Chapter 23

Question 1

What is the first stage of the transition period and how long does it last?

Answer 1

First Period of Reactivity. Lasts up to 30 minutes after birth.

Question 2

How long does the period of decreased responsiveness last?

Answer 2

60-100 minutes.

Question 3

The second period of reactivity

Answer 3

occurs between 2-8 hours after birth and lasts from 10 minutes to several hours.

Question 4

Clamping the umbilical cord causes a rise in ___ which increases what?

Answer 4

BP. Circulation and Lung perfusion.

Question 5

The alveoli of the term infant’s lungs are lined with __________, a protein manufactured in type II lung cells.

Answer 5

surfactant

Question 6

What happens with decreased or absent surfactant?

Answer 6

more pressure must be generated for inspiration, which can quickly tire a preterm or sick term infant.

Question 7

Normal breath sounds for the first few hours?

Answer 7

should be clear and equal bilaterally but fine rales are not unusual

Question 8

What is a normal respiratory rate for baby?

Answer 8

30-60. Anything below 30 or above 60 needs to be evaluated.

Question 9

What is Acrocyanosis?

Answer 9

the bluish discoloration of hands and feet. this is a normal finding in the first 24 hours after birth.

Question 10

When does TTNB usually resolve?

Answer 10

within 24-48 hours.

Question 11

What is the normal heart rate for a term newborn?

Answer 11

110-160

Question 12

Where can you palpate the heart rate immediately after birth?

Answer 12

at the base of the umbilical cord

Question 13

Where is the apical pulse on the newborn located?

Answer 13

at the fourth intercostal space and to the left of the midclavicular line

Question 14

Sinus Dysrhythmia

Answer 14

Is common in the newborn

Question 15

What is the average systolic and diastolic BP for the term newborn?

Answer 15

Systolic: 60-80
Diastolic: 40-50

Question 16

The MAP should be equivalent to the what?

Answer 16

weeks of gestation

Question 17

blood volume in the newborn averages

Answer 17

85 ml/kg

Question 18

What are benefits of delayed cord clamping?

Answer 18

improves hematocrit and iron status and decreases anemia, reduces the risk of intraventricular hemmorhage; benefits can last up to 6 months.

Question 19

what is thermoregulation?

Answer 19

the maintenance of balance between heat loss and heat production.

Question 20

heat loss in the newborn occurs by what four modes?

Answer 20

1. convection
2. radiation
3. evaporation
4. conduction

Question 21

Convection

Answer 21

the flow of heat from the body surface to cooler ambient air

Question 22

Radiation

Answer 22

the loss of heat from the body surface to a cooler solid surface not in direct contact but in relative proximity. (crib to window)

Question 23

Evaporation

Answer 23

the loss of heat that occurs when a liquid is converted to vapor

Question 24

Conduction

Answer 24

the loss of heat from the body surface to cooler surfaces in direct contact

Question 25

what is thermogenesis?

Answer 25

in response to cold the neonate attempts to generate heat by increasing muscle activity

Question 26

Brown Fat

Answer 26

newborns metabolize brown fat to produce heat; this is rapidly depleted by cold stress.

Question 27

a stool that is very soft with a high water content with a distinct water ring around the stool on the diaper can be indicative of what?

Answer 27

the infant is allergic to or unable to digest a formula

Question 28

Within the first week the newborns blood glucose level should be approximately what?

Answer 28

60-80 mg/dl

Question 29

When does physiologic jaundice appear in the newborn?

Answer 29

after 24 hours of age

Question 30

when does pathologic jaundice appear in the newborn?

Answer 30

within 24 hours of birth.

Question 31

define kernicterus

Answer 31

refers to the irreversible long term consequences of bilirubin toxicity such as hypotonia, delayed motor skills, hearing loss, cerebral palsy, and gaze abnormalities.

Question 32

breastfeeding associated jaundice begins when?

Answer 32

at 2-5 days old

Question 33

breast milk jaundice appears when?

Answer 33

5-10 days old

Question 34

what is the greatest risk factor for neonatal infection?

Answer 34

prematurity

Question 35

what is the cheeselike whitish substance found on the epidermis after 35 weeks gestation?

Answer 35

vernix caseosa

Question 36

what are Mongolian spots?

Answer 36

bluish black areas of pigmentation that can appear over any part of the body.

Question 37

Nevus simplex

Answer 37

stork bites

Question 38

petechiae can be normal if it disappears within 48 hours but if not....

Answer 38

should be report to the pcp as this can indicate underlying problems

Question 39

what is hydrocele?

Answer 39

accumulation of fluid around the testes

Question 40

what is caput succedaneum?

Answer 40

generalized edematous area of the scalp found on the occiput. Usually disappears within 3-4 days.

Question 41

what is cephalhematoma?

Answer 41

a collection of blood between a skull bone and it's periosteum. Usually resolves in 2-8 weeks.

Question 42

what is subgaleal hemorrhage?

Answer 42

bleeding into the subgaleal compartment.

Question 43

What are signs of developmental dysplasia of the hips?

Answer 43

asymmetric gluteal and thigh skinfolds, uneven knee levels, a positive Ortolani test, and a positive Barlow test.

Question 44

Moro Reflex

Answer 44

allowing head to fall backward with support or performing a sharp hand clap; infant should extend arms and fingers out like they're startled

Question 45

Babinski Reflex

Answer 45

stroking the heel of the foot up and across the ball of the foot; infant should hyperextend toes.

Question 46

newborns can see objects as far away as __ cm but their clearest visual distance is __ to __ cm away.

Answer 46

50. 17-20

Question 47

by the _____ day of life babies can recognize their mother's smell.

Answer 47

fifth

Question 48

what can a high pitched cry be a sign of?

Answer 48

a neurological disorder

Question 49

what is habituation?

Answer 49

a protective mechanism that allows the infant to become accustomed to environmental stimuli.