Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
88 Cards in this Set
- Front
- Back
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.
|