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Flashcards in Newborn Adaptation Deck (59):
1

First breath of NB should occur within what timeframe after birth?

within 1 minute

2

What is the normal RR for a NB?

30-60/min

3

How long do you count a NB's RR for?

60 seconds, may be irregular

4

What are the "bypass vessels" in a NB?

- ductus venosus
- ductus arteriosus
- foramen ovale

5

How many arteries and veins are in the umbilical cord?

2 arteries, 1 vein

6

Which vessels carry blood from the fetus to the placenta?

umbilical arteries carrying de-oxygenated blood

7

Which vessels carry blood from the placenta to the fetus?

umbilical veins carrying oxygenated blood

8

Which vessel bypassed the liver and takes blood into the inferior vena cava in a fetus?

ductus venosus

9

Which vessel shunts blood from the pulmonary artery to the aorta in a fetus?

ductus arteriosus

10

Which vessel shunts blood from the right atrium to the left atrium in a fetus?

foramen ovale

11

Describe the process for closing the foramen ovale after birth?

- air fills the alveoli, expanding them and decreasing resistance and pressure in lungs
- blood from the right side of heart can now go to the lungs, decreasing the pressure in the right atrium and increasing the pressure in the left atrium.

12

What happens in response to the release of bradykinin from the lungs after expansion in a NB?

causes constriction of the ductus arteriosus after mixing with O2 in the blood

13

How is the ductus venosus closed in a NB after birth?

clamping of the umbilical cord stops blood flow through the ductus arteriosus causing its constriction

14

How long after birth does is take for the ductus venosus close permanently?

1 week

15

The ductus venosus becomes what vessel after its closure?

ligamentum venosum

16

Functional closure of the foramen ovale occurs how long after birth?

1-2 hrs

17

The foramen ovale becomes _____ by ______ after birth?

1) fossa ovalis
2) 6 months to 1 yr

18

Initial closure of the ductus arteriosus occurs within ____, and permanently closes ______

1) within 15 hrs
2) in 3 weeks

19

What is a normal (1) NB HR, (2) when sleeping and (3) crying?

1) 110 - 160
2) 100
3) 180

20

What is acrocyanosis?

bluish coloration of the hands and feet, disappears with cry

21

Infant response to hypothermia (cold stress)?

- increase O2 consumption and RR
- vasoconstriction
- increase anaerobic glycolysis = metabolic acidosis

22

Infant response to hyperthermia?

vasodilation, some perspiration, increase o2 consumption and increase BMR

23

What is the usual cause of a transitory fever in a NB?

- dehydration

24

Normal NB temp:
1) axillary
2) rectal

1) 97.5 - 98.9 F or 36.5 - 37.2 C
2) 97.5 - 98.6 F or 36.5 - 37.0 C

25

Rectal thermometer should be inserted how far for a NB?

< 1/2 inch

26

How many we diapers should an NB have by the end of their 1st week?

6

27

A brick red stain on a diaper may indicate what?

- uric acid due to small intake
- differentiate from blood

28

What is the stomach capacity for a NB:
1) at birth
2) by day 3-4

1) 40 - 40 mL
2) up to 90 mL

29

What is Meconium?

- tar like, thick, sticky, black green poop containing instestinal tract cells, bile pigment and amniotic fluid
- occurs within 24-36 hrs

30

Patient teaching for how to clean meconium on a NB?

use vaseline

31

Description of the transitional stool color for a NB?

green-black to green brown to brownish yellow to yellow

32

When should Iron supplementation begin for a NB?

at 6 months

33

When, why and how should vitamin K be given to a NB?

IM within 1st hr to help with coagulation

34

Stool characteristics for:
1) formula fed
2) breast fed

1) more formed, brown to dark in color
2) watery, yellow color and mustard like

35

Where is glycogen stored?

in the liver

36

What is the glucose level for a NB:
1) at 4 hrs
2) at 3 days

1) 50 - 60
2) 60 - 70

37

What are the different types of neonatal jaundice?

- physiologic
- breastfeeding (early onset)
- breast milk (late onset)

38

Physiologic jaundice in a fullterm NB?

- appears after 24 hrs
- peaks on 3rd day
- disappears after 7th day

39

Physiologic jaundice in a preterm NB?

- appears after 48 hrs
- peaks on 5th day
- disappears after 10th day

40

Breastfeeding (early onset) jaundice?

- begins 2-4 days
- breast not milk jaundice, baby may not be latching on appropriately or not feeding well

41

To prevent breastfeeding jaundice, encourage the mother to nurse _____

8 or more times a day

42

What is the term for the first bit of breast milk?

colostrum

43

Effects of colostrum on the NB?

laxative effect, promotes meconium passage and lowers bilirubin levels

44

Breast milk jaundice?

- develops at 3-5 days and peaks around 2nd week
- may last 3-12 weeks
- rare

45

Treatment for breast milk jaundice?

none needed, don't D/C breast feeding

46

Antibody that can cross the placenta?

IgG

47

IgM is produced at what time in a fetus?

26 weeks

48

How are IgA antibodies passed to the infant?

through the colostrum from the mother to the NB

49

When should immunizations be started for NB?

3 months

50

Bluish coloration around the mouth of a NB?

Circumoral cyanosis, disappears by day 10, observe at feedings

51

Benign bluis pigmentation over the back, buttocks and lower legs in darker races?

mongolian spots, disappear in approx 2 yrs

52

What is a pigmented nevi?

Yellow to black pigmentation on the skin or a mole

53

Tx for Erythema Toxicum Neonatorum?

none, disappears in 48 -72 hrs

54

lotion like substance with a cheesy appearance that protects skin of fetus from amniotic fluid?

vernix caseosa

55

tiny white papules over the nose and cheeks of a NB caused by obstructed or destended sebaceous glands and its tx?

- Milia
- no tx needed, is self limiting

56

Flat purple discoloration usually on the face, a.k.a "port wine stains"?

Nevus Flammeus - do not enlarge or fade

57

When does the anterior fontanel close?

at 12-18 months

58

When does the posterior fontanel close?

8 - 12 weeks

59

How long and how often do NBs sleep?

16-20 hrs a day for 7/8 periods