exam 4-lp7 Flashcards
(130 cards)
1
Q
Fertilization
fuses/makes
how does penetration happen
when take pregnancy test
who determines gender
Fetal Development
A
sperm fuses to ovum and makes zygote
all sperm surround ovum, only one will penetrate
women can take pregnancy test after first missed period to see HCG
males determine gender
2
Q
fertilization-fetal development
how long is ovum fertile
how long is sperm fertile
how long for implantation
A
ovum is fertile for 24 hrs after release from fallopian tubes
sperm is viable in female tract from 48-72 hrs
takes 8-10 days for implantation
3
Q
how are
paternal
identical
twins made
A
faternal twins are two separate ovum and 2 separate sperm
identical are one sperm and ovum that randomly divide
4
Q
Functions of Amniotic Fluid
constantly
absorbed/back
once kidney
filled
Fetal Development
A
constantly changing as baby swallows fluid
absorbed into fetal blood stream and back into placenta into moms bloodstream
once kidneys develop urine will develop
cushy water filled sac
5
Q
Amniotic fluid will protects from what
regulates
allows
helps w/
Functions of Amniotic Fluid
A
amniotic fluid will protect baby from pressure/blows from moms abdomen
regulate temperature
allows for movements
helps with umbilical cord
6
Q
normal amniotic fluid–how much
hydramnios/ Polyhydramnios-how much
Oligohydramnios–how much
A
normal is 800-1200 mls of amniotic fluid
poly- over 2000 mls of amniotic fluid
oligo- less then 400 mls of amniotic fluid
7
Q
Umbilical Cord
of arteries and veins
arteries do what
viens do what
A
AVA” 2 Arteries and 1 Vein
Arteries carry unoxygenated blood AWAY from fetus
Vein carries oxygenated blood TO fetus
8
Q
Development and Functions of the Placenta
when start
place where
exchange, function–main functions
functions like
A
functions start at 3-4 weeks
Place where nutrient and metabolic exchange takes place.
gas exchange, nutrition, excerction and endocrine function
Functions like the fetal lungs
9
Q
4 weeks
8 weeks
8-12 weeks
16-20 weeks
24 weeks
Important Milestones in Development
A
4 weeks: heart is formed
8 weeks: organs formed; facial features discernable
8-12 weeks: fetal heart rate heard with Doppler
16-20 weeks: fetal movements felt by mother
24 weeks: fetal respiratory movements begin;
low-end age of viability
10
Q
Fetal Circulation
bypasses
A
most blood bypasses lungs because gas exchange occurs in placenta
11
Q
How does fetal circulation differ
lungs in mom
lungs in birth
3 shunts
A
Fetal lungs are fluid filled while in mom
as baby is born fluid leaves lungs
3 shunts-
Ductus venosus
Foramen Ovale
Ductus Arteriosis
12
Q
Ductus venosus
allow
A
Allows blood to bypass liver and go to inferior vena cava
13
Q
Foramen Ovale
allows
A
Allows blood to pass from right atrium to left atrium
14
Q
Ductus Arteriosis
allows
A
Allows blood to pass from pulmonary artery to aorta.
15
Q
why will shunts close
allows for
A
close due to cold air
allow for start of respiratory circulation
16
Q
-Intrauterine Factors-
fetal lung development-surfactant
surf develops/peaks
if premature
A
Fetal lung development-surfactant -helps with expansion
surfactant develops at 24 weeks/peaks 35
if premature might give surfactant shot to build up lungs
17
Q
Respiratory Adaptations
abnormalities
shunts
Newborn Physiologic Responses
A
Respiratory Adaptations are the most important part to watch for
any abnormalities follow up on
shunts should close to stimulate breathing
18
Q
Mechanical events
TS
comes out
pressure
Initiation of breathing
Newborn Physiologic Responses Respiratory Adaptations
A
-thoracic squeeze.
when baby comes out vaginal canal, fluid is squeezes out lungs
and pressure changes causes breath and expansion
19
Q
Chemical stimuli
decrease
no longer
Initiation of breathing
Newborn Physiologic Responses Respiratory Adaptations
A
decrease of placental exchange
placenta will not longer breath for baby
20
Q
Thermal stimuli
what prompts
stimulates
Initiation of breathing
Newborn Physiologic Responses Respiratory Adaptations
A
coldness prompts baby to take deep breathes
cold air stimulates crying
21
Q
Sensory stimuli
what stimulates
what do you want
Initiation of breathing
Newborn Physiologic Responses Respiratory Adaptations
A
lights
sounds
gravity
talking
rubbing
you want baby to scream and cry
22
Q
Newborn Breathing
adjusting
What is normal
retractions
A
baby will have trouble adjusting to real world
normal-irregular patterns-30-60 bpm
retractions may be near clavicle and her bottoms of ribs
23
Q
Signs of Respiratory Distress
retractions
cyanosis
nasal flaring
grunting
apnea-normal/abnormal
A
Retractions-pulling in and body is sucking itself in-caving in
Cyanosis-blueish color from not enough oxygen
Nasal flaring
–Obligatory nose breathers
Grunting-audibly hear
Periodic Breathing Pattern
–Apnea
—–Less than 20 secs with no cyanosis=normal
——-Greater than 20 seconds=abnormal
24
Q
Feeding an infant in respiratory distress
could indicate
A
could indicate that a duct didn’t close properly
25
when would you not want a baby to cry
if meconium or no suction
26
lung sound assessment-whatdo first
what helps calm down
listen to lungs first in assessment-so before crying
if baby is crying-gloved fingers or pacifiers may calm down
27
Transitional Physiology
3 closures
murmurs
go away
Birth: Physiologic Responses
Cardiovascular Adaptations
Closure of Foramen Ovale
Closure of Ductous Arteriosis
Closure of Ductous Venosis
murmurs may result as incomplete closure of these
murmurs should go away soon
28
acrocyanosis
what is it
why happens
can be/subsides
Birth: Physiologic Responses
Cardiovascular Adaptations
bluish discoloration of hands and feet
immature peripheral circulation
can be completely normal and will subside after 24 hrs
29
heart rate
normal
sleep
crying
Newborn Physiologic Responses
Cardiovascular Adaptations
120-140 bpm
90-110 during deep sleep is ok;
up to 180 if crying)
30
blood pressure
initially
first year
need
not indicator
Newborn Physiologic Responses
Cardiovascular Adaptations
Blood Pressure initially around 80/46,
then 100/50 average for the first year
Need correct cuff size
Not an accurate indicator for distress
31
screen
detects
clamping of cord-allows
clamping-helps
Newborn Physiologic Responses
Cardiovascular Adaptations
Newborn screen completed before leaving hospital to detect congential heart defects
clamping of umbilical cord allows cardiac changes to occur
helps close structures and first breath
32
intense distress baby
dont do
can cause
do do
do not feed a baby that is in intense distress
can cause aspiration
start oxygen or nebulizers or X-ray or iv to regulate nutrition/breathing
33
Blood pressure measurement using a Doppler device
– not always done routinely
34
Hematopoetic System
initial
once properly
inc can cause
Newborn Physiologic Responses
Initial decline in hemoglobin over first 2 months
once baby is properly oxygenated the need for a high RBC count diminishes
increased hemoglobin can cause jaundice because of rabbit destruction of rbc which causes elevated bilirubin
35
Leukocytosis
increases
difficult
s/s of infection
- increased WBCs d/t birth and stress in the first few days of life
---Makes it difficult to assess infection
s/s of infection-dehydration, poor eating, lowtemp, lethargy
36
Temperature Regulation
decreases/thin
blood vessels
posture
make sure
normal temp-
Factors affecting stability
Birth: Physiologic Responses
Decreased fat and thin epidermis
Blood vessels close to skin (more sensitive to environmental temps)
Flexed posture (less surface area exposed to environment, heat loss reduced).
make sure baby is wrapped up tightly
Normal Temp
97.6 – 98.6ºF (axillary)
37
Methods of heat loss
convection -what is it
examples
1. convection -flow of heat from body surface to cooler surrounding air- air conditioner /open window
38
evaportaion- what is it
examples
loss of hear through conversion of a liquid to a vapor
amniotic fluid evaporation when born
39
conduction-what is
example
-transfer of heat to solid object in contact with baby-
cold stethoscope on skin
40
radiation-what is it
examples
transfer of body hear to a cooler solid object not in contact with baby
heat from baby moving to an open window
41
Heat Production
NST
BAT
Newborn Physiologic Responses
Temperature Regulation
Nonshivering thermogenesis (NST)
Brown fat/Brown Adipose Tissue (BAT-- skin detects change in template and will use brown fat to change temperature
42
Pathology altering ability to generate heat
indicator of specific problems
Newborn Physiologic Responses Temperature Regulation
decrease in temperature can be indicator of problems--
Hypoxia
Acidosis
Hypoglycemia- Blood glucose first 24 hrs can be 30// standard is 40-45
Effects of certain drugs (Demerol given to mom in labor)
43
Iron storage and RBC Production-
when destroyed
iron is stored where-why
Newborn Physiologic Responses
Hepatic Adaptations
as RBCs are destroyed after birth,
the iron is stored in the liver until needed for new RBC production
44
Conjugation of Bilirubin
placenta/liver
start
liver performs
Newborn Physiologic Responses
Hepatic Adaptations
placenta took care of RBC breakdown, now liver needs to start to do
takes a few days for liver to start functioning
liver performs breakdown of bilirubin and breakdown goes through bowel movements and gives stool its color
45
Conjugation of Bilirubin
direct
indirect
What happens if bilirubin is too high -get
Hepatic Adaptations
Direct-water soluble
Indirect-non excrete able and can be potentially toxic
high bilirubin can cause nuerological issues-get daily labs
46
Physiologic Jaundice
caused by(accelerated, impaired, increased)
is this normal /when
Newborn Physiologic Responses
Hepatic Adaptations
(caused by accelerated RBC destruction, impaired conjugation, increased bili reabsorption from intestine)
NORMAL RESPONSE BY NEWBORN
Signs after first 24 hrs
47
Physiologic Jaundice-labs-
treatment
/dangerous
light therapy when
treatment is when lab goes as high as 10-12
more then 20 is dangerous to infant
light therapy at 15
48
breastfeeding jaundice
breastmilk jaundice
Pathologic Jaundice
one other cause
Newborn Physiologic Responses
Hepatic Adaptations
Breastfeeding Jaundice- (caused by poor feeding practices)
BreastMIlK Jaundice -caused by milk composition.
Pathologic Jaundice- signs WITHIN 24hrs of life.
vacuum can cause jaundice
49
treting jaunduice
therapy
skin
want/much
light therapy with eye protection
as much skin exposed as possible
want baby to eat and have as much bowel movements as possible-gets rid of bilirubin
50
Blood Coagulation
what is
cannot make
needed
given when
where given
Newborn Physiologic Responses
Vitamin K
(cannot make vitamin K at birth due to absence of normal flora in GI system)
needed for clotting factors
given at first day of birth
im Injection into thigh
51
nutrition
---Caloric Requirements
first 10
---Weight loss
Newborn GI Adaptations
---Caloric Requirements--110-120 calories per kilogram per day to keep up with growth
first 10 days are toughest since digestive system is immature
---Weight loss- baby can lose up to 10% of birthweight
52
Regurgitation
what is
due to
dont
often
Newborn GI Adaptations
spit up of food
due to immature sphincter in stomach
dont overfeed
burp as often as possible- to expel gas so they feel less full
53
Stools-
--Meconium-
--Breast fed-
formula fed
when's first(meconium)
Newborn GI Adaptations
--Meconium-thick tarry black stool-
--Breast fed-3-4 yellow stools a day dt lactic acid
formula-2-3 bright yellow stools a day
mecronium passes within 24-48 hrs-ensures gi function
54
Urinary Function
1st
alert
Urinary Adaptations
Newborn Physiologic Responses
1st void- within 24 hr;
Alert provider if no void in 24hr
55
What does first urine look like
from
but __
Cloudy or “dusky”
from uric acid crystals and can appear like blood in urine,
but reassure scant amt it is okay.
56
Immunologic Adaptations
dont
inability
fever
Newborn Physiologic Responses
dont really have immune system built up
Inability to recognize, localize, and destroy bacteria –
fever is not reliable indication of infection
57
More reliable signs of infection:
Newborn Physiologic Responses Immunologic Adaptations
resp distress
↓ BS
hypothermia
58
Immunologic Adaptations
produce
most
what given in hospital
where do pts get antibodies from
Newborn Physiologic Responses
Produce antibodies around 2 months
Most immunizations start at this time
erethymyocin, vit k, and hep b(not important for right away) given in hospital
babies get antibodies from mothers milk
59
Newborn Reflexes:
Blink
Rooting
Sucking
Swallowing
Extrusion
Palmar Grasp
Stepping/Walk-in-place
Placing
Plantar grasp
Tonic neck
Moro
Babinski
Magnet
Crossed extension
Trunk incurvation
60
Hearing
recognize
womb
fluid
every
might not
Sensory
Newborn Physiologic Responses
recognize mom’s voice immediately is common
babies can hear in womb
fluid drains from middle ear within hours after birth, then hearing becomes acute (just trouble locating/tracking sound)
every newborn has hearing screen in hospital
may not pass right away, if fail second time may need to go to audiologist
61
Vision
reflex
loses
objects
cannot
black and white
Sensory
Newborn Physiologic Responses
Blink/squint reflex starting in utero @26 wk gestation
Loses track of subjects/toys easily,
object needs to be close to infant
cannot track across midline
Black and white objects 9-12 inches from face for a few months
62
Touch
well
do not
sleep
cry
Sensory
Newborn Physiologic Responses
Well developed – hold, cuddle, swaddle for security feeling
babies do not like to be out in open and like to be help tightly
sleep better when swaddled
Cry with pain
63
Taste
taste
prefer
circumcision baby
Sensory
Newborn Physiologic Responses
Taste buds are developed
Prefer sweet
circumsise babies-use glucose pacifiers to calm baby
64
Smell
present
prefers
Sensory
Newborn Physiologic Responses
Present after clearing nose of fluid
Prefers mother scent/breastmilk
65
Newborn Assessments
done when
what's good
under
under immediatly
0/1/2
APGAR
done at 1 minute at 5 minute
7-10 is considered good
under 7 might need resuscitation
under 3 needs immediate resuscitation
0/1/2 pts
Activity/absent/flexed arms/ active
Pulse-absent/below 100 bpm/ above 100 bpm
Grimace-floppy/ minimal repsonse/ prompt response to stimulation
Appearance-blue pale/ pink body, blue extremities/ pink
Respiration-absent/ slow irregular/ vigorous cry
66
Physical maturity
book 446 if you need to fill out idfk
Gestational Age Assessment
routinely done,
do if no prenatal care for person
most accurate if done in first 12 hrs
takes about 5-10 minutes to complete
Skin
Lanugo-fine blond hair-immature
Plantar surface
Breast
Eye/ear
Genitals
67
Neuromuscular maturity
Gestational Age Assessment
Posture
Square window
Arm recoil
Popliteal angle
Scarf sign
Heel to ear
68
General Appearance
why doing
head
Nursing Assessment Physical Assessment and Health History
visualizing baby
head is approximately 2 cm larger then chest
69
Weight and Measurements
plotting
looking at
do
Nursing Assessment Physical Assessment and Health History
Plotting on Growth Chart
height, weight, chest and head circumference
do % to check where baby is and were they should be
70
nerbown measurements
weight
length
head
chest
wt- F-7lbs M7.5 lbs
length- F19.2 in M 19.6
H 12.7-14.1
chest- 0.75-1 in less then head
71
Temperature
preferred
normal range
unstable
rectal
Nursing Assessment Physical Assessment
Axillary preferred
97.6-98.6 normal range
Skin Probe for unstable newborns-stickers on stomach with sensor
Rectal temp not routinely recommended due to causing problems
72
Skin and Color
Acrocyanosis vs central cyanosis
are each normal/abnormal(what does it mean)
Nursing Assessment Physical Assessment
A- when Lips/ hands/Feet
are blue-normal 24-48 hrs after birth
C-cyanosis of trunk- abnormal and can indicate issues with heart and lungs
73
Skin and Color
Jaundice
what caused from-large
need to
color
Nursing Assessment Physical Assessment
– hyperbilirubinemia-large amount of red cells that are broken down but cant be excepted as fast,
need to be feeding and watching bm
yellow color
74
Skin and Color
what does pallor mean
might
treat
Nursing Assessment Physical Assessment
– anemia-
most aren't, so might be issues
can treat with iron or blood transfusion
75
Skin and Color-Harlequin sign
when occur
type of condition
occurs
side
Nursing Assessment Physical Assessment
-2-5 days,
benign condition,
change in colors, occurs when baby sleep on side
side baby slept on is a different color then side not slept on
76
Nevus flammeus (“Port-wine stain”) or (“Stork bite”)
what type
what color
treatment
may need to remove
can be
Nursing Assessment-Hemangiomas
benign,
dark or light port wine stain color,
treatment -may spontaneous fade,
may need surgery to remove,
can be covered by hair
77
Infantile hemangiomas (“strawberry hemangiomas”)-
what looks like
when appear
enlarged
when shrink
Nursing Assessment
Hemangiomas
elevated areas of immature capillaries and epithelial cells,
appear 2 weeks of birth,
enlarged after 1 year
, after a year they are absorbed and shrink in size
78
Cavernous-
what is it
what type of shapes
do they dissepear
can appear where
if on organs
treatment
watch
Nursing Assessment
Hemangiomas
dilated vascular spaces
, irregular shapes,
does not disapeaer,
can appear on organs,
surgical removal if interfering with organs,
steroids, radiation therapy,
watch h and h
79
Mongolian spots-
blue areas that occur over body, fade away over time,
80
Vernix Caseosa-
what looks like
will
noticeable
look
indicator
if assessing...
Physical Assessment
Nursing Assessment
white cream cheese lubricant all over baby body- ,
will fade,
noticeable in skin folds,
look at color and areas,
indicator of immature baby if al over
wear gloves to assess
81
Desquamation
what is
what do
- dry skin,
usually nothing, but if so then mild lotions or baby lotions
82
Lanugo-
fine
usually
keeps
fine hair all over,
usually falls off,
keeps baby warm
83
Milia
what are they
why occur
will
do not
little white heads all over nose
plugged/unopened sebaceous glands
will go away on own
do not push or squeeze them-can cause infection.
84
Erythema toxicum-
what are they
also called
disappears
do not
Physical Assessment
Nursing Assessment
pinpoint red papules,
"baby acne" ,
disappears in a few days and sometimes will go back a couple days into age-
do not poke or prode
85
Forceps marks-
what is forceps
what happens
when disappear
check when
forceps go around cheek or head,
scrath marks around baby head from them
disappear in 1-2 days
check face during crying to look for symmetry
86
Skin turgor-
should
if dehydrated
should have good elasticity
if dehydrated will tent
87
Fontanelles
when anterior and posterior close
soft spots allow
if sunken
if bulging and not crying
best to look when
Nursing Assessment Physical Assessment - Head
anterior -Closes by 18 months-
posterior- closes by 8 weeks
soft spots-open to allow for flexibility and allow brain to grow
if looking sunken in-then look for dehydration
if bulging and not crying, then increased intracranial pressure, doctor needs to be contacted immediately.
best to do when not crying
88
sutures
overide/subside
molding/subside
Physical Assessment-Head
Nursing Assessment
Sutures – override due to vaginal birth
(subsides in 24-48 hrs)
Molding also due to birth
(subsides in a few days
89
Caput succedaneum-
what is it
suture lines
vaccume
hats
Physical Assessment-Head
Nursing Assessment
collection of fluid.
DOES cross suture lines.
vaccumes can cause hematoma
hats can cause headaches and can make baby crabby
90
Cephalohematoma-
what is it
suture line
increases
vacuumed
hat
Physical Assessment-Head
Nursing Assessment
collection of blood.
Does NOT cross suture lines.
can increase chances of jaundice
vaccumes can cause hematoma
hats can cause headaches and can make baby crabby
91
Physical Assessments
eyes
looking for
Nursing Assessment
slight edema
no tears
hemmoraghe-could have bloodshot eyes due to pressure at birth
92
Physical Assessments
ears
sides
low
make sure
Nursing Assessment
equal on both sides
low set ears can indicate abnormality like down syndrome
make suer can hear
93
Physical Assessments
Nose
usually
where in head
assess
obligatory
Nursing Assessment
usually short, creased with skin folds
midline in head
assess symmetry and choanal atresia- blockage of the rear of the nose by compressing one nare at a time
obligatory nose breathers
94
Physical Assessments
mouth
thrush
epsteins pearls
Nursing Assessment
Thrush-(white patches that look like milk curds) on tongue and cheeks
Epstein Pearls (small white specks on hard palate and gum margins)
95
neck
what looking for
Physical Assessments
Nursing Assessment
short creased
white skin folds
head lay
cant support head-support for them
96
Physical Assessments
chest
Nursing Assessment
some children have engorged breast tissue from moms hormones
small
97
Physical Assessments
cry
make sure
high pitched
looking for
easily
Nursing Assessment
make sure loud
high shrill cat cry may mean intracranial pressure or trauma
looking for pain
easily distinguishable from toddler
98
female-Anogenital
Pseudomenstruation-
may/
subsude
Nursing Assessment Physical Assessments
- may have blood in diaper from moms hormones,
will subsides when hormones leave the body
99
Abdomen
looking for
usually
some may
Physical Assessments
Nursing Assessment
- looking for bowel sounds,
usually aucaltating 1 hr after birth,
some may have bowel movement in 24-48 hrs
100
Umbilical Cord-
pull-will
turns what color
leave what
when fall
should not be
if__ looking for
treat infections
dont do what
dont pull off-will fall off on own
, cord turn brown and dries up,
leave clamp and security tag-
6-10 days should fall off,
should not be any bleeding or wetness-
if wetness or odor looking for infection-
treat infections with antibiotic,
dont submerge baby into bath to keep uc dry
101
Male-Anogenital
Hypospadias
Male-Anogenital
Nursing Physical Assessment
- urinary meatus is on ventral surface of penis
102
Phimosis
what is it
what needs
Male-Anogenital
Nursing Physical Assessment
- foreskin cannot be pulled back over glans-
surgery Neds to be performed because of urinary retention
103
Cryporchidism-
what is it
Male-Anogenital
Nursing Physical Assessment
failure of testes to descend-
104
Hydrocele-
what is it
what look like
scortal sac
Male-Anogenital
Nursing Physical Assessment
fluid surrounding the testes-
very enlarged
-scrotal sc can be reddened and swelling
105
Back
assess
when supine
make sure
checking
Nursing Assessment Physical Assessment
asses prone-lay on stomach
when supine- back should be flat
make sure spine bifida
checking extremities
106
Extremities
paralysis
digits
clubfoor
hip dysplasia
Physical Assessment
Nursing Assessment
Paralysis-inability to move extremities
Digits/webbing-fingers are together-or any extra digits
Clubfoot -foot is tuned inwards-can be aligned with brace or surgery
Congenital hip dysplasia- make sure baby ball and socket aren't out of place
107
Heel stick –
after when
3 h's
numbers
can help determine
Newborn Lab studies
after 1 hr to asses how baby is adapting to outside world
Hematocrit
Hemoglobin
Hypoglycemia
numbers will be lower then adults
if large or gestational diabetes, questionable infections can help determine.
108
Newborn Screen
after
sent
card
can look
– after 24 hrs
sent to state
card with 3 dots
can look at different genetical problems
109
Newborn ID and registration
what Prevents abduction-
registration Info
banding
Registration info given to parents – use birth certificate to obtain social security, etc..
110
Erythromycin
prevents
prevention
nursing considerations
wear
babies
swelling
Newborn Needs and Care
-profilactive to prevent gonorrhea and chalmydia,
Prevention of Eye Infection
nursing considerations
wear gloves,
babies dont open eyes completely.
swelling does get better
111
Initiation of first feeding
teaching
maintaining clear airways/vitals
Newborn Needs and Care Interventions
teaching parent to look for rooting and sucking reflexes
Maintain clear airway and stable vital signs:
Position
Remove mucous
112
Maintain a neutral thermal environment
what per protocol
RW
will always need what
what helps
environment
babies dont
Skin sensor per protocol
Radiant warmer
Hat-babies will always need hat to keep warm
Baths
warm environment
babies dont eat if cold
113
Newborn Needs and Care Hep B
when done
can be
given
1st vaccination given within 12 hrs after birth
can be held off a little bit
given within 1,3,6 months
114
Newborn Needs and Care \ Vitamin K
when done
prevents
done with
IM within first hr of life
prevent bleeding problems
done with erythromycin
115
Newborn Circumcision
up to
any
usually
Current recommendations
up to parents to do,
any gi/gu issues may be held off for a little bit
usually 24 hrs into stay
116
Newborn Circumcision
Care during-
strap
put
make sure
releive pain
strap baby down onto board
, put emela cream to numb area,
make sure vit k has been given
, sugar water, sucrose water, and glucose pacifier helps to relieve pain
117
Newborn Circumcision
Care after
s/s infection
may have
do not
keep
use
change
if bleeding
heals in
s/s of infection-odor, discharge,
may have some shroud drainage at first,
do not wash right away ,
keep area clean
, use vaciliene gauze to keep moist for 3 days post circumcision,
change gauze every diaper change,
if bleeding hold pressure and if continue call doctor.
heals in 7-10 days
118
Assess home environment
car seat
crying
anticipatory
Newborn Needs and Care Parent Teaching
home- put bias aside- try to promote healthiest environment for baby
car seat- parents need car seat to leave hospital-nurse do not install
crying is how babies communicate
anticipating-need to eat, sleep, changed
119
Where should baby sleep
on back
120
Newborn nutrition
Breast Feeding
advantages
disavantages
contraindications
Advantages
Immunologic aspect
high Nutrition
Psychosocial-helps bonding
Disadvantages-releis a lot on mom and can be exhausting/frustrating to mom
can cause a lot of problems to mom
Contraindications- breast surgery, any specific reasons why mom cant give milk
121
how long to breastfeed
when whole milk
what's in breastmilk
baby food when
breastfeeding/formula up to first birthday,
baby cannot get whole milk until then-done have enzymes to break down
baby get iron from milk
at 4 months you can start adding baby foods per pshycian
122
Newborn Nutrition
how often breast feeding
know if enough
how many cals per day
Caloric and fluid needs
breast feeding should be done 8 times in 24 hrs
know if baby is getting enough bc of weight gain
120 calories per kilogram on average per day
123
Newborn Nutrition
listening for
watching
looking for
Caloric and fluid needs
listening for swallowing
watching amount of ounces baby ate
looking for wet diapers and stools
124
lactation education
lactation is what
what if needed
hormones
sites
get baby
- breastfeeding,
there is lactation consultants if needed,
prolactin is released at birth and stimulates milk production,
alternate breast sites,
get baby to latch onto
125
Leaking-- education
is it normal
can leak where
subside when
can leak more why
- does happen
, can leak out of other side,
after month it will subside,
can leak more if there's time in between pumps
126
Breastfeeding education
establish
Establishing a feeding pattern
127
Breastfeeding education
expressing
support
Expressing milk-done by hand, there's also electric pumps,
Support-lactation consultant, family/friends, work needs to provide rooms for at work pumping,
128
Storing milk education
put in what
originally put where
for how long
then where
for how long
-sterile container, and in bag,
put in fridge
fridge for 8 days,
then in freezer or dumped,
freezer last 3-4 months
129
breastfeeding problems
pacifiers
warming
never
feed
make sure to
Problems-
pacifiers shouldn't be used until breastfeeding is well established,
warm breastmilk by warm water and place bag in there,
never microwave breastmilk,
feed on demand,uslaly every 1.5-3 hrs
make sure burping and rotating sites
130
Formula Feeding
just as
types
techniques
dont want formula
amounts
tempature
burping
just as effective
Types- cans/powder,
Techniques/ Positioning-always hold baby head higher then body, baby can hold own bottle around 6 months,
dont want formula siting out for more then an hour, dont want formula in fridge longer then 4 hrs
Amounts-1-3 ounces every 2-4 hrs. formula is more filling
Temperature-bottle is warmed with warm water, bottle warmers. make sure its safe
Burping- burp every 0.5-1 ounce, establish a feeding pattern
