MCN Newborn 1 Flashcards
(110 cards)
1
Q
average weight of a newborn
A
6.5 to 7.5 lbs (2.9 kg to 3.4 kg
2
Q
average chest circumference of a newborn
A
31-33 cm or 2 cm less than head circumference
2
Q
average length of a newborn
A
50 cm (20 in)
2
Q
average head circumference of a newborn
A
33 to 35 cm (13 to 13.7 in)
3
Q
average abdominal circumference of a newborn
A
31-33 cm
4
Q
average temperature of a newborn
A
36.5 - 37.2
5
Q
average pulse of a newborn at birth
A
180 bpm
6
Q
average rr of a newborn immediately at birth
A
80 cmp
7
Q
average pulse of a newborn after birth
A
120-140 bpm
8
Q
average rr of a newborn after birth
A
30-50 cpm
9
Q
average bp of a newborn immediately at birth
A
80/46 mmHg
10
Q
average bp of a newborn after birth by the 10th day
A
100/50 mmHg
11
Q
Newborns loose heat by four separate mechanisms:
A
convection, conduction, radiation, and evaporation
12
Q
flow of heat from newborn’s body surface to surrounding air
A
CONVECTION
13
Q
effectiveness depends on velocity of flow (a current of air cools faster than nonmoving air)
A
CONVECTION
14
Q
eliminating ____ from windows or air conditioners reduces convection heat loss
A
drafts
15
Q
transfer of body heat to a cooler solid object in contact with a baby
A
CONDUCTION
16
Q
a baby placed on a cold counter or on cold base of a warming unit quickly loses heat to the colder metal surface
A
CONDUCTION
17
Q
____ helps to minimize conduction heat loss
A
covering surfaces with a warmed blanket or towel
18
Q
transfer of body heat to a cooler solid object not in contact with the baby, such as a cold window or air conditioner
A
RADIATION
19
Q
moving an infant as far from the cold surface as possible helps reduce this type of heat loss
A
RADIATION
20
Q
loss of heat through conversion of a liquid to a vapor
A
EVAPORATION
21
Q
newborns are wet, so they lose a great deal of heat as ____ on their skin evaporates
A
amniotic fluid
22
Q
to prevent this heat loss, dry newborns as soon as possible, especially their face and hair as head, a large surface area in a newborn, can be responsible for a great amount of heat loss
A
EVAPORATION
23
____ after drying further reduces possibility of evaporation
covering head with a cap
24
what are the two umbilical blood vessels?
one umbilical vein, two umbilical arteries
24
as lungs inflate for the 1st time, pressure decreases in ____
pulmonary artery
25
also called fetal shunt
ductus arteriosus
26
is a blood vessel that connects the pulmonary artery and the aorta in a fetus
ductus arteriosus
27
pressure increases in left side of the heart from increased blood volume causes closure of the ____
foramen ovale
28
newborn blood volume
80 to 110 mL/k BW, or about 300 mL total
29
newborn Hb
17 to 18 g/100 mL of blood
30
newborn Hct
45% and 50%
30
newborn RBC
6M cells/m3
31
newborn WBC
15,000 to 30,000 cells/mm3
32
prolonged coagulation or prothrombin time due to ____
decreased vit K
33
vit K is synthesized through action of ____
intestinal flora
34
newborn’s intestine is sterile at birth & it takes ____ hours for flora to accumulate and for vitamin K to be synthesized
24
35
newborn’s intestine is ____ at birth
sterile
36
necessary for formation of clotting factors ____ and ____
FII (prothrombin)
FVII (proconvertin)
37
____ is usually administered IM into lateral anterior thigh immediately after birth for blood coagulation
vit K
38
first breath is a major undertaking because it requires a tremendous amount of pressure (about ____ to ____ cm H2O)
about 40 to 70 cm H2O
39
first breath is initiated by
lowered partial pressure of oxygen (PO2), which falls from 80-15 mm Hg before a first breath
increased partial carbon dioxide pressure (PCO2), which rises to 70 mmHg before a first breath
all newborns have some fluid in their lungs from intrauterine life that will ease surface tension on alveolar walls and allows alveoli to inflate more easily than if the lung walls were dry
a third of this fluid is forced out of the lungs bypressure of vaginal birth
additional fluid is absorbed by lung blood vessels and lymphatics after first breath
40
gastrointestinal tract is usually ____ at birth
sterile
41
bacteria may be cultured from the intestinal tract in most babies within ___ hours after birth and from all babies at 24 hours of life
5
42
most of gastrointestinal bacteria enter the tract through newborn’s mouth from ____, from ____ at birth, from ____, and from ____
from airborne sources, from vaginal secretions at birth, from hospital bedding, and from contact at the breast
43
accumulation of bacteria in the gastrointestinal tract is necessary for digestion and for the synthesis of ____
vitamin K
44
____ is usually passed within 24 hours after birth
meconium
45
sticky, tar- like, blackish-green, odorless material formed from mucus, vernix, lanugo, hormones, and carbohydrates that accumulated during intrauterine life
meconium
46
fourth day, breastfed babies pass three or four light yellow stools per day.
transitional stool
46
if a newborn does not pass a meconium stool by 24 to 48 hours after birth, the possibility of ____, ____, or ____ should be suspected
meconium ileus, imperforate anus, or volvulus
47
second or third day of life, newborn stool changes becoming green and loose
transitional stool
47
average newborn voids within ____ hours after birth
24
47
a newborn who ____ for the first 24 hours may void later than this, but the 24-hour point is a good general rule
does not take in much fluid
48
newborns who do not void within 24 hours or more should be examined for the possibility of ____ or ____
urethral stenosis or absent kidneys or ureters
49
newborns are prone to infection because they have difficulty forming ____ until about ___ months of age
antibodies, 2
50
newborns are born with passive antibodies called
immunoglobulin G
51
immunoglobulin G of newborns is from
their mother that crossed the placenta
52
immunoglobulin G include antibodies against
poliomyelitis, measles, diphtheria, pertussis, chickenpox, rubella, and tetanus
53
place your fingers into the baby's hands and press against the palmar surfaces. the baby will flex all fingers to grasp your fingers
palmar grasp reflex
54
stroke the perioral skin at the corers of the mouth. the mouth will open and the baby will turn the head toward the stimulated side and suck
rooting reflex
54
touch the sole at the base of the toes. the toes curl.
plantar grasp reflex
55
hold the baby supine, support-ing head, back, and legs. abruptly lower the entire body about 2 feet. the arms abduct and exextend, hands open, and legs may flex.
moro reflex
56
with the baby supine, turn head to one side, holding jaw over shoulder. the arms/legs on side to which head is turned extend while the opposite arm/leg flex.
asymmetric tonic neck reflex
57
support the baby prone with one hand, and store one side of the back 1 cm from shoulder to buttocks. the spine will curve toward the stimulated side.
trunk incurvation (Galant's reflex)
58
suspend the baby prone with one hand. the head will lift up, and the spine will straighten
Landau reflex
59
suspend the baby prone and slowly lower the head toward a surface. the arms and legs will extend in a protective fashion
parachute reflex
60
hold baby around the truck and lower until the feet touch a flat surface. the hips, knees, and ankles extend, the baby stands, partially bearing weight, sags after 20-30 secs.
support reflex
61
hold baby uprght as in positive support reflex. have one sole touch the table-top. the hip and knee of that foot will flex and the other will step forward. alternate stepping will occur.
placing and stepping reflexes
62
begins in utero and is acute after birth
HEARING
63
blinking at strong light or following a bright light
VISION
64
well developed sense. Reacts to soothing touch and painful stimuli
TOUCH
65
taste buds are developed and functioning; like sweets better
TASTE
66
____ complexion due to increased concentration of RBC
Ruddy complexion
67
Generalized mottling of the skin
Cyanosis
68
Blueness of the hands and feet
Acrocyanosis
69
Cyanosis of the trunk
Central cyanosis
70
happens when there is too much bilirubin in your baby's blood
Hyperbilirubinemia
71
Yellow discoloration of skin
Jaundice
72
caused by breakdown of RBCs after birth
Jaundice
73
most jaundice in newborns is _____
physiologic
73
2 types of jaundice
Physiologic jaundice (2nd to 3rd day)
Pathologic jaundice (1st 24 hours)
73
physiologic jaundice peaks between ____ hours
48-72 hrs
74
physiologic jaundice usually disappears within ____
a week
75
it is prevented from entering the brain by blood brain barrier. but
blood brain barrier isn’t well developed in newborns therefore, bilirubin is ____
neurotoxic
76
Unconjugated bilirubin is also called ____
lipid soluble
77
Unconjugated bilirubin (lipid soluble) could cross the BBB and cause ____ aka ____
encephalopathy (Kernicterus)
78
Causes of Pathologic Jaundice
Excessive hemolysis
-Rh incompatibility
- ABO incompatibility
- G6PD deficiency
Infection
Metabolic/endocrine abnormalities
Delayed defecation/intestinal obstruction
Liver/biliary disease
Spleen pathology
Polycythemia
79
Care to prevent Hyperbilirubinemia
Early feeding
Frequent feeding
Neutral thermal environment
Prevention of hypoglycemia
Prevention of hypoxia
Phototherapy with fluorescent light
80
Infant on Phototherapy adverse effects
Risk of injury to eyes
Risk of injury to gonads
Risk of impaired skin integrity
Risk for fluid volume deficiency
Risk for hyperthermia or hypothermia
Risk of neurological injury
Imbalance nutrition
Parental anxiety
81
Result of anemia
Pallor
81
Nursing care on infant receiving phototherapy
Proper covering and shielding of gonads
Assess skin temperature
Baby is places naked 45 cm away from the tube lights in a crib or incubator
Turn baby every 2 hours or after each feeding
Protect the newborn’s eyes with patches
Maintain adequate hydration and nutrition
Periodic assessment of serum bilirubin levels
81
Cause of newborn of anemia
excessive blood loss when the cord was cut
inadequate flow of blood from cord to infant at birth
fetal-maternal transfusion
low iron stores cause by poor maternal nutrition during pregnancy
blood incompatibility in which a large number of red blood cells were hemolyzed in utero
82
newborn who has been lying on his side appears red on the dependent side of the body and pale on the upper side
Harlequin sign
82
most will fade by school age, although an association between children with ____ and development of childhood cancer exists
Birthmarks
83
it is important to be able to differentiate various types of hemangiomas that occur, so that you neither give false reassurance to parents nor worry them unnecessarily about these lesions
Birthmarks
84
macular purple or dark-red lesion that is present at birth
Nevus Flammeus (port-wine stain)
85
Nevus flammeus lesion that are light and pink patches at the nape of the neck (covered by hairline)
Stork’s beak mark
86
elevated areas formed by immature capillaries and endothelial cells
Strawberry hemangioma
87
Dilated vascular spaces
Cavernous hemangioma
88
Resemble a strawberry hemangioma but does not disappear with time
Cavernous hemangioma
89
Collection of pigment cells that appear as slate-gray patches across the sacrum or buttocks and possibly on arms and legs
Mongolian spots
90
white, cream-cheese like substance that serves as skin lubricant in utero
Vernix Caseosa
91
fine, downy hair that covers a newborn’s shoulders, back, and upper arms, forehead and ears
Lanugo
92
peeling of some areas of the skin similar to a sunburn due to dryness of infant’s skin
Desquamation
93
pinpoint white papule found on cheek or across the bridge of the nose of the newborn
Milia
94
newborn rash caused by newborn’s eosinophils reacting to the environment as immune system matures
Erythema toxicum
95
circular or Linear contusion matching the rim of the blade of the forceps on the infant’s cheek
Disappears 1-2 days
Forceps Mark
96
newborn skin should feel ____ if underlying tissue is well hydrated
resilient
97
signs of severe dehydration
skin remain in an elevated ridge
poor turgor
