Heat Loss & Immediate Needs

Question 1

what are the four mechanisms of heat loss?

Answer 1

Evaporation
Conduction
Radiation
Convection

Question 2

what is the first mechanism of heat loss at birth and why?

Answer 2

Evaporation → baby comes out wet with amniotic fluid

Question 3

what should the nurse do to prevent evaporation at birth?

Answer 3

dry the baby!

Question 4

how does the baby experience heat loss through conduction?

Answer 4

they will transfer their heat to a cold surface

Question 5

what do we do to prevent conduction heat loss at birth? (2)

Answer 5

• skin to skin
• warmed blankets on top of both mom & baby

Question 6

how does the baby experience heat loss through radiation?

Answer 6

a naked baby will radiate their heat to room temp

Question 7

to prevent radiation heat loss, what should always be ready for when the baby is warm?

Answer 7

a hat

Question 8

list ways to prevent radiation heat loss at birth (3)

Answer 8

• hat
• cover with blankets, clothing
• radiant warmer

Question 9

does clothing get put on in L&D?

Answer 9

no, it waits until mom is transferred to postpartum unit

Question 10

how should babies be dressed?

Answer 10

always dressed in one more layer of clothing than adults

Question 11

how do radiant warmers work?

Answer 11

they only warm the outside of things

Question 12

should the baby be placed into blanket under the warmer?

Answer 12

no they should be naked only in diaper

Question 13

how do we prevent convection heat loss? (4)

Answer 13

• keep out of drafts
• keep away from doors or fans
• perform baths away from drafty areas as well
• keep warmer away from door

Question 14

what does low temp in baby equal? (3)

Answer 14

low glucose and ↑ risk for respiratory distress or loss of brain cells

Question 15

how can heat loss lower glucose?

Answer 15

If baby has to use a lot of its brown fat to keep warm → will have less reserve to maintain glucose

Question 16

what babies is low glucose often seen in? (3)

Answer 16

• preemies
• large babies
• babies born to diabetic mothers

Question 17

keeping baby warm is a _____ _____ measure!

Answer 17

life saving

Question 18

when should the warmer be checked?

Answer 18

prior to baby being born

Question 19

90% of babies will go…?

Answer 19

right to skin-to-skin contact

Question 20

how are warmers properly checked?

Answer 20

Turn it on & put hand underneath to check for heat
Make sure there is a temperature probe

Question 21

what is attached to warmer? (5)

Answer 21

oxygen with ambu bag
suction
stethoscope
laryngoscope
meconium aspirator

Question 22

when you turn on oxygen what do you need to make sure of?

Answer 22

you need to make sure it regulates to the proper amount of flow!!
Enough flow but not too much

Question 23

what is necessary to have at delivery incase we need to clear the airway?

Answer 23

mechanical suction

Question 24

what do we set mechanical suction to?

Answer 24

Set between 80-120 (usually 100)

Question 25

Why is a laryngoscope necessary to have at delivery?

Answer 25

incase of intubation

Question 26

Why is a meconium aspirator necessary to have at delivery?

Answer 26

incase of meconium fluid

Question 27

you want to try to get baby to skin-to-skin right away, before what?

Answer 27

before the cord is clamped

Question 28

how do we dry the infant & stimulate them gently?

Answer 28

by gently rubbing the baby dry with a warmed blanket while on mom’s chest/ abdomen

Question 29

drying the baby & stimulating them gently stimulates what?

Answer 29

their first breath

Question 30

drying the baby & stimulating them gently promotes what?

Answer 30

lusty cry to clear the airway → all baby needs to get started in life

Question 31

most babies only need ____ _____

Answer 31

gentle stimulation

Question 32

what should be used if secretions are blocking the baby's airway?

Answer 32

- bulb suction - mechanical suction

Question 33

where is bulb suction performed?

Answer 33

side of mouth & nose

Question 34

if the baby is trying to breath & cry, what should you get?

Answer 34

bulb suction

Question 35

what is considered ineffective breathing at birth?

Answer 35

gasping breathing or grunting cry

Question 36

what should be done if the baby is not breathing or is ineffectively breathing?

Answer 36

ventilate with bag-valve mask