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[Crash Course] NCLEX-RN (7) Maternity > Newborn > Flashcards

Newborn Flashcards

Review APGAR, fontanels, birthmarks, normal and abnormal findings, jaundice, reflexes, and complications. (68 cards)

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1
Q

What is an APGAR assessment?

A

An APGAR assessment is done on the newborn at 1 minute and 5 minutes after birth to assess for immediate complications.

It is done more often if there are complications.

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2
Q

What is the highest and best score a newborn can get for an APGAR score?

A

Highest APGAR score = 10

Many newborns get a 9 due to cyanotic feet or hands.

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3
Q

What are the 5 categories of an APGAR assessment?

A
  1. Activity/muscle tone
  2. Pulse
  3. Grimace/response to stimulation
  4. Appearance/skin color
  5. Respiration effort
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4
Q

What is the possible score for each APGAR category?

A

The newborn can be assigned a 0, 1 or 2 for each category of APGAR.

  • 0 is the worst score
  • 2 is the best score
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5
Q

What is the scoring for APGAR Activity/muscle tone?

A
  • 0 = flaccid/limp
  • 1 = minimal flexion
  • 2 = good flexion/active
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6
Q

What is the scoring for APGAR Pulse?

A
  • 0 = absent
  • 1 = < 100 beats/minute
  • 2 = >100 beats/minute
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7
Q

What is the scoring for APGAR Grimace/response to stimulation?

A
  • 0 = absent
  • 1 = grimace to suction or slap on soles of feet
  • 2 = responds promptly with cry or active movement
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8
Q

What is the scoring for APGAR Appearance/skin color?

A
  • 0 = pallor or cyanosis (blue color)
  • 1 = cyanotic extremities
  • 2 = all normal color / pink
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9
Q

What is the scoring for APGAR Respiration effort?

A
  • 0 = absent
  • 1 = slow and weak
  • 2 = vigorous cry and respirations between 30 - 60
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10
Q

What are the 2 interventions immediately following the birth of a newborn?

A
  1. suction mouth and nares with a bulb syringe
  2. dry the newborn and stimulate crying by rubbing the back
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11
Q

How is cold stress avoided in a newborn?

A
  • dry infant immediately
  • place skin-to-skin contact on mom
  • put hat on baby

If client is not available, wrap baby in blankets and place in warmer.

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12
Q

What is a normal heart rate for a newborn?

A

Heart rate for newborn: 120 - 160

  • if sleeping: down to 80 beats/minute
  • if crying: up to 180 beats/minute
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13
Q

What are normal respirations for a newborn?

A

Respirations for newborn: 30 - 60 breaths/minute

Irregular breathing is common.

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14
Q

What is a normal temperature for a newborn?

A

Normal temperature for a newborn: 96.8oF - 99oF (37oC - 37.2oC)

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15
Q

Where is the anterior fontanel of a newborn located?

A

Anterior fontanel is located on the top of the head.

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16
Q

Where is the posterior fontanel of a newborn located?

A

Posterior fontanel is located on the back of the head.

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17
Q

When does the anterior fontanel close on a newborn?

A

The anterior fontanel closes between 12 and 18 months of age.

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18
Q

When does the posterior fontanel close on a newborn?

A

The posterior fontanel closes between birth and 3 months.

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19
Q

What is caput succedaneum?

A

Caput succedaneum is edema of soft tissue over bone on the newborn’s head.

It crosses the suture line and subsides within a few days.

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20
Q

What is cephalhematoma?

A

Cephalhematoma is swelling on the head caused by bleeding.

It does not cross the suture line. It is usually absorbed by 6 months and does need treatment.

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21
Q

What is thrush?

A

Thrush is a fungal infection in the newborn’s mouth. It looks like white, patchy areas in the mouth.

It may clear up in a few days. If it doesn’t, oral antifungal medicine will be given.

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22
Q

What is vernix caseosa?

A

Vernix caseosa is a normal finding of a cheesy-white looking substance covering a newborn’s skin.

It’s a protective cover over the skin from amniotic fluid.

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23
Q

What does a stork bite birthmark look like?

A

Stork bite birthmark looks like a red patch.

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24
Q

What does a port-wine stain birthmark look like?

A

A port wine stain birthmark looks like a dark red patch.

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25
What does a **strawberry birthmark** (or **hemangioma**) look like?
Strawberry birthmark (hemangioma) looks like a **dark red patch**.
26
What does a **mongolian spot birthmark** look like?
Mongolian spot birthmark looks like **purple-blue patches usually on the sacrum.**
27
What is **lanugo**?
Lanugo is fine **body hair on a newborn**. ## Footnote *It is found on term infants (39 weeks and later) and helps to hold vernis caseosa on the skin which protects it from amniotic fluid.*
28
How many **vessels** should the **umbilical cord** have and what are they?
A normal umbilical cord should have **3 vessels:** * 2 arteries * 1 vein
29
What should be **assessed** after circumcision?
bleeding and urinary retention
30
What is the **first stool** of a newborn?
The first stool of a newborn is **meconium: it is black and tarry.**
31
When should the **first stool pass (meconium)**?
The first stool should pass **within 24 hours of being born.**
32
What do the baby's **first stools** look like after the meconium has passed?
The baby's first stools are **yellow and look like there are small seeds** in it.
33
What is **physiological jaundice**?
Physiological jaundice is an **increase in bilirubin that causes yellowing of the skin**. It is caused by an immature liver. ## Footnote ***It occurs after 24 hours** and is a mild and common condition.*
34
# Immediate complication What is **pathological jaundice**?
Pathological jaundice is an **increase in bilirubin and yellowing of the skin.** It is caused by a hemolytic disease such as Rh incompatibility or liver disease. ## Footnote ***It occurs before 24 hours** and is a serious life-threatening condition.*
35
What is the **pathophysiology of jaundice** in a newborn?
Jaundice is from an **increase of bilirubin in the blood**. Bilirubin is a waste product of **red** blood cells and is a **yellow** color. The liver is unable to get rid of the bilirubin.
36
# Lab value: **bilirubin** in a newborn born at term (not premature)
**\< 12 mg/dL (180 mcmol/)**
37
What **complication** can occur if jaundice is not treated?
**Brain damage** can occur if jaundice in the newborn is not treated. ## Footnote *High levels of bilirubin can enter the newborn's brain and cause toxicity.*
38
What are the **interventions** for jaundice in a newborn?
1. **frequent feedings** * to flush bilirubin out 2. **phototherapy** * light makes it easier for liver to break down and remove bilirubin 3. **vitamin K injection** * to prevent bleeding disorders from an immature liver
39
In how many days after birth should the **birth weight be regained** by the newborn?
**10 - 14 days after birth.**
40
Do **newborns shiver** when they are cold?
**No** *Newborns do NOT shiver when they are cold.*
41
How do **newborns keep warm**?
Newborns have **brown fat deposits** that keep them warm. They also should be wrapped in a blanket with a hat on.
42
What is the **sucking (rooting) reflex**?
An automatic response by the newborn when they **turn their face toward the stimulus and make a sucking or rooting motion with the mouth** when the cheek or lip is touched. ## Footnote *The rooting reflex helps to ensure successful breastfeeding.*
43
What is the **swallowing reflex**?
An automatic response by the newborn to **swallow without gagging or coughing**.
44
What is the **tonic neck (fencing) reflex**?
An automatic response by the newborn when the **arm is extended and the face points in that direction**. ## Footnote *Reflex goes away at about 4 months old.*
45
What is the **palmar grasp reflex**?
An automatic response by the newborn when an object is placed in the infant's hand and they **involuntary grasp it tightly**. ## Footnote *Reflex goes away between 3 - 6 months old.*
46
What is the **moro (startle) reflex**?
An automatic response by the newborn when the **arms go out to the sides if they feel like they are falling**.
47
What is the **babinski reflex**?
An automatic response by the newborn when the sole of the foot is firmly stroked. The **big toe then moves upward or toward the top surface of the foot. The other toes fan out.**
48
What is the parent teaching on how to **bathe a newborn**?
1. keep room warm * *cold rooms cause too much oxygen demand* 2. use a mild soap 3. clean from the cleanest spot to the dirtiest spot last 4. clean eyes from inner to outer area 5. dress in layers and put a hat on baby
49
How should an **uncircumcised** baby be cleaned?
* there is no special cleaning * never pull on foreskin or underneath foreskin * clean with mild soap and water
50
What are the safety measures for a newborn in a hospital to **prevent infant abduction**?
* ID bracelet is applied to both mom and baby * every person caring for baby must have ID on * baby is wheeled in a bassinet when leaving the room, never carried by staff
51
What is the gestational age for a **preterm newborn**?
**\< 37 weeks**
52
What is the gestational age for a **post-term baby**?
**\> 42 weeks**
53
What is the **most common complication** of a post-term newborn?
The most common complication of a post-term newborn is **hypoglycemia**. ## Footnote *Infant does not have enough stored glucose at birth.*
54
# Immediate complication What can **cause** respiratory distress syndrome in an infant?
Respiratory distress syndrome is caused by the newborn **unable to produce enough surfactant**. It can occur in preterm infants. ## Footnote *Surfactant helps open up the lungs to breathe better.*
55
# Medications: respiratory distress syndrome in an infant
give surfactant through the ET tube
56
# Describe: Meconium aspiration syndrome ## Footnote *Immediate complication*
Meconium aspiration syndrome is when **meconium gets into the lungs** and causes respiratory distress and/or pneumonia.
57
# Interventions: Meconium aspiration syndrome
* oxygen * antibiotics * ventilator if severe
58
# Describe: **Dysplasia**
Dysplasia is **chronic inflammation of the lungs** when the newborn has been oxygen dependent for more than a month.
59
# Medications: **Dysplasia**
* surfactant * bronchodilators * steroids
60
# Describe: Erythroblastosis fetalis
Erythroblastosis fetalis is when the **red blood cells get destroyed** due to an Rh incompatibility.
61
# Treatment: Erythroblastosis fetalis
give **Rh-negative blood** infusions to the infant
62
# Describe: **Addicted newborn** and **fetal alcohol spectrum disorders**
Addicted newborn and fetal alcohol spectrum disorders is when the infant is born **addicted to alcohol or other substances**. ## Footnote *The infant is highly irritated and has an increase in metabolism.*
63
# Interventions: **Addicted newborn** and **fetal alcohol spectrum disorders**
* wrap baby snuggly * seizure precautions * reduce stimulation * let mom express guilt and encourage treatment for mom
64
What are the **priority assessments** of a newborn from a diabetic mother?
* assess for respiratory distress * assess blood sugar ## Footnote *Increased insulin from mother can cause delayed production of surfactant, which is needed for lung development*
65
# Lab value: blood glucose in a one day old infant
**40 - 60 mg/dL (2.3 mmol/L)**
66
# Interventions: **Hypoglycemic newborn**
* feed baby * give glucose if needed
67
# Immediate complication What are the **steps** for CPR on an infant?
1. check for pulse with brachial artery 2. use 2 fingers or 2 thumbs for chest compressions 3. go down 1 1/2 inches (2 cm) for compressions * 1 rescuer: 30 compressions then 2 breaths * 2 rescuers: 15 compressions and then 2 breaths *Click [HERE](http://www.youtube.com/watch?v=I3pvuYMcPg4) for an instructional video on infant CPR and Choking*
68
# Immediate complication What are the **steps** for a choking infant?
**Steps for a choking infant:** 1. hold infant face down with head lower than feet 2. support head and jaw 3. give 5 back slaps 4. then put baby face up and give 5 chest thrusts 5. repeat until obstruction clears *Click [HERE](http://www.youtube.com/watch?v=I3pvuYMcPg4) for an instructional video on infant CPR and Choking*

[Crash Course] NCLEX-RN (7) Maternity (5 decks)

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