Newborn nursery

Question 0

Capital SUCcedaneum

Answer 0

Cause: From the sustained pressure of long,difficult labor or vacuum extraction causes slow venous return
Def: soft fluid-filled area on scalp
CROSSES THE SUTURE LINE

Question 1

Cephalohematoma

Answer 1

Does NOT cross the suture line
Disappear in 2weeks - 3 months
Can lead to anemia

Question 2

Epstein pearls

Answer 2

Keratin filled cyst in mouth

Question 3

Normal fetal respiration

Answer 3

30-60 breathes/min

Question 4

Periodic breathing

Answer 4

Pauses less than 20 seconds

Anything over 20 seconds is considered apnea and could be signs of SEPSIS

Question 5

Why is suctioning NOT recommended?

Answer 5

Can cause vagal response

Question 6

Why is Aquameohyton (Vit K) given?
Route?
Needle, gauge, angle?
Do you aspirate or massage?

Answer 6

To prevent hemorrhage, since Vit K is produced in the intestines but needs a food source to activate it

IM (Bunch tissue of upper outer thigh VASTUS LATERALIS )
Not given in rectus femoras be it is immature

5/8 inch needle, 25 gauge at 90 degree angle
Aspirate, then gently massage the site with alcohol swab

Question 7

Umbilical cord
How often is care?
When is cord clamp removed?
When should cord fall off?

Answer 7

Care: on admission and every 8 hours
Clamp: remove 24-48
Falls: 10-14 days / 2 weeks

Question 8

Who would they check the cord blood?

Answer 8

For infants with type O blood or Rh negative mom, infants with Coombs

Question 9

What are they checking the umbilical cord blood for?

Answer 9

Blood incompatibilities like pathological jaundice

Neonatal bilirubin on the cord blood, do heel stick CBC and reticulocyte count

Question 10

What does GBS cause?

When are abx given?

Answer 10

Most common is RESP DISTRESS
Also sepsis, pneumonia, or meningitis
Intrapartum

Question 11

What/ when is Newborn screening test?

Answer 11

Drops of blood collected on paper to test for things like cystic fibrosis.
Heel stick or venipuncture 24hours AFTER FEEDINGS INITIATED and repeated in 2 WEEKS

Question 12

What does the EVOKED OTOACOUSTIC EMISSIONS (EOAE) measure?

Answer 12

Sound waves generated in cochlea

Question 13

What does the Auditory brain stem Response measure?

Answer 13

Measures EEG activity generated in response to clicks

Question 14

What are you monitoring for after circumcision?

How often should you change there diaper?

Answer 14

Note the first void and adequacy of stream
Watch for bleeding (report)

Keep area dry and clean, change diapers every 4 hours

Question 15

When does surfactant production begins?

What is surfactant?

Answer 15

24-28 weeks

Coating in lungs to keep alveolar from sticking

Question 16

When do fetal breathing movements begin?

What are these essential fall?

Answer 16

17-20weeks

Chest wall muscles and diaphragm

Question 17

What are the two significant changes tha must occur after delivery for sufficient breathing?

Answer 17

Pulmonary ventilation

Increased pulmonary circulation

Question 18

Factors that stimulate infant breathing:

What happens in MECHANICAL EVENTS?

Answer 18

Vaginal birth: increasing thoracic pressure causes SQUEEZING fluid out of lungs
At Delivery: chest wall recoils, creating NEGATIVE pressure thought to produce small passive inspiration of air
After First Inspiration: exhales against a partially closed glottis, creating POSITIVE pressure

Question 19

What establishes Functional Residual Capacity (FRC) in eh MECHANICAL EVENTS of breathing?

Answer 19

High Intrathoracic pressure

Question 20

What is the Chemical stimuli in the initiation of breathing?

Answer 20

Prostaglandin

Question 21

What does the ductus venosus do?

Answer 21

Increases arterial pressure due to mechanical pressure from severing of cord

Question 22

Why are babies usually anemic after birth and for how long?

Answer 22

Erythropoietin does not restart until 2-3 months of life

Hgb declines first 2-3 months

Question 23

What is the most important way for temperature regulation?

Answer 23

Evaporation

Question 24

What should be neutral thermal environment?

Answer 24

89.6- 93

Question 25

What is chemical thermogenesis "non shivering thermogenesis"?

Answer 25

Stimulation of sympathetic nervous system when skin perceives cold

Question 26

What are the babies methods of thermogenesis?

Answer 26

Increased BMR Muscle activity Chemical thermogenesis "Brown fat"

Question 27

What is the newborn liver function?

Answer 27

Iron storage and RBC production Carbohydrate metabolism Conjugation of bilirubin Coagulation

Question 28

How long does infant have iron stored from mom, before they need foods containing iron?

Answer 28

5-6 months supply is stored in liver, after that they will need iron fortified foods

Question 29

What is the main source of energy at birth and for how long?

Answer 29

Glucose ; 4-6hours | When glucose decreases the newborn changes to fat metabolism (of brown fats)

Question 30

When does bilirubin peak?

Answer 30

3-5 days

Question 31

When does Physiologic jaundice occur and last till? | During the first week bilirubin should not get higher than?

Answer 31

AFTER the first 24 hours LAST 3-5 days 13-15mg

Question 32

When does Pathologic Jaundice occur and how long does it last?

Answer 32

WITHIN first 24 hours of life | PERSISTENT VISIBLE JAUNDICEafter 1 week in term infants and 2 weeks in preterm

Question 33

Explain IgG | How it's transferred?

Answer 33

Only immunoglobulin to cross placenta Transferred during 3rd trimester PASSIVE ACQUIRED IMMUNITY

Question 34

Explain IgA

Answer 34

Protects SECRETING SURFACES on Resp, intestinal, eye Colostrum in breast milk provides PASSIVE IMMUNITY 4 weeks newborn produces IgA in intestine

Question 35

What is habituation?

Answer 35

Ability to ignore repetitious disturbing stimuli | Can alter response to repeated stimuli

Question 36

How do babies see best ?

Answer 36

Near sighted, 8-15 inches

Question 37

When should gestational age "Ballard scale" be done and what components are done?

Answer 37

Most accurate 24 hours after birth, not later than 4 hours ( gestational age decreases Components: Physical characteristics Neurological/ neuromuscular development

Question 38

When is the gestational age assessment most accurate?

Answer 38

28- 43 weeks gestation