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Newborn Care Flashcards

This flashcard deck was created using Flashcardlet's card creator (108 cards)

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0
Q

What must happen in establishment of respiratory function?

A

Fluid in the lungs must be replaced by air

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1
Q

What is the first few hours of life as the neonate stabilizes respiratory and circulatory function?

A

Neonatal transition

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2
Q

How is fluid in the lungs replaced by air?

A

It occurs by mechanical force or “squeezing”

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3
Q

Where is the fluid in the lungs absorbed?

A

Into the interstitial tissue, lymphatics and vascular system

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4
Q

How much fluid is in the lungs at birth?

A

Approx 20mL

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5
Q

How much fluid is in the entire respiratory tract at birth?

A

80-120mL

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6
Q

What does crying against closed glottis do at birth?

A

It creates positive pressure inflates alveoli

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7
Q

What does lungs expanding with subsequent breaths result in?

A

Decrease pulmonary vascular resistance

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8
Q

What does lungs expanding with subsequent breaths which decrease pulmonary vascular resistance allow?

A

More pulmonary blood flow (oncotic pressure)

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9
Q

What does the fetal experience in chemical stimulation of breathing?

A

Elevated CO2
Decreased O2
Decreased pH (acidosis)

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10
Q

What does the chemical change simulate?

A

Chemoreceptors in the aorta and carotid arteries

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11
Q

What happens after chemoreceptors are stimulated in the aorta and carotid arteries?

A

Causes stimulation of the respiratory center in medulla which triggers a breath

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12
Q

What three things are stimulated that cause a breath to trigger in an newborn?

A

Chemoreceptors in the aorta and carotid arteries and respiratory center in medulla

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13
Q

What is the thermal stimulation of breathing in the newborn?

A

The decrease in ambient temperature at birth

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14
Q

What does decrease in ambient temperature at birth stimulate?

A

Stimulates nerve endings in skin which sends signal to medulla which triggers a breath

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15
Q

When nerve endings in the skin are stimulated what does it send a signal to?

A

To the medulla which triggers a breath

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16
Q

What three things stimulate sensory of breathing?

A

Touch
Noise
Light

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17
Q

If newborn is depressed, what do you do to stimulate breathing?

A

Rub back vigorously

Flick bottom of foot

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18
Q

What is the fluid that lines the alveoli?

A

Surfactant

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19
Q

What is surfactant composed of?

A

Phospholipids
• lecithin
• sphingomyelin

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20
Q

What is the role of Surfactant?

A

Lowers alveolar surface tension promotes lung compliance

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21
Q

When does Lecithin production peak?

A

At 35 weeks

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22
Q

What does Sphingomyelin do?

A

Remains constant

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23
Q

What does the mature L/S ratio?

A

2:1

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24
When a newborn grunts, what is it doing?
Attempting to increase positive pressure in alveoli to keep them down
25
What are the structures of fetal circulation?
Foramen Ovale Ductus Ateriosus Ductus Venosus
26
What takes place with the foramen ovale in the first breath?
Decrease in pulmonary vascular resistance | Increase in pulmonary flow
27
What does a fecrease in pulmonary vascular resistance and an increase in pulmonary flow result in?
An increase in venous flow to L heart an increased pressure in L atrium which closes the foramen ovale
28
What causes the foramen ovale to close?
Pressure change
29
When is there a permanent closure in the Foramn Ovale?
6 months
30
What takes place on closure of ductus arteriosus?
Systemic vascular pressure becomes greater than pulmonary vascular pressure
31
When systemic vascular pressure becomes greater than pulmonary vascular pressure what happens?
Blood flow is reversed through the DA and increased pO2 levels cause construction of DA
32
When does the closure of the ductus venosus occur?
When umbilical cord is clamped
33
What us neonatal jaundice?
Physiologic hyperbilirubinemia
34
What percentage of newborns does neonatal jaundice effect?
60% full term and 80% of preterm infants
35
What is the liver of a newborn responsible for?
Conjugating bilirubin for excretion (iron storage)
36
Where is Bilirubin is released in?
In unconjugated form from RBC's
37
Where does bilirubin deposited in?
In tissues, skin, sclera
38
How long does fetal iron stora last?
5 months
39
What bilirubin levels may result in brain damage?
Levels > 17
40
What helps manage neonatal jaundice?
Phototherapy with bili-lights
41
When is jaundice observable?
When bilirubin levels reach 5 mg/dL in caucasions and AA 10-15 in Asians
42
When are bilirubin peak levels?
Term (3-5 days) | Preterm (5-7 days)
43
What are kernicteris?
Pigment deposit in brain
44
What should kernicteris levels be?
25-30mg/dL
45
What should newborn diet contain?
``` Protein Fat Carbohydrate Water Vitamins and minerals ```
46
How long should mother breast feed exclusively?
6 months
47
What is extrusive reflex?
Newborn infant spits out
48
What should the caloric intake be for a newborn?
50-55 kcal/lb/day
49
What is the fluid requirement for a newborn?
64-73 ml/lb/day
50
How much should an infant gain in the first 6 months?
1 oz per day
51
How much should an infant gain in the second 6 months?
0.5 oz per day
52
When should birthweight be regained when formula fed?
10 days
53
When should birthweight be regained when breast fed?
14 days
54
What properties does breast milk have?
Antiviral Antibacterial Antigenic inhibiting properties (fewer allergies)
55
What does breast milk lower the risk of?
``` Childhood: obesity Diabetes Ear infections/tubes Childhood cancers ```
56
When breast fed, infants have less _____ and bowel movements are less _________.
Less spit-ups | BM less offensive
57
When is breastfeeding contraindicated?
HIV/AIDS in mother Breast cancer When mother requires certain medications Active TB, HSI in breast
58
When should mother initiate breast feeding?
1st 30 minutes
59
What are the first signs of hunger before crying?
Hand to mouth motions Whimpering Sucking Rooting
60
How often should mother breast feed?
On demand - usually every 1 1/2 to 3 hours | 8-10 feedings in 24 hours
61
What can "watching the clock" do to milk production?
Impair milk production
62
When should mother feed until?
Until signs of infant satiety - relaxes, falls asleep, slows down r stops sucking
63
When does Colostrum production begin and end?
Begins during pregnancy and ends a few days after birth?
64
What is colostrum high in?
Protein Fat-soluble vitamins Minerals Antibodies
65
Transitional milk
Until about two weeks
66
What does transitional milk contain?
More fat, lactose, water-soluble vitamins More calories than colostrum
67
What does mature milk contain?
Carbohydrates Protiens Fats Water
68
What is foremilk and hindmilk in?
Mature milk
69
When assessing proper breastfeeding, feeding is appropriate if?
* 6 or more wet diapers/day * adequate weight gain * adequate bowel movements * infant is satisfied
70
What can pacifiers help prevent?
SIDS
71
What helps assess for proper breastfeeding?
LATCH
72
What does L in LATCH stand for?
Latch
73
What does A in LATCH stand for?
Audible swallowing
74
What does the T in LATCH stand for?
Type of nipple
75
What does the C in LATCH stand for?
Comfort
76
What does the H in LATCH stand for?
Hold or positioning
77
What amount size should breast milk be stored in?
2-4 ounces
78
Refrigeration time for breast milk?
72 hours to 8 days
79
Freezer time for breast milk?
6 months
80
Whole milk should be used until when?
For the 1st to years of life
81
When is semi-solid foods be introduced?
At 4-6 months
82
What food seldom causes allergies when introduced at 4-6 months?
Rice cereal with iron
83
What foods can be introduced 6-8 months?
Vegetables and fruits
84
How should you introduce fruits and vegetables?
Introduce one new food at a time and then wait 3 days to introduce another
85
What foods can be introduced at 8-10 months?
Strained meats and proteins Soft finger foods Begins to use cup with a lid
86
What can be introduced between 10-12 months?
Eats soft table foods w/ family Attempts to feed self with spoon Eats 4x/day
87
What foods need to be delayed until 4 months?
Carrots Beets Spinach
88
What foods need to be delayed until 1 year?
Cow milk
89
What foods need to be delayed until 2 years?
Eggs
90
What foods need to be delayed until 3 years of age?
Peanuts Nuts Fish Shellfish
91
What foods need to avoided to prevent choking?
``` Hot dogs Hard vegetables Candy Whole grapes Chunks of peanut butter ```
92
What food needs to be avoided to prevent botulism?
Honey
93
When can newborn have first tub bath?
After cord fall off
94
How should cord be taken care of?
Kept dry and exposed to air Clean cord and skin with cotton ball 2-3 x per day. Alcohol 1-2 x per day. Fold diaper below the cord
95
Following circumcision how often do you check for signs of bleeding or infection?
q 30 min X 2 hours
96
How should circumcision care be cared for?
Clean with Soap and water, rinse, pat dry
97
What does normal drainage look like after circumcision?
Light, sticky, and yello
98
If circumcision has a plastibell, when should it fall off?
In 8 days
99
If there is no plastibell placed after circumcision, what needs to be applied with each diaper change?
Petroleum jelly
100
When should head control be achieved by newborn?
3-4 months
101
How should newborn be positioned for sleeping?
On their backs
102
What things help reduce SIDS risk?
Sleep on back Baby's head uncovered Avoid overheating Offer a pacifier for sleep
103
What does the AAP say about tummy time?
Recommends that when the infant is alert, he should be placed in his tummy for "play" sessions
104
If baby chokes, how should parents help?
Turn baby's head to the side to bulb suction
105
Where is the safest spot for the car seat?
Middle of the back seat
106
How long does the baby need to face the rear in the car?
Until 1 year-old or weighs 20 pounds
107
What temperature are signs of illness?
Above 101 R or 100.4 ax | Below 97 R or 97.8 ax

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