OB TEST 2 CHAPTER 24

Question 1

WHEN DOES CARE FOR A NEWBORN BEGIN?

Answer 1

• Care begins immediately after birth and focuses on assessing and stabilizing the newborn’s condition

Question 2

o Initial assessment and Apgar scoring

Answer 2

 Performed immediately after birth using the apgar score and a brief physical examination

Question 3

 Apgar scoreS ARE TAKEN

Answer 3

1 minute and 5 minutes after birth

Question 4

 Apgar scores

Answer 4

• Scores of 0-3 indicate severe stress…..4-6 indicate moderate difficulty…..7-10 indicate minimal or no difficulty
• 1. Heart rate
• 2. Respiratory rate
• 3. Muscle tone
• 4. Reflex irritability
• 5. Generalized skin color

Question 5

• Classification of Newborns by Gestational Age and Birth weight

Answer 5

o AGA: presumed to have grown at a normal rate regardless of the length of gestation.
o LGA: can be presumed to have grown at an accelerated rate during fetal life
o SGA: grown at a restricted rate during intrauterine life
o Preterm: before completetion of 37 weeks
o Late preterm: between 34 and 36
o Postterm: after week 42
o Postmature: after week 42 showing the effects of progressive placental insufficiency

Question 6

• Airway maintainence

Answer 6

o Most secretions are moved by gravity and brought by the cough reflex to the oropharynx to be drained or swallowed

Question 7

o Suctioning with a bulb syringe

Answer 7

 Keep in crib
 Mouth suctioned first
 Bulb is compressed and inserted into one side of mouth
 Nasal suctioned one side at a time
 When cry does not sound bubbly suction can be stopped

Question 8

o Suctioning with a nasopharyngeal catheter with mechanical suction apparatus

Answer 8

 Adjust pressure to less than 80mmHg
 Lubricate catheter in sterile water and insert either orally along the base of the tongue or up and back into the nares
 Create suction as the catheter is rotated and gently withdrawn
 Repeat until cry sounds clear and air entry into lungs is heard by stethoscope

Question 9

• Maintain adequate oxygen supple

Answer 9

o Clear airway
o Effective establishment of respirations
o Adequate circulation, perfusion and cardiac function
o Adequate thermoregulation

Question 10

• Maintaining body temp

o Ways to stabilize babys body temp include

Answer 10

 Placing infant directly on the mothers chest and covering with warm blanket
 Drying and wrapping the newborn in warmed blankets immediately after birth
 Keeping the head well covered
 Keeping ambient temperature of the nursery or mothers room at 22-26 degrees

Question 11

• Eye prophylaxis

Answer 11

o Mandatory in the US
o Precautionary measure against ophthalmia neonatorum, which is an inflammation of the eyes resulting from gonorrheal or chlamydial infection contracted by the newborn during passage through the mothers birth canal
o Forms used are erythromycin, tetracycline and silver nitrate

Question 12

• Vitamin K prophylaxis

Answer 12

o Single IM of 0.5-1mg of vitamin K is given soon after birth to prevent hemorrhagic disease of the newborn

Question 13

• Umbilical cord care

Answer 13

o Asses stump and base of cord for edema, redness, and purulent drainage with each diaper change.
o Average cord separation time is 10-14 days. Dry blood may be seen

Question 14

o Average cord separation time is

Answer 14

10-14 days. Dry blood may be seen

Question 15

• Care management from 2 hours after birth till discharge

Answer 15

o Many of the procedures such as assessment of weight and measurement of head circumference and length, instillation of eye medication, administration of vitamin k and physical assessment, are carried out in the labor and birth unit