Newborn (Part 1) - Unit 4

Question 1

What are some responsibilities at delivery?

Answer 1

Dry & stimulate the baby, provide resuscitation if necessary, assign APGAR, assessment, administer meds, check glucose.

Question 2

What are some important parts of the history to know at delivery?

Answer 2

Maternal age, gravida/para, infections, labor history, fetal minotoring, ROM, medications, lab work

Question 3

Should the infant go right on the mom’s chest after birth?

Answer 3

YES

Question 4

APGAR - Heart rate - 0, 1, 2

Answer 4

0 = Absent
1 = Below 100
2 = 100 or higher.

Question 5

APGAR - Respiratory Effort - 0, 1, 2

Answer 5

0 = No spontaneous respirations
1 = slow or weak respirations
2 = Strong, lusty cry.

Question 6

APGAR - Muscle Tone - 0, 1, 2

Answer 6

0 = Limp
1 = Minimal flexion
2 = Flexed posture

Question 7

APGAR - Reflex Response - 0, 1, 2

Answer 7

0 = No response
1 = Minimal response 
2 = prompt response

Question 8

APGAR - Color - 0, 1, 2

Answer 8

0 = pallor or cyanois
1 = Bluish hand and feet
2 = pink

Question 9

APGAR scores are assigned at one and five minutes of age, or ever 5 minutes until a score of 7 or higher is achieved. T/F?

Answer 9

TRUE

Question 10

What are some of the general assessment things we do on the baby after it’s born?

Answer 10

Weight, measurements, bands, vital signs ever 30 minutes for 2 hours.

Question 11

What are some meds that are given to the baby right after birth? They need to be given within ____ hour of delivery.

When is the Hep B vaccine given?

Answer 11

Erythromycin eye ointment, Vitamin K.

One hour.

Vaccine is given later, unless mom is HBsAG+ - then within 12 hours!

Question 12

When is the blood sugar checked? What do we want it above?

Answer 12

Within 1st 1/2 hour and then 1/2 hour later - we want it above 40.

Question 13

What are some risk factors for hypoglycemia?

Answer 13

Maternal history of diabetes and terbutaline, preterm/post term, “late preterm infant”, IUGR, LGA or SGA, Asphyxia, problems at birth, cold stress.

Question 14

what are some signs of hypoglycemia?

Answer 14

Jitteriness and tremors, poor muscle tone, diaphoresis, poor suck, tachypnea, tachycardia, dyspnea, grunting, cyanosis, apnea, low temp, high pitched cry, irritability, lethargy, seizure/coma :(

Question 15

What is the purpose of the gestational age exam?

Answer 15

Determines gestational age.

Question 16

Preemie - will they have sticky or soft skin? Lanugo?

Answer 16

They will have sticky skin and lanugo.

Question 17

Preemies - are they very straight?

Answer 17

Yes

Question 18

What’s the scarf sign?

Answer 18

When you can almost wrap the preemies arm around them like a scarf.

Question 19

What is caput succedaneum? When does it go away?

Answer 19

A bulge on the head that crosses the suture line. Goes away within a few days.

Question 20

What is cephalematoma? When does it go away?

Answer 20

A bulge that doesn’t cross the suture line. Goes away at a slower pace.

Question 21

What is the moro reflex?

Answer 21

Startle reflex - pull the hand and they startle.

Question 22

What is the root/suck reflex? Tonic neck?

Answer 22

Root/suck = stroke their cheek and they move and start sucking.
Tonic looks like fencing!

Question 23

Hearing - starts at __ to __ weeks gestation.

Sight = __ to __ inches away.

Answer 23

23-24 weeks.

8-12 inches.

Question 24

Should we assess all the skin on da baby?

Answer 24

YES

Question 25

Mongolian spots - look like what?

Answer 25

Bruising.

Question 26

Milia - pick them. T/F?

Answer 26

FALSE

Question 27

Strawberry hemangioma - fall off and disappear on their own. T/F?

Answer 27

FALSE - they have to be removed in order to disappear.

Question 28

What causes the first breath (Internal Stimuli)?

Answer 28

Decreased PO2, increased Pc02, decreased pH that affects the chemoreceptors ----> message is transmitted to repsiratory center in the medulla ----> diapgrahm is stimulated to contract ---> infant draws first breath.

Question 29

What causes the first breath (external stimuli?)

Answer 29

Cold air and touch stimulate skin sensors --- > impulses from skin sensors and responses to sound and light affect respiratory center ---> infant draws first breath ---> chest compression and release during birth causes air to be drawn into lungs.

Question 30

What's the normal RR for a bambino? What is apnea?

Answer 30

30-60 RPM. Apnea is defined as 20 seconds without a breath.

Question 31

If the baby gets too hot, what happens to their breathing? Too cold?

Answer 31

``` Warm = panting. Cold = conserve energy. ```

Question 32

Is grunting a good thing?

Answer 32

NO - it may sound cute, but it is NOT

Question 33

What is the normal pulse rate? What is bradycardia defined as?

Answer 33

120-160 - bradycardia is defined as less than 80 BPM.

Question 34

What's the normal BP?

Answer 34

``` Systolic = 65-95 Diastolic = 30-60 ```

Question 35

Weak femoral pulse = what?

Answer 35

Might have pressure issues.

Question 36

MAP - should be equal or great then what?

Answer 36

Gestational age.

Question 37

What should the temp be? What's the preferred method for measuring it?

Answer 37

97-99. | Axillary.

Question 38

Bowel sounds occur within __ hour of birth.

Answer 38

1 hr

Question 39

Gut is sterile prior to birth - but changes a few days after birth. T/F?

Answer 39

TRUE

Question 40

Abdomen should be soft & rounded but not distended. T/F?

Answer 40

TRUE

Question 41

Stools should occur within 24 hours of birth. T/F?

Answer 41

TRUE

Question 42

meconium - sticky and tar like. Transition - light green. then depends on what is being eaten. T/F?

Answer 42

TRUE

Question 43

What is hypospadius?

Answer 43

Opening of pee pee is on the underside.

Question 44

What is epispadias?

Answer 44

Opening of the pee pee is on the top.

Question 45

What is cryptorchidism?

Answer 45

Undescended testy.

Question 46

What is phimosis?

Answer 46

Tightening of the foreskin.

Question 47

What is a hydrocele?

Answer 47

Fluid filled sac - typically goes away on their own.

Question 48

Is it normal for girls to have some mucus and discharge after birth?

Answer 48

YES - parents worry but still.

Question 49

Babies should void within 12-24 hours. T/F?

Answer 49

TRUE

Question 50

1-2 voids a day for first 2 days is common, then 6 a day. T/F?

Answer 50

TRUE

Question 51

For a circumcision, there shouldn't be a dripping/discharge but a yellow crust is okay. Although, it heals within 10 days. T/F?

Answer 51

TRUE