Initial Assessment of the Newborn

Question 1

Normal Weight Range:

Answer 1

2.5 – 4.7 kg (5.5-10 lbs)

Question 2

Average kg Female

Answer 2

3.4 kg

Question 3

Average kg Male

Answer 3

3.5 kg

Question 4

First few days, newborns lose about ___________________ of birth weight

Answer 4

5 % to 10% (6 to 10 oz)

Question 5

Breastfed newborns recapture birth wt within

Answer 5

10 days

Question 6

Formula fed newborns recapture birth wt within

Answer 6

7 days

Question 7

Normal Weight Range

Answer 7

Doubles at 5 months, Triples at 12 months and Quadruples at 2 to 2.5 years of age (based on weight at birth).

Question 8

Normal Length Range:

Answer 8

46-54 cm (18-22 inches )

Question 9

Normal Length Range:
Average (50th Percentile)

Answer 9

49 cm (19.2 in.) for females and 50 cm (19.6 in.) for males

Question 10

Second important determinant in relation to weight in confirming a healthy newborn

Answer 10

Length

Question 11

Normal Head Circumference Range:

Answer 11

34-35 cm (13.5 to 14 in.)

Question 12

Normal Chest Circumference Range:

Answer 12

32-33 cm (12.6 to 13 in.)

Question 13

Usually 2 to 3 cm smaller than the head

Answer 13

Chest Circumference

Question 14

Normal Abdominal Circumference Range:

Answer 14

32-33 cm (12.6 to 13 in.)

Question 15

Blood Pressure

Answer 15

Approximately 80/46 mmHg at birth and rises to about 100/50 mm Hg by the 10th day.

Question 16

Not routinely measured unless a cardiac anomaly is suspected.

Answer 16

Blood Pressure

Question 17

For an accurate reading, the cuff width used ___________________________________________________________________________________

Answer 17

must be no more than two thirds the length of the upper arm or thigh

Question 18

TEMPERATURE:

Answer 18

36.5 °C– 37 °C (97.7 °F- 98.6°F)

Question 19

PULSE

Answer 19

110-160 beats per minute

Question 20

Slightly irregular due to immaturity of the cardiac regulatory center in the medulla.

Answer 20

PULSE

Question 21

_____________________ may result from the incomplete closure of fetal circulation shunts.

Answer 21

Transient murmurs

Question 22

Transient murmurs may result from the

Answer 22

incomplete closure of fetal circulation shunts.

Question 23

When crying, pulse usually elevates to

Answer 23

180 bpm and decreases to 90 to 110 bpm during sleep.

Question 24

_________________________ pulses are palpable compared to radial and temporal pulses which are more difficult to palpate with any degree of accuracy.

Answer 24

Brachial and femoral

Question 25

Newborn’s heart rate is always determined by listening for an ____________________ for a full minute, rather than assessing a pulse in an extremity.

Answer 25

apical heartbeat

Question 26

Always palpate for ______________________

Answer 26

femoral pulses

Question 27

RESPIRATION

Answer 27

30 to 60 breaths per minute (at rest)

Question 28

Irregular respiratory depth, rate, and rhythm

Answer 28

NORMAL

Question 29

Respirations are observed most easily by watching the movement of a newborn’s _____________________, because breathing primarily involves the use of the ___________________________________________

Answer 29

abdomen; diaphragm and abdominal muscles

Question 30

are present at birth to clear the airway

Answer 30

Coughing and sneezing reflexes

Question 31

Newborns are obligate

Answer 31

nose-breathers

Question 32

may be beneficial to a newborn.

Answer 32

Short periods of crying, which increase the depth of respirations and aid in aerating deep portions of the lungs

Question 33

APGAR meaning

Answer 33

Apperance, Pulse, Grimace, Activity, Respiration

Question 34

Proponent of APGAR SCREENING TEST:

Answer 34

Dr. Virginia Apgar

Question 35

Used to evaluate the prognosis of a newborn to determine if there is adjustment on extrauterine life.

Answer 35

APGAR SCREENING TEST

Question 36

APGAR SCREENING TEST is done

Answer 36

twice at 1 and 5 minutes respectively

Question 37

The Newborn Maturity Rating and Classification

Answer 37

BALLARD’S ASSESSMENT OF GESTATIONAL AGE

Question 38

A. Physical Maturity 6 categories

Answer 38

1. Skin 2. Lanugo 3. Plantar creases 4. Breast buds 5. Ears 6. Genitals

Question 39

Neuromuscular Maturity 6 Categories:

Answer 39

1. Posture 2. Square window (measurement of wrist angle with flexion toward forearm until resistance is met) 3. Arm recoil (extension and release of arm after arm is completely flexed and held in position for approximately 5 seconds) 4. Popliteal angle (measurement of knee angle on flexion of thigh with extension of lower leg until resistance is met). 5. Scarf sign (arm pulled gently in front of and across top portion of body until resistance is met). 6. Heel to ear (movement of foot to near the head as possible)

Question 40

measurement of wrist angle with flexion toward forearm until resistance is met

Answer 40

Square window

Question 41

extension and release of arm after arm is completely flexed and held in position for approximately 5 seconds

Answer 41

Arm recoil

Question 42

measurement of knee angle on flexion of thigh with extension of lower leg until resistance is met

Answer 42

Popliteal angle

Question 43

arm pulled gently in front of and across top portion of body until resistance is met

Answer 43

Scarf sign

Question 44

movement of foot to near the head as possible

Answer 44

Heel to ear

Question 45

Mucus is removed using a ____________________________________________________ only when necessary

Answer 45

bulb syringe and/or with a suction catheter

Question 46

Never suction vigorously---- Why?

Answer 46

1. to prevent irritation of mucous membranes 2. to prevent infection 3. to prevent bradycardia due to vagal nerve stimulation.

Question 47

an excellent way to meet the needs of the newborn and provide family-centered care

Answer 47

Kangaroo care

Question 48

If a clamp loosens before thrombosis obliterates the umbilical vessels, ____________________ could result.

Answer 48

hemorrhage

Question 49

Count number of cord vessels after cutting:

Answer 49

AVA- 2 arteries, 1 vein

Question 50

diapers are folded ______________________________, so that, when the diaper becomes wet, the cord does not become wet as well.

Answer 50

below the level of the umbilical cord

Question 51

Newborns receive prophylactic eye treatment to prevent _____________________________

Answer 51

ophthalmia neonatorum

Question 52

a severe eye infection contracted in the birth canal of a woman with gonorrhea or chlamydia.

Answer 52

ophthalmia neonatorum

Question 53

Three ophthalmic agents that have been approved for eye prophylaxis:

Answer 53

1% silver nitrate, 0.5% erythromycin, and 1% tetracycline

Question 54

VITAMIN K ADMINISTRATION

Answer 54

1.0 mg of vitamin K, administered IM within the first hour of life to prevent bleeding problems.

Question 55

VITAMIN K ADMINISTRATION Possible adverse reactions:

Answer 55

Local irritation, such as pain and swelling at the site of injection.

Question 56

Administer IM injection into large muscle

Answer 56

(anterolateral muscle of a newborn’s thigh)

Question 57

Assess for signs of bleeding

Answer 57

black, tarry stools, hematuria, decreased hemoglobin and hematocrit levels, and bleeding from any open wounds or base of the cord

Question 58

All newborns receive a first vaccination against

Answer 58

hepatitis B within 12 hours after birth

Question 59

Infants whose mothers are positive for the hepatitis B surface antigen (HBsAg) also receive ______________________________ at birth

Answer 59

hepatitis B immune globulin (HBIG)

Question 60

Bath water should be approximately ________________________________, a temperature that feels pleasantly warm to the elbow or wrist.

Answer 60

98° to 100° F (37° to 38° C)

Question 61

soap should be mild and without a __________________ base

Answer 61

hexachlorophene

Question 62

Bathing should proceed from the ______________________________________________________ of the body—that is, from the __________________________________________________________

Answer 62

cleanest to the most soiled areas; eyes and face to the trunk and extremities and, last, to the diaper area

Question 63

Eyes: Wipe with clear water from the ________________________________, using a clean portion of the washcloth for each eye

Answer 63

inner canthus outward

Question 64

serves as a lubricant and is protective against infections

Answer 64

Vernix

Question 65

Remains the ideal nutritional source for infants through the first year of life

Answer 65

BREASTFEEDING

Question 66

A thin, watery, yellow fluid composed of protein, sugar, fat, water, minerals, vitamins, and maternal antibodies.

Answer 66

COLOSTRUM

Question 67

COLOSTRUM is secreted starting in the

Answer 67

fourth month of pregnancy.

Question 68

COLOSTRUM production continues for the

Answer 68

first 3 or 4 days after birth.

Question 69

high in protein and fairly low in sugar and fat, making it easy to digest and capable of providing adequate nutrition for a newborn until it is replaced by transitional breast milk on the second to fourth day.

Answer 69

COLOSTRUM

Question 70

True or mature breast milk is produced by the

Answer 70

10th day

Question 71

______________________________________________ is an acceptable position

Answer 71

Placing the baby over one shoulder and gently patting or stroking the back

Question 72

is often the best position to use for burping

Answer 72

Holding the baby in a sitting position on the lap, then leaning the child forward against one hand, with the index finger and thumb supporting the heads