18-Nursing Management Of the Newborn Flashcards
(78 cards)
What are some assessment findings during the initial newborn assessment that can indicate a problem
Nasal flaring, chest retractions, grunting on exhalation, labored breathing, generalized cyanosis, abnormal breath sounds, abnormal respiratory rates, flaccid body temperature, abnormal heart rates, abnormal newborn size
When are the assessments of a newborn done?
Initial assessment completed in birthing area to see if newborn can stay with parents. A second assessment is done within the first 2-4 hours when the newborn is admitted to the nursery or LDR where the parents are
What is the Apgar score
Used to evaluate a newborns physical condition at 1 minute and 5 minutes after birth
When would you do an additional Apgar assessment
If the 5 minute score is less than 7 you then do one at 10 minutes
What does the Apgar assessment at 1 minute provide
Data about the newborns initial adaption to extrauterine life
What does the Apgar assessment at 5 minutes provide
A clearer indication of the newborns overall central nervous system status
What are the five parameters assessed with Apgar scoring
A= appearance (color) P= pulse (heart rate) G= grimace (reflex irritability) A= activity (muscle tone) R= respiratory (respiratory effort)
Each Apgar parameter is assigned a score ranging from ___ to ____
0 to 2
What does a score of 0 indicate
Absent or poor response
What is the Apgar score where no interventions are needed besides maintaining normal respiratory efforts and thermoregulation
8 or higher
Apgar score that indicates moderate difficulty
4-7
What Apgar score signifies severe distress in adjusting to extrauterine life
0-3
What are some things that influence the Apgar score
Infection, congenital anomalies, physiologic immaturity, maternal sedation via medications, labor management, and neuromuscular disorders
What is the predictable manner of characteristics disappearing when a newborn is experiencing physiologic depression
First pink coloration is lost, next respiratory effort, and then the tone, followed by reflex irritability and finally heart rate
How is length of a newborn measured
Head of newborn to the heel with the newborn unclothed
What position should newborn be in when measuring length
Supine position and extend the leg completely when measuring the length
What is expected length range of a full term newborn
44-55 cm ( 17-22 inches)
How is the weight of newborns usually read? What is a typical newborn weight?
Using a digital scale that reads weight in grams
2,500-4,000 g ( 5 pounds, 8 ounces to 8 pounds, 14 ounces)
Newborns typically lose ____% or their initial birth weight by ____ to ____ days of age
10% by 3-4 days of age
What are some of the causes of newborns weight loss
Loss of meconium, extracellular fluid, and limited food intake
When is the newborn weight loss usually regained by ?
By the 10th day of life
Low birth weight=
Very low birth weight=
Extremely low birth weight=
Low birth weight=< 1,000 g (<2.5 lb)
How do you take a heart rate on a newborn? What is a typical heart rate?
Apical pulse for 1 full minute
120-160 bpm
When are newborns respirations assessed? How do you assess them?
When they are quiet or sleeping. Place a stethoscope on the right side of the chest and count the breaths for 1 full minute to identify any irregularities
