ch 7 health promotion of newborn and family

Question 1

respiratory changes in the newborn

Answer 1

-fetal lung fluid removal
-compression of chest through birth canal
-lymphatic vessels and capillaries

Question 2

cardiac changes in the newborn

Answer 2

-closure of fetal shunts (foramen ovale, ductus venosus and arteriosus)
-decreased pulmonary vascular resistance

Question 3

factors that predispose the newborn to excessive heat loss

Answer 3

-large surface area results in heat loss to environment (evaporation, radiation, conduction)
-thin layer subq fat
-can’t shiver
-brown fat metabolism used for thermogenesis

Question 4

when should meconium stool be passed in newborn

Answer 4

24-48 hrs after birth (black and tarry appearance)

Question 5

when do transitional stools occur in the newborn? when do milk stools occur in the newborn?

Answer 5

-transitional: day 3 of life (colostrum)
-milk: day 4 of life

Question 6

factors that could contribute to low apgar score

Answer 6

-low tone
-reduced reflex irritability
-infection
-congenital anomalies
-maternal sedation/analgesia (+drugs)
-hypovolemia
-neuromuscular disorders

Question 7

what might a weak/groaning/grunting cry at birth indicate

Answer 7

resp disturbance

Question 8

what might a absent/weak/constant cry at birth indicate

Answer 8

pathology anomaly

Question 9

what might a high pitched shrill cry at birth indicate

Answer 9

intracranial pressure
neurological issue

Question 10

what is the NPI

Answer 10

neonatal perception inventory
mom’s perception of her baby compared with image of “average” baby

Question 11

how many weeks is a term baby?
post-term?
preterm?

Answer 11

term: 36-42 wks
preterm: <36 wks
term: 42+ wks

Question 12

when does the posterior fontanel close in a newborn?
anterior fontanel?

Answer 12

posterior: by 2 months
anterior: by 18 months

Question 13

what is the red reflex

Answer 13

-direct visualization of retina to evaluate for congenital cataract

Question 14

when should strabismus (eyes wander in and out) resolve by in newborn

Answer 14

4-6 months

Question 15

potential problem from drainage of newborn’s eyes

Answer 15

infection (gonorrhea/syphilis)
can lead to blindness

Question 16

normal findings in lungs of newborn

Answer 16

-30-60 breaths/min
-episodes of apnea up to 20 secs

Question 17

how long can you access the veins/arteries in the umbilical cord in a newborn

Answer 17

almost 2 weeks

Question 18

possible abnormalities in the back of a newborn

Answer 18

-sacral tuft: spina bifida
-pilonidal cyst/sinus
-tethered spinal cord

Question 19

when are eyedrops and vitamin k (and hep b vaccine) given to newborn after birth

Answer 19

within 2 hrs

Question 20

why can you not microwave breastmilk

Answer 20

destroys anti-infective properties
negates vitamin C

Question 21

when can infant have cows milk

Answer 21

after 1 year old

Question 22

what 3 factors cause a newborn to be more prone to dehydration, acidosis and overhydration

Answer 22

-high rate metabolism
-more acid is formed (leading to acidemia)
-immature kidneys (can’t concentrate urine to conserve body water)

Question 23

APGAR score (what indicates a 2 in each category)

Answer 23

-Heart rate: 100+ bpm
-resp effort: good strong cry
-muscle tone: well flexed
-reflex irritability: cry, sneeze
-color: completely pink

Question 24

how is thermogenesis achieved in the newborn

Answer 24

brown fat metabolism