Flashcards in Newborn Adaptation Deck (59):
First breath of NB should occur within what timeframe after birth?
within 1 minute
What is the normal RR for a NB?
How long do you count a NB's RR for?
60 seconds, may be irregular
What are the "bypass vessels" in a NB?
- ductus venosus
- ductus arteriosus
- foramen ovale
How many arteries and veins are in the umbilical cord?
2 arteries, 1 vein
Which vessels carry blood from the fetus to the placenta?
umbilical arteries carrying de-oxygenated blood
Which vessels carry blood from the placenta to the fetus?
umbilical veins carrying oxygenated blood
Which vessel bypassed the liver and takes blood into the inferior vena cava in a fetus?
Which vessel shunts blood from the pulmonary artery to the aorta in a fetus?
Which vessel shunts blood from the right atrium to the left atrium in a fetus?
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.
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
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
How long after birth does is take for the ductus venosus close permanently?
The ductus venosus becomes what vessel after its closure?
Functional closure of the foramen ovale occurs how long after birth?
The foramen ovale becomes _____ by ______ after birth?
1) fossa ovalis
2) 6 months to 1 yr
Initial closure of the ductus arteriosus occurs within ____, and permanently closes ______
1) within 15 hrs
2) in 3 weeks
What is a normal (1) NB HR, (2) when sleeping and (3) crying?
1) 110 - 160
What is acrocyanosis?
bluish coloration of the hands and feet, disappears with cry
Infant response to hypothermia (cold stress)?
- increase O2 consumption and RR
- increase anaerobic glycolysis = metabolic acidosis
Infant response to hyperthermia?
vasodilation, some perspiration, increase o2 consumption and increase BMR
What is the usual cause of a transitory fever in a NB?
Normal NB temp:
1) 97.5 - 98.9 F or 36.5 - 37.2 C
2) 97.5 - 98.6 F or 36.5 - 37.0 C
Rectal thermometer should be inserted how far for a NB?
< 1/2 inch
How many we diapers should an NB have by the end of their 1st week?
A brick red stain on a diaper may indicate what?
- uric acid due to small intake
- differentiate from blood
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
What is Meconium?
- tar like, thick, sticky, black green poop containing instestinal tract cells, bile pigment and amniotic fluid
- occurs within 24-36 hrs
Patient teaching for how to clean meconium on a NB?
Description of the transitional stool color for a NB?
green-black to green brown to brownish yellow to yellow
When should Iron supplementation begin for a NB?
at 6 months
When, why and how should vitamin K be given to a NB?
IM within 1st hr to help with coagulation
Stool characteristics for:
1) formula fed
2) breast fed
1) more formed, brown to dark in color
2) watery, yellow color and mustard like
Where is glycogen stored?
in the liver
What is the glucose level for a NB:
1) at 4 hrs
2) at 3 days
1) 50 - 60
2) 60 - 70
What are the different types of neonatal jaundice?
- breastfeeding (early onset)
- breast milk (late onset)
Physiologic jaundice in a fullterm NB?
- appears after 24 hrs
- peaks on 3rd day
- disappears after 7th day
Physiologic jaundice in a preterm NB?
- appears after 48 hrs
- peaks on 5th day
- disappears after 10th day
Breastfeeding (early onset) jaundice?
- begins 2-4 days
- breast not milk jaundice, baby may not be latching on appropriately or not feeding well
To prevent breastfeeding jaundice, encourage the mother to nurse _____
8 or more times a day
What is the term for the first bit of breast milk?
Effects of colostrum on the NB?
laxative effect, promotes meconium passage and lowers bilirubin levels
Breast milk jaundice?
- develops at 3-5 days and peaks around 2nd week
- may last 3-12 weeks
Treatment for breast milk jaundice?
none needed, don't D/C breast feeding
Antibody that can cross the placenta?
IgM is produced at what time in a fetus?
How are IgA antibodies passed to the infant?
through the colostrum from the mother to the NB
When should immunizations be started for NB?
Bluish coloration around the mouth of a NB?
Circumoral cyanosis, disappears by day 10, observe at feedings
Benign bluis pigmentation over the back, buttocks and lower legs in darker races?
mongolian spots, disappear in approx 2 yrs
What is a pigmented nevi?
Yellow to black pigmentation on the skin or a mole
Tx for Erythema Toxicum Neonatorum?
none, disappears in 48 -72 hrs
lotion like substance with a cheesy appearance that protects skin of fetus from amniotic fluid?
tiny white papules over the nose and cheeks of a NB caused by obstructed or destended sebaceous glands and its tx?
- no tx needed, is self limiting
Flat purple discoloration usually on the face, a.k.a "port wine stains"?
Nevus Flammeus - do not enlarge or fade
When does the anterior fontanel close?
at 12-18 months
When does the posterior fontanel close?
8 - 12 weeks