[Exam 2] Chapter 18 – Nursing Management of the Newborn Flashcards
(186 cards)
1
Q
Nursing Management Immediate Newborn Period - Assessment: What is an easy, rapid newborn assessment tool?
A
RARP. Respiratory, Activity, Perfusion, and Position
2
Q
Nursing Management Immediate Newborn Period - Assessment: When would a second assessment be performed?
A
Within the first 2-4 hours, when admitted to nursery, or labor and birth room
3
Q
Nursing Management Immediate Newborn Period - Assessment: When is a third assessment completed?
A
BEfore discharge
4
Q
Nursing Management Immediate Newborn Period - Assessment: What problems may you look for in the initial assessment?
A
Nasal Flaring, Chest Retractions
Grunting on exhalation
Generalized Cyanosis
Abnroaml breath sounds/respiratory rates
Pallor and abnormal size/heart rates
5
Q
Nursing Management Immediate Newborn Period - Assessment - Apgar Scoring: When is this performed?
A
At 1 minute and 5 minutes after birth . Additional one done at 10 minutes if score less than 7
6
Q
Nursing Management Immediate Newborn Period - Assessment - Apgar Scoring: What are the five parameters of this?
A
Appearance (Color) Pulse (Reflex Irritability) Grimace (Reflex Irritability) Activity (Muscle Tone) Respiratory ( Respiratory Effort)
7
Q
Nursing Management Immediate Newborn Period - Assessment - Apgar Scoring: What should the normal score be?
A
Between 8-10
8
Q
Nursing Management Immediate Newborn Period - Assessment - Apgar Scoring: What do scorees of 4-7 and 0-3 represent?
A
Signify moderate difficulty
0-3 points to severe distress
9
Q
Nursing Management Immediate Newborn Period - Assessment - Length and Weight: Expected length of a newborn?
A
44 to 55 cm (17-22 cm)
10
Q
Nursing Management Immediate Newborn Period - Assessment - Apgar Scoring: Heart Rate scoring for 0, 1, 2?
A
0 = Absent
1= SLow <100 bpm
2= >100 bpm
11
Q
Nursing Management Immediate Newborn Period - Assessment - Apgar Scoring: RR scoring for 0, 1, 2?
A
0 = Apneic
1 = Slow, irregular, shallow
2 = Regular respirations
12
Q
Nursing Management Immediate Newborn Period - Assessment - Apgar Scoring: Muscle tone scoring for 0,1,2?
A
0 = Limp, Flaccid
1 = Some flexion, limited resistance to extension
2 = Tight flexion, good resistance to extension with quick return to flexed positiona fter extension
13
Q
Nursing Management Immediate Newborn Period - Assessment - Apgar Scoring: Reflex Irritability (flicking soles of feet) for 0, 1,2?
A
0 = No response
1 = Grimace or frown when irritated
2 = Sneeze, cough, or vigorous cry
14
Q
Nursing Management Immediate Newborn Period - Assessment - Apgar Scoring: Skin Color scoring for 0,1,2?
A
0 = Cyanotic or Pale
1 = Appropriate body color, blue extremities
2 = Completely approrpiate color (pink on both trunk and extremities)
15
Q
Nursing Management Immediate Newborn Period - Assessment - Length and Weight: Typical weight of a newborn?
A
2500 - 4000 g (5 lb 8 oz to 8 lb 14 oz
16
Q
Nursing Management Immediate Newborn Period - Assessment - Length and Weight: How much weight can infants lost after birth?
A
10% by 3-4 days due to loss of meconium, ECF, and limited food intake
17
Q
Nursing Management Immediate Newborn Period - Assessment - Length and Weight: What is a low birth weight baby
A
> 2500 g ( > 5.5 lb)
18
Q
Nursing Management Immediate Newborn Period - Assessment - Length and Weight: Very low birth weight range?
A
> 1500 g ( > 3.5 lb)
19
Q
Nursing Management Immediate Newborn Period - Assessment - Length and Weight: Extremely low birth weight ?
A
> 1000 g ( >2.5 lb)
20
Q
Nursing Management Immediate Newborn Period - Assessment - VS: How is this obtained, and normal range?
A
Apical pulse for 1 minute, and typically 110 to 160
21
Q
Nursing Management Immediate Newborn Period - Assessment - VS: RR for infant?
A
30/60 breaths / min
22
Q
Nursing Management Immediate Newborn Period - Assessment - VS: How often are heart and RR assessed?
A
Every 30 mins until stable for 2 hours after birth
23
Q
Nursing Management Immediate Newborn Period - Assessment - VS: HR and RR checks how often once stable?
A
Every 8 hours
24
Q
Nursing Management Immediate Newborn Period - Assessment - VS: When are VS assessed?
A
Within 1-4 hours after birth
25
Nursing Management Immediate Newborn Period - Assessment - VS: Normal axillary temperature?
97.7 to 99.5
26
Nursing Management Immediate Newborn Period - Assessment - VS: Typical BP if assessed?
50-75/30-45 mm Hg
27
Nursing Management Immediate Newborn Period - Gestational Age Assessment: How is this determined?
Ballard gestational age assessment or Ballard scale. Determines gestational age between 20-44 weeks
28
Nursing Management Immediate Newborn Period - Gestational Age Assessment: Range of Ballard Scale?
Low score of -1 or -2 points for extreme immaturity to 4-5 points for postmaturity
29
Nursing Management Immediate Newborn Period - Gestational Age Assessment: When is the physical maturity section of the exam done?
During the first 2 hours after birth
30
Nursing Management Immediate Newborn Period - Gestational Age Assessment: Areas assessed on the physical maturity exam?
```
Skin Texture
Lanugo
Plantar Creases
Breast Tissue
Eyes/Ears
Genitals
```
31
Nursing Management Immediate Newborn Period - Gestational Age Assessment: What is assessed in skin texture?
Sticky and transparent to smooth, with varying degrees of peeling and crackking, or leathery with significant cracking and wrinkling
32
Nursing Management Immediate Newborn Period - Gestational Age Assessment: What is assessed with lanugo?
Soft downy hair on newborn body, which is absent in preterm. Disappears with postmaturity
33
Nursing Management Immediate Newborn Period - Gestational Age Assessment: What is assessed with plantar creases?
Creases on the soles of the feet , which range from absent to covering the entire foot, depending on maturity
34
Nursing Management Immediate Newborn Period - Gestational Age Assessment: What is assessed with breast tissue?
Thickness and size of breast tissue and areola. Range from imperceptible to full and budding
35
Nursing Management Immediate Newborn Period - Gestational Age Assessment: What to assess with eyes and ears
Eyes can be fused or open and ear cartilage and stiffness. Greater the stiffness, greater the maturity
36
Nursing Management Immediate Newborn Period - Gestational Age Assessment: What to assess with genitals?
Testicular descent and appearance of scrotum.
Females, appearance and size of clitoris and labia
37
Nursing Management Immediate Newborn Period - Gestational Age Assessment: When is neuromuscular maturity completeled?
Within 24 hours of birth
38
Nursing Management Immediate Newborn Period - Gestational Age Assessment: What are the six parts of neuromsucular assessment?
Posture
```
Square Window
Arm Recoil
Popliteeal Angle
Scarf Sign
Heel to Ear
```
39
Nursing Management Immediate Newborn Period - Gestational Age Assessment: What is assessed with posture?
How do they hold extremities in relation to trunk. Greater the degree of flexion, greater the maturity.
40
Nursing Management Immediate Newborn Period - Gestational Age Assessment: Example of posture assessment?
Extension of arms and legs score as 0, full flexion of arms and legs is scored for 4 points
41
Nursing Management Immediate Newborn Period - Gestational Age Assessment: Example of square window?
How far newborns hands flexed toward wrist. Angle more than 90 degrees is 1, and angle of 0 degrees is 4 points
42
Nursing Management Immediate Newborn Period - Gestational Age Assessment: Example of Arm recoil?
How far do arms spring back to flexed position?
Recoil less than 90 degree angle is scored as 4 points
43
Nursing Management Immediate Newborn Period - Gestational Age Assessment: Example of popliteal angle?
How far will knees extend? Angle less than 90 indicates maturity. 180 degrees is one point. less than 90 is 5 points
44
Nursing Management Immediate Newborn Period - Gestational Age Assessment: Example of scarf sign?
How far can elbows be moved across chest?
If elbow reaches or enars the opposite shoulder , 1 point . if elbow does not cross axillary line, 4 points
45
Nursing Management Immediate Newborn Period - Gestational Age Assessment: Example of heel to ear?
Scored the same way as scarf sign
46
Nursing Management Immediate Newborn Period - Gestational Age Assessment: What are preterm infants classified as?
Born prior to 37 weeks
47
Nursing Management Immediate Newborn Period - Gestational Age Assessment: Term babies are born when
38-42 weeks
48
Nursing Management Immediate Newborn Period - Gestational Age Assessment: Postterm babies born when
After 42 weeks
49
Nursing Management Immediate Newborn Period - Gestational Age Assessment: Postmature baby born when
AFter 42 weeks and showing signs of placental aging
50
Nursing Management Immediate Newborn Period - Gestational Age Assessment: Size for small for gestation age?
> 5.5 lb
51
Nursing Management Immediate Newborn Period - Gestational Age Assessment: Large for gestational age normal size?
> 9 lb
52
Nursing Mx Immediate Newborn Period - Intervention and Maintaining Airway: What happens right after birth?
Newborn is suctioned to remove fluids and mucus from the mouth and nose. First with bulb syringe to remove debris and then nose suctioned
53
Nursing Mx Immediate Newborn Period - Intervention and Maintaining Airway: What to know about bulb syringe before suctioning?
Compress the bulb before placing into oral or nasal cavity.
54
Nursing Mx Immediate Newborn Period - Admin Prescribed Meds: What two meds are commonly ordered?
Vitamin K and Eye Prophylaxis with either Erythromycin or tetracycline opthalmic ointment
55
Nursing Mx Immediate Newborn Period - Admin Prescribed Meds, Vit K: What does this promote?
Blood clotting by increasing the synthesis of prothrombin by hte liveer
56
Nursing Mx Immediate Newborn Period - Admin Prescribed Meds, Vit K: What does deficiency of Vit K cause?
Delays clotting and might lead to hemorrhage
57
Nursing Mx Immediate Newborn Period - Admin Prescribed Meds, Vit K: Why does an infant need Vit K?
Vit K is not produced in the intestine until after microorganisms hae been introduced, such as first feeding. Usually takes a week to produce enough Vi K
58
Nursing Mx Immediate Newborn Period - Admin Prescribed Meds, Vit K: How often are oral doses given?
Three doses needed over 1 month period
59
Nursing Mx Immediate Newborn Period - Admin Prescribed Meds, Eye Prophylaxis: What does this prevent?
Ophthalmia neonatorum (which can cause neonatal blindness)
60
Nursing Mx Immediate Newborn Period - Admin Prescribed Meds, Eye Prophylaxis: What is opthalmia neonatorum?
Hyperacute purulent conjunctivitis occuring during first 10 days of life. usually contracted during birth
61
Nursing Mx Immediate Newborn Period - Maintaining Thermoregulation: SHould be taken how often?
Every 30 mins for first 2 hours, then every 8 hours until discharge
62
Nursing Mx Immediate Newborn Period - Maintaining Thermoregulation: Ways to maintain body temperature?
Dry newborn after birth
Wrap in warm blankets
USed a warmed cover on scale
63
Nursing Mx Early Newborn - Assess, Perinatal Hx: Historical information includes what?
Mothers name, maternal tests, antiobiotic therapy, rf blood group incompatibility, social history
64
Nursing Mx Early Newborn - Assess, Newborn Physical Exam: When is this performed?
Within 24 hours.
65
Nursing Mx Early Newborn - Assess, Newborn Physical Exam: What do you begin this exam with?
Auscultation of ehart and lungs. And then move to areas that would irritate the newborn.
66
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Length: Average length?
20 inches, but can range from 17 to 22 inches.
67
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Weight: Average weight?
7.5 lbs, but can range from 5 lb 8 oz to 8 lb 13 oz
68
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Head Circumference: Average circumference?
13 to 15 inches
69
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Head Circumference: This should be what length?
1/4 of the newborns length or haalf of infants body plus 10 cm
70
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Head Circumference: Small head might indicate what?
Microcephaly caused by rubella, taxoplasmosis, or SGA
71
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Head Circumference: Enlaged head might indicate what?
Hydrocephalus or increased intracrial pressure
72
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Chest Circumference: Average here?
30 - 36 cm (12-14 inches). usually 3 cm less than head
73
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and VS: How often is this taken?
On admission
Once every 30 mins until stable for 2 hours
Then once every 4-8 hours until discharge
74
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Skin Cond/Color: How do you check for tugor?
By pinching a small area of skin over the chest or abdomen and now how quickly it returns . If tented, indicates dehydration
75
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Skin Cond/Color: Lanugo may be seen where?
Over the shoulders and on the sides of thef ace and upper back
76
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Skin Cond/Color: What is acrocyanosis?
Persistent cyanosis of fingers, hands, toes, and feet with mottled blue or red discoloration and coldness. Is normal for first few week s
77
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Skin Variations: Common skin variations include what?
```
Vernix Caseosa
Stork Bites
Milia
Mongolian Spots
Erythema Toxicum
Harlequim Sign
Nervus Flammeus
Nervus Vasculous
```
78
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Skin Variations: What is Vernix Caseosa?
Thick white susbtance that protects the skin of fetus. Fored by secretions from the fetus's oil gland. Will be absorbed into skin
79
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Skin Variations: What are stork bites?
Superficial vascular areas found on the nape of the deck, on eyelids, and between eyes and upper lip. Caused by concentration of immature blood vessels. Disappear within first year
80
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Skin Variations: What is Milia?
Multiple pearly-white or pale yellow unopened sebaceous glands found on nose. Form oil glands and disappear within 2-4 weeks.
81
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Skin Variations: What are Epstein Pearls?
When Milia occurs in the mouth and gums.
82
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Skin Variations: What are Mongolian Spots?
Benign blue or purple splotches that appear solitary on the lower back and buttocks of newborns. Caused by concentration of pigmented cells. Disappear within 4 years
83
What is Erythema Toxium? (Newborn Rash)
Benign, idiopathic, generalized, transient rash that occurs in 70%. Consists of smal papules or pustules on the skin resembling flea bites. Disappears within few days
84
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Skin Variations: What is Harlequin Sign?
Dilation of blood cells on one side of body, gives sappearance of waearing a clown suit. Gives midline demarcation. Results from immature autoregulation of blood flow. Lasts 20 mins
85
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Skin Variations: What is Nevus Flammeus?
Port-wine stain, found on face or other body areas.
86
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Skin Variations: What is Nevus Vasculosus?
Strawberry mark. It is raised, rough, dark red, and sharply demarcated. Commonly found on head region. Come sin the first few months of life.
87
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Head: What is molding?
Elongated shaping of the fetal head to accommodate passage through the birth canal. Occurs with vaginal birth froma vertex position. Resolves within a week
88
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Head: What is Caput succedaneum?
Describes localized edema on the scalp tha toccurs form pressure of the birth process. Usually seen in prolonged labor. Swelling leaves in 3 days
89
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Head: What is cephalhematomais?
Subperiosteal collection of blood of the skull confined to one cranial bone. Due to pressure on head.
90
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Head: Clinical features of cephalhematomais?
Well-demarcated, often fluctuant swelling with no overlying skin discoloration.
91
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Head: What is microcephaly?
Head circumference more than 2 standard deviations, caused by failure of brain development.
92
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Head: What is macrocephaly?
Head circumference more than 90% of normal, related to hydrocephalus
93
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Head: What is Large Fontanels?
More than 6 cm in the anterior diameter bone to bone . .Possibly associated with malnutrition
94
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Face: When is paralysis observed?
First or second day of lie. Will demonstrate asymmetry of the face with inability to close the eye or more the lips
95
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Mouth: Variations in mouth include what?
Epstein pearls (small, white epidermal cysts on the gums and hard palate
Erupted Nasal Teeth
Thursh (white plaque inside the mouth)
96
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Genitalia: Whatis hypospadiais?
When the meatus is on the ventral surface of the penis
97
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Genitalia: What is epispadias?
When the meatus is on the dorsal surface on the penis
98
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Genitalia: What is cryptochidism?
Undescended testes
99
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Extremities: What is polydactlyl?
Any extra digits
100
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Extremities: What is syndactyly?
Fusing of two or more digits
101
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Extremities: What is Erb Palsy?
Injury resulting from damage to the upper plexus and palsies associated with the lower bracial plexus termed klumpke palsies
102
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Neurological Status: How to assess for muscle tone?
Support the newborn with one hand under the chest. Observe how the neck muscles hold the head
103
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Reflex: What is the sucking reflex?
Elicited by gently stimulating the newborns lips by touching them
104
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Reflex: What is the Moro Reflex?
When the neonatle startle. Place them on their back. Supprt the upper body wight of supine newborn by the arms, using lifting otion, then release the arms suddenly. Will throw the arm outward and flex the knees
105
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Reflex: What is the stepping reflex?
Hold the newborn upright and inclines forward with the soles of the feet touching a flat surface. Baby should make stepping motion
106
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Reflex: What is the tonic neck reflex?
Lie on back. Turn head to one side. The arm toward which baby facing should extend straight away from the face if flexed and the fist is clenched tightly
107
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Reflex: What is the rooting reflex?
Stroking the newborn cheek. Newborn should turn toward it
108
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Reflex: What is the Babinski reflex?
Should be present at birth and disappears at 1 year. Elicited by stroking the lateral sole of the newborns foot from the heel toward ball of the foot. Toes should fan out
109
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Reflex: How to elicit the palmar grasp?
By placing a finger in newborns open palm
110
Nursing Mx Early Newborn - Assess, Newborn Physical Exam and Newborn Reflex: What is the truncal incurvation reflex?
Disappears at 4 weeks. Prone position, apply firm pressure and run finger down spine. Will cause the pelvis to flex toward stimulated side
111
Nursing Mx Early Newborn - Intervention, Bathing and Hygiene, Elim. and Diaper Area Care: How often is a diaper soaked daily?
6-12 x
112
Nursing Mx Early Newborn - Intervention, Bathing and Hygiene, Elim. and Diaper Area Care: How does meconium appear for first 48 hours?
thick, tarry, sticky, and dark green
113
Nursing Mx Early Newborn - Intervention, Bathing and Hygiene, Elim. and Diaper Area Care: When do transitional stools appear?
By 3 days after initiation of feeding.
114
Nursing Mx Early Newborn - Intervention, Bathing and Hygiene, Cord Care: When does this usually fall off?
Within 7-10 days
115
Nursing Mx Early Newborn - Intervention, Bathing and Hygiene, Cord Care: What to know for baths?
Avoid tub baths
116
Nursing Mx Early Newborn - Intervention, Bathing and Hygiene, Circumscision: What are the three common methods?
Gomco clamp, Hollister Plastibell DEvice, and Mogen Clamp
117
Nursing Mx Early Newborn - Intervention, Bathing and Hygiene, Circumscision: Preopertion preparation includes what?
Infant at least 12 hours or older
Has received Vit K
Voided normally at least once an hour prior
118
Nursing Mx Early Newborn - Intervention, Sleep: How to reduce risk of SIDS?
Always place babby on back
Room share, keep in same room where you sleep
Use a firm, sleep surface
119
Nursing Mx Early Newborn - Intervention, Assisting w/ screening tests - genetic and newborn: Most common ones?
PKU, Hypothyroidism, galactosemia, and sickle cell disease
120
Nursing Mx Early Newborn - Intervention, Assisting w/ screening tests - genetic and newborn: How to treat jaundice?
Hydration.
If not successful, Phototherapy has been useful, along with fiberoptic pads that wrap around the newborn
121
Nursing Mx Early Newborn - Intervention, Common Concerns and Hypoglycemia: How are glucose levels during first 24-48 hours?
Typically lower than later in life. Defined as left then 30 mg/dL or plasma concentration of less than 40 mg/dL during first 72 hours
122
Nursing Mx Early Newborn - Intervention, Common Concerns and Hypoglycemia: What infants are at greater risk for this?
Moms with diabetes, preterm newborns, and newborns with intrauterine growth restriction, hypothermia,
123
Nursing Mx Early Newborn - Intervention, Common Concerns and Hypoglycemia: Symptoms of this?
Jiteriness, lethargy, cyanosis, apnea, seizures, highpitched/weak cry, hypothermia and poor feeding
124
Nursing Mx Early Newborn - Intervention, Common Concerns and Hypoglycemia: Treatment for this?
Rapid-acting source of glucose. Such as sugar/water mixture or early formula feeding.
125
Nursing Mx Early Newborn - Intervention, Promoting Nutrition: Emptying time of stomach?
Short. Only 2-3 hours. Peristalsis is also rapid.
126
Nursing Mx Early Newborn - Intervention, Promoting Nutrition: Why should you not introduce solid foods prior to six months?
Baby is at high risk for food allergies.
127
Nursing Mx Early Newborn - Intervention, Promoting Nutrition: What to know about pancreatic enzymes?
Pancreatic enzymes and bile to digest fat limited until 3-6 months.
128
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Newborn Nutrtional Needs: Newborns caloric needs?
110 - 120 cal / kg body weight.
129
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Newborn Nutrtional Needs: Calories in breast milk and formulas?
20 cal/oz
130
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Newborn Nutrtional Needs: Fluid requirements for newborns?
100 to 150 mL/kg daily
131
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Newborn Nutrtional Needs: Why should babies be given iron?
Iron levels are low in all types of formula mil. Be sure to give iron-fortified formula from birth
132
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Newborn Nutrtional Needs: What to know for Vitamin D?
Give 400 IU within first few days to prevent rickets and Vit D deficiency
133
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Newborn Nutrtional Needs: What to know for iodine?
Take supplement of 150 mcg of iodine daily. Deficiency can afect fetal and early childhood neurocognitive development
134
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Newborn Nutrtional Needs: How often should they be fed?
Every 2-4 hours during day and only when newborn awakens at night
135
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Newborn Nutrtional Needs: Most breast fed infants need to be fed how often?
Every 2-3 hours, nursing for 10-20 mins on each breast
136
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Newborn Nutrtional Needs: Formula-fed newborns fed how often?
Every 3-4 hours, finishing bottle in 30 mins or less.
137
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Newborn Nutrtional Needs: Daily formula intake for infant?
!.5 to 2oz / lb
138
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Brest-Feeding: How long should infant be breast-fed for?
For the first 6 months of life
139
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Brest-Feeding: What is colostrum?
Thick, yellowish susbtance secreted during first few days after birth
140
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Brest-Feeding: What is mature milk?
Appears blueish, and not as thick as colostrum. Provides 20 cal/oz.
141
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Brest-Feeding: What happens to mother as infant is placed on abdemon and scoots toward the nipple?
Produces high level of oxytocin, which contracts the uterus and minimizes bleeding.
142
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Brest-Feeding: Keys for breast feeding?
Initiating breast-feeding within first hour of life.
Place newborn on mother's chest
Follow newborns feeding schedule
Offering no supplement
Have lactation consultant observe
143
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Brest-Feeding: What are some indicators of sufficient intake from infant?
6-10 wet diapers daily
WEaking up hungry 8-12 times in 24 hours.
Acting content and falling asleep after sleeping
144
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Brest-Feeding: What is the LATCH scoring tool?
Breast-feeding charting system that provides a systematic method for gathering information about individual breast-feeding sessions
145
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Brest-Feeding: What does LATCH stand for?
Scores from 0-2. L is how well infant latches. A is amount of audible swallowing
T is mothers nipple type
C is mothers comfort
H is amount of help mother needs
146
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Brest-Feeding Positions: What is the football hold?
Mother holds infant back and shoulders in her palm and tucks the infant under her arm. Supports breast with hands and brings infants lips to latch on. Allows her to see infants mouth
147
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Brest-Feeding Positions: What is the cradling position?
Most common. Holds baby in crook of her arm with infant facing the mother.
148
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Brest-Feeding Positions: What is the across-the-lap position?
Mother places a pillow across her lap, with infant facing the mother. Supports infants back
149
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Brest-Feeding Positions: What is the side-lying position?
Mother lies on her with a pillow supporting her back and another pillow supporting the newborn in the front
150
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Brest-Feeding Positions: How to promote latching-on?
Instruct the mother to make a C or a V with her fingers.
151
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Brest-Feeding Positions: How is the C hold performed?
Mother places her thumb well above the areola and other four fingers below the areola and under the breast
152
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Brest-Feeding Positions: How is the V hold performed?
Mother places her index finger above the areola and her other three fingers below the areola and under the breast
153
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Breast Milk Storage/Expression: How soon must you use chilled and stored milk?
Within 24 hours
154
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Breast Milk Storage/Expression: Use any frozen expressed milk within what time?
3 Months
155
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Breast Milk Storage/Expression: What should you not do with chilled milk?
Use microwave oven to warm
156
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Breast Milk Storage/Expression: What do you do with used milk?
Discard it. Never refreeze it.
157
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Breast Milk Storage/Expression: What should you do with milk before using it?
Thaw the milk in warm water
158
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Breast Feeding Concerns: Sore nipples are usually caused why?
By proper infant attachment.
159
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Breast Feeding Concerns: How do you prevent improper infant attachment?
Use only warm water to prevent dryness
Express some milk before feeding
Apply few drops of breast milk to nipples after feeding
Allow nipples to air dry after feeding
160
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Breast Feeding Concerns: When may engorgement occur?
AS milk comes in around day 3 or 4 after birth
161
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Breast Feeding Concerns: How to relieve engorgement?
Take warm to hot showers
Express some milk before breast-feeding
Feed newborn in vriety of positions
Increase frequency of feedings
162
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Breast Feeding Concerns: What does Mastitis cause?
It's inflammation of the breast. Causes flu-like symptoms, chills, fever, and malaise. Occurs when one breast milk duct becomes blocked.
163
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Breast Feeding Concerns: Tx for Masitis?
Rest, warm compress, antibiotics, breast support and continued breast-feeding
164
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Formula Feeding: How fast should the botle drip per second?
A drop per second
165
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Formula Feeding: What should you do with well water?
Should boil for 1-2 mins and then cool to room temperature before use
166
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Formula Feeding: Opened cans of readymade or concentraded formula should be covered and refrigerated for how long?
24 hours
167
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Weaning/Solid Foods: Weaning usually occurs when?
Between 6 months and 1 year of age
168
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Weaning/Solid Foods: How do you begin weaning?
Sub breast-feeding wiht a cup or bottle.
169
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Solid Foods: When should solid foods be introduced?
When infants double their birth weight and weigh at least 13 lbs
170
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Solid Foods: Readines ccues for solid foods?
Consumption of 32 oz of formula
Ability to sit up with minimal support
Reduction in protrustion reflex
171
Nursing Mx Early Newborn - Intervention, Promoting Nutrition and Solid Foods: New foods should be introduced how frequently?
Every 3 to 5 days to help identify allergies if they were to occur
172
Nursing Mx Early Newborn - Intervention, Follow Up Care: When is the first appointment scheduled?
Within 2-4 dys after discharge
173
Nursing Mx Early Newborn - Intervention, Follow Up Care: Typical schedule for visits?
2-4 Weeks
2,4,6 Month Checkup and Vaccine
9 Month
12 Month plus TB
15-18 Mon for Vaccines
2 Years
174
Nursing Mx Early Newborn - Intervention, Follow Up Care: Warning signs of illness?
Temperatures of 101
Forceful, persistent vomiting
Refusal to take feedings
Abdominal distention
175
Nursing Mx Early Newborn - Intervention, Providing Immunization Information: How is passive immunity used?
Protection transferred via already formed antibodies from one person to another. Such as from mother to newborn
176
Nursing Mx Early Newborn - Intervention, Providing Immunization Information: What is active immunity?
Protection produced by an individuals own immune system. Can be obtained by having the actual disease or receiving a vaccine
177
Nursing Mx Early Newborn - Intervention, Providing Immunization Information: First immunization received?
Hep B. After birth or by 2 months of age
178
At birth, a newborn’s assessment reveals the following: heart rate of 140 bpm, loud crying, some flexion of extremities, crying when bulb syringe is introduced into the nares, and a pink body with blue extremities. The nurse would document the newborn’s Apgar score as:
5 points
6 points
7 points
8 points
8 points
179
The nurse is explaining phototherapy to the parents of a newborn. The nurse would include which of the following as the purpose?
Increase surfactant levels
Stabilize the newborn’s temperature
Destroy Rh-negative antibodies
Oxidize bilirubin on the skin
Oxidize bilirubin on the skin
180
The nurse administers a single dose of vitamin K intramuscularly to a newborn after birth to promote:
Conjugation of bilirubin
Blood clotting
Foreman ovale closure
Digestion of complex proteins
Blood clotting
181
A prophylactic agent is instilled in both eyes of all newborns to prevent which of the following conditions?
Gonorrhea and chlamydia
Thrush and enterobacter
Staphylococcus and syphilis
Hepatitis B and herpes
Gonorrhea and Chlamydia
182
The AAP recommends that all newborns be placed on their backs to sleep to reduce the risk of:
Respiratory distress syndrome
Bottle mouth syndrome
Sudden infant death syndrome
GI regurgitation syndrome
Suden infant death syndrome
183
Which one of the following immunizations is most commonly received by newborns before hospital discharge?
Pneumococcus
Varicella
Hepatitis A
Hepatitis B
Hep B
184
Which condition would be missed if a newborn were screened before he had tolerated protein feedings for at least 48 hours?
Hypothyroidism
Cystic fibrosis
Phenylketonuria
Sickle cell disease
PKU
185
Which of the following findings in a newborn would the nurse document as abnormal when assessing the newborn head?
Two soft spots palpated between the cranial bones
A spongy area of edema outlined on the head
Head circumference 32 cm, chest 34 cm
Asymmetry of the head with overriding bones
Head circumference 32 cm, chest 34 cm
186
Which of the following findings in a newborn would be considered normal?
Passage of meconium within the first 24 hours
Respiratory rate of 80 breaths per minute
Yellow skin tones at 10 hours after birth
Bleeding from the umbilicus area
Passage of meconium within the first 24 hours
