Class 9 newborn uncomplicated

Question 1

What are the 3 priority assessments for newborn?

Answer 1

1. Are they TERM
2. Are they CRYING
3. Do they have good TONE

Question 2

What are the 2 most important thing we are checking when assessing the head?

Answer 2

1.symmetrical
2.fontanels soft and level

Question 3

Respiratory distress

Answer 3

Nasal flaring, intercostal or substernal retractions, stridor, grunting, gasping, apnea lasting 20 seconds or longer

Question 4

What are the three most important things to watch from birth to the first 2 hours of life?

Answer 4

1. respirations
2. regulat temperature
3. eliminate waste

Question 5

What connects the umbilical vein to the inferior vena cava?

Answer 5

ductus venosus

Question 6

what shunts blood from the pulmonary artery to the descending aorta ?

Answer 6

ductus arteriosus

Question 7

how long do we wait to do cord clamping?

Answer 7

30 sec to 1 min

Question 8

how do babies tend to breathe mouth or nose?

Answer 8

nose breathe

Question 9

do we suction all babies?

Answer 9

no, we only suction if indicated

Question 10

what is meconium aspiration syndrome?

Answer 10

resp distress in newborns
d/t meconium-stained amniotic fluid
- symptoms can’t otherwise be explained

Question 11

What are the interventions for a baby with meconium aspiration syndrome?

Answer 11

1. EFM
2. Neonatal team at delivery: suction, intubate

Question 12

What do we NEVER do with mecoinum aspiration syndrome baby?

Answer 12

DO NOT RUB BABY

Question 13

What is the O2 % goal for each min from 1-5min and then 10 min at delivery?

Answer 13

1 min= 60-65%
2 min- 65-70
3 min = 70-75%
4 min = 75%-80%
5 min = 80-85%
10 min = 85-95%

Question 14

what HR do we start positive pressure ventilation?

Answer 14

<100 BPM

Question 15

at what HR do we start CPR?

Answer 15

<60 BPM

Question 16

What does pH help us know ?

Answer 16

1. the wellbeing of the baby
2. Rh - birthers

Question 17

what is the normal pH value for arterial blood?

Answer 17

7.2-7.34

Question 18

What is normal pH for venous blood?

Answer 18

7.28-7.4

Question 19

How do we help baby with their thermoregulation?

Answer 19

1. skin to skin
2. put hat on baby or replace if wet
3. warm blankets
4. check BG if they are still cold

Question 20

What 3 things does neutral thermal environment help?

Answer 20

1. minimizes oxygen and glucose consumption
2. prevents hypothermia
3. prevents hyperthermia

Question 21

What can flexion be a sign of?

Answer 21

babies attempt to get thermogenesis - newborns trying to generate heat by increasing muscle activity

Question 22

If we suspect cold stress, what two things do we check?

Answer 22

blood gas
blood glucose

Question 23

what can cold stress lead to?

Answer 23

metabolic acidosis
respiratory acidosis
hypoglycemia

Question 24

What can cause hypoglycemia in babies?

Answer 24

• diabetic/gestational diabetic birther
• cold stress

Question 25

What are the 4 aspects of heat loss prevention?

Answer 25

Convection- temp 24C radiation- no drafts - use radiant warmer if skin to skin not working evaporation - dry baby off conduction - skin to skin!

Question 25

Why does cold cause metabolic acidosis?

Answer 25

baby burns more energy uses glucose less oxygen available so lactic acid builds pH goes lower

Question 26

What is the first intervention with a cold baby?

Answer 26

skin to skin contact

Question 27

What is the rapid assessment of the newborn?

Answer 27

APGAR score A- appearance (skin colour) P- Pulse (heart rate). we want >100 G- grimace (reflex irritability ) A- activity (muscle tone) no floppy babies R- Respirations (resp rate) crying and auscultate RR

Question 28

When do we do APGAR?

Answer 28

min 1 min 5

Question 29

What is severe distress for APGAR score?

Answer 29

0-3

Question 30

What is moderate difficulty for APGAR score?

Answer 30

4-6

Question 31

What is normal transition, little difficulty for APGAR?

Answer 31

7-10

Question 32

If the score is <7 when do we repeat APGAR?

Answer 32

10 min 20 min

Question 33

What is a normal temp for baby?

Answer 33

37 (36.5-37.5)

Question 34

What is a normal HR for baby?

Answer 34

110-160 BPM (80-100 when sleeping) (180 BPM if crying)

Question 35

What is normal RR in baby?

Answer 35

30-60 breaths per min apnea <20 sec is normal

Question 36

what's the last vital we should check on baby and why?

Answer 36

temp cuz it stresses them out

Question 37

Do we assess BP in newborns?

Answer 37

NO- not routinely

Question 38

if birther is GBS pos. how often do we check temps?

Answer 38

q 4 hrs q 8 hours until discharge home unless worried about infection, etc

Question 39

What is the priority assessment with newborn?

Answer 39

1. observe 2. auscultate 3. temp & reflexes 4. head circumference

Question 40

How do we help prevent newborn infections?

Answer 40

hand hygiene do not visit if sick

Question 41

What is the Ballard scale used for?

Answer 41

gestational age

Question 42

where do we measure baby?

Answer 42

top of the head to heel

Question 43

where do we measure head circumference ?

Answer 43

above the ears occipitolfrontal circumference

Question 44

what is acrocyanosis?

Answer 44

extremeties are blue. this can be normal. we want centrally pink/healthy 7-10 days

Question 45

what is vernix?

Answer 45

white all over baby. more with preemies

Question 46

what is Lanugo hair?

Answer 46

fine hair over body

Question 47

what hair placement is not normal?

Answer 47

lower tailbone hair could be NTD

Question 48

What skin things are normal?

Answer 48

-cracking/peeling of hands & feet - mottling to extremities - congenital dermal melanocytosis - telangiectatic nevi (stork bite) - erythema toxicum (newborn rash) - petechiae - sweat glands - white little pimples

Question 49

What 4 skin issues are NOT normal?

Answer 49

1. bruising 2. Jaundice within first 24 hours 3. central cyanosis 4. pallor

Question 50

what do we want the fontanals to be like?

Answer 50

1. symmetrical 2. soft and level

Question 51

what shape is the anterior fontanel?

Answer 51

diamond shape 5 cm

Question 52

what shape is posterior fontanel?

Answer 52

triangular 3 cm

Question 53

What is moulding?

Answer 53

cone head

Question 54

What is cephalohematoma?

Answer 54

Collection of blood between skull & bone, and its periosteum

Question 55

What is the relationship with cephalohematoma and suture lines?

Answer 55

does not cross suture lines

Question 56

What are the signs of cephalohematoma?

Answer 56

Does not cross suture lines Does not pulsate/bulge when baby cries Appears several hrs/day after birth Largest on 2nd or 3rd day Fullness resolves in 3-6 weeks

Question 57

What is subgaleal hemorrhage?

Answer 57

Bleeding into the subgaleal compartment

Question 58

What is the relationship with subgaleal hemorrhage and suture lines?

Answer 58

Crosses suture lines

Question 59

Which is most dangerous, cephalohematoma or subgaleal hemorrhage?

Answer 59

Subgaleal hemorrhage

Question 60

What are the symptoms/signs of Subgaleal hemorrhage?

Answer 60

Crosses suture lines Potential space: loosely arranged connective tissue; blood loss in this space can be severe

Question 61

What is a normal head related issue?

Answer 61

caput succedaneum

Question 62

why are low set ears concerning?

Answer 62

could be congenital concern

Question 63

what is a normal finding of the chest that changes over time?

Answer 63

a prominent sternum

Question 64

What is normal for the respiratory system?

Answer 64

-Lungs contain approximately 20 mL of fluid/kg -Air replaces the fluid during newborn transition -Some lung fluid retention can be experienced -Surfactant reduces surface tension -Immature respiratory control -Newborns tend to nose breathe -Abdominal breathing is normal

Question 65

What is a signs of respiratory distress?

Answer 65

Nasal flaring, intercostal or substernal retractions, stridor, grunting, gasping, apnea lasting 20 seconds or longer

Question 66

what is TTN- transient tachypnea of the newborn?

Answer 66

parenchymal lung disorder -pulmonary edema d/t not absorbing fetal alveolar fluid

Question 67

What is the most common cause of resp. distress in late preterm and term infants, benign, self limited?

Answer 67

TTN transient tachypnea

Question 68

when does TTN resolve?

Answer 68

within 24 hours

Question 69

how many RR max can a baby with TTN have?

Answer 69

up to 100 breaths/min

Question 70

what are the symptoms of TTN?

Answer 70

RR up to 100 breaths/min Intermittent grunting Nasal flaring Mild retractions

Question 71

how do we help babies with TTN?

Answer 71

-Support with feeding -Neutral thermal environment -O2 supplementation may be provided to maintain O2 sats b/w 90-95%

Question 72

why do we give Vit K IM?

Answer 72

gut bacteria is nonexistent and vit K needs it. so we give vit K till they’re eating

Question 73

what are the 3 vessels o the umbilical cord?

Answer 73

2 umbilical arteries 1 umbilical vein

Question 74

are the arms of babies longer or shorter than legs?

Answer 74

longer

Question 75

which way do babies toes go with babinski?

Answer 75

toes span out

Question 76

what is the startle response called?

Answer 76

Moro

Question 77

how long do babies sleep in a day?

Answer 77

up to 17 hours

Question 78

if a baby is inconsolable what do we suspect?

Answer 78

possibly withdrawl baby

Question 79

If crying is shrill- high pitched what could that indicate?

Answer 79

neurological issues

Question 80

what is the goal of vitamin K?

Answer 80

reduce risk of bleeding - helps baby clot their blood

Question 81

what is the timing of vitamin K?

Answer 81

within 6 hours of birth

Question 82

where do we give vitamin k?

Answer 82

vastus lateralis

Question 83

what is erythromycin ointment giving for?

Answer 83

ghonorrhea and chlamydia birther for sure we give to all babies (with birther consent) regardless of STBBI status