18-Nursing Management Of the Newborn Flashcards Preview

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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 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


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



What Apgar score signifies severe distress in adjusting to extrauterine life



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


Normal newborn respiratory rate

30 to 60 breaths/minute with systemic chest movement


How long are respiratory and heart rates assessed

Every 30 minutes until stable for 2 hours after birth, then once stable every 8 hours


When is axillary temperature typically assessed?

Not immediately after birth but upon arrival to the nursery or in LDR room when initial,newborn assessment is carried out


Normal axillary temperature range

97.7* F - 99.5* F


Why are rectal temperatures no longer taken

Because of the risk of perforation


How often should you assess temperature

Every 30 minutes until it has been stable for 2 hours then every 8 hours until discharge