to flow to the lungs for oxygenation?

Back 12

ductus arterius

Front 13

Closure of the ________ directs blood from the right atrium to the right ventricle?

Back 13

Forum Ovale

Front 14

Dilitation of the _____ allows blood flow into the lungs?

Back 14

Pulmonary vessels

Front 15

Closure of the ______ _______ causes blood to pass through the liver for filtration?

Back 15

ductus venous

Front 16

Functional at first and not permanent for weeks after birth. Can be reversed in the early days?

Back 16

Closure of cardiovascular structures

Front 17

Neonate Thermogenics

Exposure of wet surfaces to air and from insensible water losses from the skin and respiratory tract. Examples include amniotic on the skin at birth and bathing?

Back 17

Evaporation

Front 18

Neonate Thermogenics

Direct contact with objects cooler than the infants skin (cold hands, a scale). Heat can also be gained this way (a warm blanket and mothers skin).

Back 18

Conduction

Front 19

Heat transfers to air surrounding the infant (air conditioning, people moving and if put on oxygen)?

Back 19

Convextion

Front 20

Heat transfers to cooler objects that are not in direct contact with the infant (cold windows, outside walls, walls of incubators)?

Back 20

Radiation

Front 21

Increased motabolism with increased use of glucose and oxygen?

Back 21

Cold stress

Front 22

Decreased surfactant production?

Back 22

Cold Stress

Front 23

Can cause repiratory distress in the infant?

Back 23

Cold Stress

Front 24

Hypoglycemia, metabolic acidosis, jaundice, and vasoconstriction in the infant?

Back 24

Cold stress

Front 25

May lead to non-shivereing thermogenesis and the oxydation of brown fat to produce heat?

Back 25

The infant exposed to cold

Front 26

Begins before there is a change in the core or rectal temperature?

Back 26

Non-shivering thermogenesis
(oxydation of brown fat)

Front 27

Increases the need for oxygen and glucose in the infant?

Back 27

Non-shivering thermogenesis
(oxydation of brown fat)

Front 28

It produces fatty acids that interfere with bilirubin transport and increases risk for jaundice?

Back 28

Non-shivering thermogenesis
(oxydation of brown fat)

Front 29

An environment in which an infant maintains a stable body temperature without an increase in oxygen or metabolic rate?

Back 29

Neutral thermal environment

Front 30

32 degrees to 33.5 degrees Celsius or 89.6 degrees to 92.3 degrees farenheight?

Back 30

Neutral thermal environment for healthy, full-term newborn

Front 31

Newborn

Caused by overheating from poorly regulated heating equipment?

Back 31

Hypothermia

Front 32

Newborn

Increased metabolic rate and need for oxygen in the infant?

Back 32

Hypothermia

Front 33

Newborn

Vasodilation causes insensible fluid loses in the infant?

Back 33

Hypothermia

Front 34

Newborn

Normal breakdown of unneeded eurythrocytes may cause neurological?

Back 34

Jaundice

Front 35

Newborn

Polycythemia increases the risk of what, and may damage the brain or other organs from stasis?

Back 35

Jaundice

Front 36

Newborn

Does not necessarily indicate infection in the newborn?

Back 36

high leukocytes

Front 37

Newborn

Increased numbers of immature leukocytes or decreased platelets are signs of what in the newborn?

Back 37

Infection

Front 38

Newborn

Newborns cannot synthsize what that is necessary for normal clotting until flora are established?

Back 38

Vitamin K

Front 39

Newborn

These drugs interfere with clotting ability in the newborn if taken by the mother during pregnancy?

Back 39

Phenytoin, phenobarbital, aspirin

Front 40

Newborn

Capacity is about 6mL at birth but expands to about 90mL in the first week of life?

Back 40

The newborn stomach

Front 41

Newborn

Often occurs due to the relaxed cardiac sphincter in the newborn?

Back 41

regurgitation

Front 42

Newborn

Are established in the newborn within a few days of birth?

Back 42

Normal intestincal flora

Front 43

Newborn

A babies first stool, black, thick and sticky, tar-like. usually passed within twelve hours of birth, suspect obstruction if not passed within 48 hours?

Back 43

Meconium

Front 44

Newborn

After meconium stool(s), greenish brown and looser in consistency?

Back 44

Transitional

Front 45

Newborn

After transitional stool(s), characteristic of the type of feeding the infant receives?

Back 45

Milk stool

Front 46

Newborn

A blood glucose level below 40-45 in the term infant, is often used to indicate?

Back 46

Hypoglycemia

Front 47

Newborn

Cardiovascular adaptation in the infant is truly?

Back 47

Cardio-pulmonary adaptation

Front 48

Newborn

As pulmonary vascular resistance in the infant decreases?

Back 48

Pulmonary blood flow increases

Front 49

Newborn

For adequate oxygenation, the heart must deliver sufficient blood to?

Back 49

funtioning alveoli

Front 50

Newborn

Shunting of blood leads to unstable?

Back 50

oxygenation

Front 51

Newborn

A normal blood pressure is what, and should only be taken if a murmur is suspected?

Back 51

70/45

Front 52

Newborn

The infant has more what and what to facilitate oxygenation?

Back 52

RBCs and HGBs

Front 53

Newborn

Normal hematocrit is what?

Back 53

48-69%

Front 54

Newborn

Elevation does not mean infection, increase in immature ones my mean infection?

Back 54

leukocytes

Front 55

Newborn

Increased by 50% with delayed chord clamping?

Back 55

Blood volume

Front 56

Newborn

Decreased subcutaneous fat and thin epidermus, blood vessels close to the skin.

Back 56

Risks for ineffective thermoregulation

Front 57

Newborn

This posture helps maximize heat retention in the infant?

Back 57

Flexed

Front 58

Newborn

Do this only when temperature is stable?

Back 58

Bath

Front 59

Newborn

Increased metabolic rate, muscular activity, and non-shivering thermogenesis?

Back 59

The ways an infant makes heat

Front 60

Newborn

As red blood cells are destroyed, what is stored in the liver?

Back 60

Iron

Front 61

Newborn

If mom's iron is adequte, iron will be stored in the baby until about?

Back 61

5 months of age (then dietary iron is required)

Front 62

Newborn

Stored glucose is used rapidly at?

Back 62

Delivery

Front 63

Newborn

The main source of energy in the first few hours of life?

Back 63

Stored glucose

Front 64

Newborn

Normal neonatal glucose is?

Back 64

40-60mg per deciliter

Front 65

Newborn

Jitteryness, poor muscle tone, poor suck, tachypenia, respiratory distress, cyanosis, apnea, low temperature, high pitched cry, irritability or lethargy, seizures or coma, some infants may be asymptomatic, a blood sugar that is 40-45?

Back 65

Clinical signs of neonatal hypoglycemia

Front 66

Newborn

Prematurity, postmaturity, intrauterine growth restriciton, asphyxia, cold stress, LGA or SGA, maternal diabetes, maternal intact of turbutaline or ritrodine?

Back 66

Infants most at risk for hypoglycemia

Front 67

Newborn

A major function of the liver is to ________ bilirubin. Immature livers may not be able to complete this function and jaundice develops in 60% of term infants?

Back 67

conjugate

Front 68

Newborn

Normal bilirubin levels are?

Back 68

2-3mg per deciliter

Front 69

Newborn

Produced by hemolysis of RBCs?

Back 69

Bilirubin

Front 70

Newborn

Bilirubin is _________ and must be excreted?

Back 70

toxic

Front 71

Newborn

Bilirubin is released in the _________ form.

Back 71

unconjugated or indirect

Front 72

Newborn

Bilirubin is not soluble in water before excretion, it must be converted to being water soluble. This process is called?

Back 72

Conjugation or direct bilirubin

Front 73

Newborn

Conjugated bilirubin is fat soluble and may be stored in the subcutaneous tissues, causing?

Back 73

Yellow skin

Front 74

Newborn

Hemolysis of excessive RBCs
Short RBC life
Liver imaturity
Lack of intestinal flora
Delayed feeding
Trauma or bruising
Fatty acids from cold stress or asphyxia?

Back 74

Factors increasing Hyperbilirubinemia

Front 75

Newborn

Normal and transient on days 2 to 3, visible when bilirubin reaches 5-7mg/dL, phototherapy for elevations of 15-18mg/dL, Kernicterus can occur with high levels?

Back 75

Physiological Jaundice

Front 76

Is always abnormal and requires further investigation
First 24 hours
Excessive destruction of RBCs
Incompatibility with mothers blood
infection
metabolic disorders?

Back 76

Pathological Jaundice

Front 77

Newborn

Suggested at 15-18mg/dL, helps eliminate bilirubin from the skin, must protect the infants eyes, provide for warmth and hydration, mom must be educated?

Back 77

Phototherapy for Jaundice

Front 78

Newborn

Cardiac sphincter is immature and causes frequent?

Back 78

regurgitation

Front 79

Newborn

Intestinal tract is?

Back 79

Sterile

Front 80

Newborn

A byproduct of swallowed amniotic fluid and epithelial cells, greenish-black in color and tar-like?

Back 80

Meconium

Front 81

Newborn

Kidneys are fully developed by______ and function fully after birth with increased blood flow?

Back 81

35 weeks

Front 82

Newborn

Newborns have decreased GFR and _________ ability?

Back 82

filtering

Front 83

Newborn

Newborns should void in 24 hours, 2-6 times per day or ____________.

Back 83

1-3cc kg/hr

Front 84

Newborn

Newborn urine is dilute, SpGv equals?

Back 84

1001-1005

Front 85

Newborn

An infant needs _______/kg/day for the first few days?

Back 85

65mL

Front 86

Newborn

This is immature and their is little inflammatory response in the newborn?

Back 86

Hypothalamus

Front 87

Newborn

Leukocyte response is blank in the newborn?

Back 87

Delayed

Front 88

Newborn

Infants receive antibodies from the mother in the _____ trimester and from breast milk?

Back 88

3rd

Front 89

Newborn

This helps protect the infant from disase IgA, IgGm, IgM?

Back 89

Immunoglobulins

Front 90

Newborn

IgA does not cross the _______.

Back 90

placenta

Front 91

Newborn

Infant must produce, is not adequate until 6-12 weeks?

Back 91

IgA

Front 92

Newborn

Protects GI and Respiratory Tracts?

Back 92

IgA

Front 93

Newborn

Is included in breast milk?

Back 93

Immunoglobulins
IgA, IgGm, IgM

Front 94

Newborn

This crosses the placenta and provides passive immunity to bacteria and viruses?

Back 94

IgG

Front 95

Newborn

Fetus produces IgG at ____ weeks in limited amounts and is not reproduce until ___ - ___ weeks of age?

Back 95

20, 3-4

Front 96

Newborn

This protects against gram negative bacteria's?

Back 96

IgM

Front 97

Newborn

Protects agains gram negative bacterias, produced rapidly after birth, does not cross the placenta, if elevated in the newborn, suggests intra-uterine exposure to bacteria?

Back 97

IgM

Front 98

Newborn

Immature nervous system and uncordinated activity when moving?

Back 98

Normal Neurological adaptation

Front 99

Newborn

Able to fix on faces, positive blink reflex, loud, lusty cry?

Back 99

Normal Neurological adaptation

Front 100

Newborn

Good muscle tone with resistance to extension, Moro, babinsky, rooting, sucking, tonic neck, step, grasping, reflexes?

Back 100

Normal Neurological adaptation

Front 101

Newborn

Trunk incurvature?

Back 101

Nomal Neurological adaptation

Front 102

Newborn

Infants are active, alert and are often interested in breastfeeding?

Back 102

First period of reactivity

Front 103

Newborn

Respirations are as high as 80 breaths a minute, there may be crackles, retractions, nasal flaring and increased mucus secretion?

Back 103

First period of reactivity

Front 104

Newborn

The heart rate may be as high as 180 beats per minutes, after 30 minutes to 2 hours, the infant becomes sleepy?

Back 104

First period of reactivity

Front 105

Newborn

This period lasts about 2 to 4 hours, the pulse and respirations are normal, the temperature may be low?

Back 105

Sleep period

Front 106

Newborn

This period lasts up to several hours, infants are alert, interested in feeding and may pass meconium, they may have increased pulse, respirations, cyanosis, or apnea, they may gag and have increased mucus secretions?

Back 106

Second period of reactivity

Front 107

Newborn

Deep sleep without eye movements, quiet, regular respirations, little or no response to noise?

Back 107

Quiet sleep state

Front 108

Newborn

Movement, startles from disturbances, brief fussing, rapid irregular RR, rem, may return to sleep or awaken?

Back 108

Active sleep state

Front 109

Newborn

Eyes are closed or glazed and unfocused, startling, slow movement, may progress to sleep or awake states?

Back 109

Drowsy state

Front 110

Newborn

Intense gazing at objects or people, excellent time for bonding?

Back 110

Quiet alert state

Front 111

Newborn

Fussy, restless, seems aware of discomfort, respirations are faster and irregular?

Back 111

Active alert state

Front 112

Newborn

Continuous lust crying?

Back 112

Crying State

Front 113

Newborn

Ability to respond and process to tactile and auditory stimulation, i.e. can ignore repetition?

Back 113

Habituation

Front 114

Newborn

Ability to be alert and fixate on complex visual stimuli, i.e. fixates on moms voice and face?

Back 114

Orientation

Front 115

Newborn

Self consolation, hand to mouth, sucking on hand or tongue, covering face?

Back 115

Self quieting ability

Front 116

Newborn

Physical Assessment
Airway
Vital Signs
Temperature
Routine meds
Feeding and hydration
Skin integrity
Bonding and safety?

Back 116

Newborn care

Front 117

Newborn

Usually a cultural consideration, not recommeded by the AAP, pain management advised, should not be done if preterm, has bleeding disorders or GU defects?

Back 117

The surgical removal prepuce or circumcision

Front 118

Newborn

Triple dye or alcohol with each diaper change, observe for drainage and odor, clamp is removed within 24 to 48 hours, the cord stump has no nerve endings and will fall off within 7 to 10 days?

Back 118

Cord care

Front 119

Newborn

After Circ. use what to prevent diaper adherence?

Back 119

Vaseline, gauze

Front 120

Newborn

After a circ. the nurse must be aware of the pt's first what?

Back 120

Void

Front 121

Newborn

To help with the discomfort of a circ. use?

Back 121

Tylenol

Front 122

Newborn

Normal healing of a circ. looks like?

Back 122

An infection

Front 123

Newborn

A small plastic ring, no vaseline, ring falls off after a few days, infants must void within 12 hours?

Back 123

Plastibel circ.