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Flashcards in Normal Newborn Deck (60):
0

length of infant transition period from inside to out

8 hours

1

how the baby breathes in utero

oxygenation is across placental membrane
lungs are filled with fluid and blood vessels are constricted

2

initial breathing is stimulated by reflex of...

physical, sensory, and chemical factors

3

what occurs to respiratory system once cord is cut?

decreased arterial o2
increased co2 pressure
decreased ph

4

benefits of first cry

grabs air and clears lungs

5

physical stimuli at birth

heat loss from wet body/cold air
release from fluid environment/gravitational forces
release of resistance from vaginal walls

6

APGAR scoring

activity
pulse
grimace
appearance
respiration
at birth, 1 minute and 5 mins

7

acrocyanosis

circulatory (not resp) issue.. infants hands and feet are blue

8

normal respiration rate and pattern

norm- 30-60 /min
tachy- >60/min
shallow, quiet, irregular, nose breather, chest and abdomen rise with inspiration

9

how the heart adapts

closure of foremen ovale (atrium) from pressure in left atrium
ductus arteriosum closes
dectus venosus doesn't transport blood

10

normal cardiac rate and rhythm

120-160 bpm
irregular
take apical for 1 minute

11

GI adaptation

sucking reflex
enzymes for digestion of fat, CHO, proteins
immature sphincter between esophagus and stomach

12

tracheosophageal fistula

hole/channel between esophagus and tracheal

13

meconium

thick, sticky, dark green/black transitional stool

14

renal system adaptations

urine is present in bladder at birth, void within 24 hours
6-8 wet diapers a day
limited ability to excrete drugs

15

hepatic system adaptation

production of hgb
production of products for blood coagulation
depend on iron for 3months from pregnancy
need iron intake after 4 months

16

liver changes at birth

extra bilirubin that liver needs to break down

17

immune system

risk for infection
breast fed will increase passive immunity for up to 3 months

18

integumentary system

skin is red and beefy at birth
vernix helps maintain heat
lanugo
desquamation- peeling/scaling
Mongolian spots
milia
Epstein pearls
nevi

19

Epstein pearls

papules on tongue/pallet

20

nevi

birthmarks

21

Changes with birth- female reproductive

Labia is swollen and covers the clitoris

22

Changes with birth - male

Urinary meatus is at the tip of the penis, testes are descended, scrotum is large

23

Changes with birth - musculoskeletal system

Flexed position, symmetrical movements, head is largest part, cranium is molding, Fontanels open

24

Anterior fontanel location and when it closes

At the top of the head, larger, closes at 18 months

25

Posterior fontanel

Back of the head, closes in 6-8 weeks after birth

26

Neurological system Changes with birth

Uncoordinated movements, startles easily

27

Moro-startle reflex

Arms go out when startled

28

Babinski reflex

Toes fan out= positive, up to 2 years

29

Tonic neck reflex

Fencing position with one arm out

30

Feeding reflexes

Rooting, sucking, swallowing, gag

31

Grasp reflex

Closes hand around finger

32

Stepping or dancing reflex

Pulls feet up when they hit a surface

33

Cough and sneeze reflex

Sneezing because of fluid in the esophagus

34

Metabolic control Changes with birth

Burns brown fat to keep warm, heat depletes rapidly when exposed to air

35

Heat loss-convection

Heat flows from body surface in cooler surrounding air- prevent heat loss with warm room and wrap infant

36

Heat loss- radiation

Lose body heat it cooler solid surface, not in direct contact (window)

37

Heat loss-evaporation

Loss of heat when liquid converts to vapor, dry newborn immediately

38

Heat loss- conduction

Lose heat directly from body surface to cooler surfaces in direct contact

39

Sensory changes with birth

Right sided preference, alert if held upright

40

Visual sensory changes with birth

Like back dots on white background, moving items, circles, recognize faces, see 9-12 inches away

41

Auditory senses changes with birth

Becomes acute within the first few hours, can't tell which way a sound is coming from, can tell moms and dads voices in two weeks

42

Sensory- touch changes with birth

Very sensitive, cuddle and swaddle

43

Hematology levels

Hemoglobin- 16-20 g/dl
Hematocrit- 45-65%

44

Bilirubin changes

Released with destruction of RBCs, excreted in feces and bile

45

Physiologic jaundice

Increased bilirubin during 2nd-3rd day of life, subsides by 2nd week

46

Pathological jaundice

Occurs within first 24 hours and is bc of over abundance of RBCs that need to be broken down

47

What helps with blood coagulation that newborns cannot produce?

Vitamin k- they need anyhow of it at birth to help

48

Sleep state I

Deep sleep

49

Sleep state II

Light sleep

50

Awake state III

Drowsy

51

Awake state IV

Alert- feed at this stage

52

Awake state V

Eyes open- feet at this state

53

Awake state VI

Crying

54

Upon admission to nursery

Clear mucus from nose
First feeding with sterile water
Hand wash and use gloves
Match bracelets
Check blood glucose
Erythromycin in eyes

55

Physical assessment of newborn

Skin turgor, plantar creases, head and chest circumference, nose shape, ear placement, palate and lips, eye symmetry and movement, fontanels, abdomen bowel sounds, appropriate genitalia, extremities, birthmarks, reflexes

56

Circumcision care

Cover with sterile gauze with sterile petroleum jelly, note voiding and bleeding, expect yellow exudate

57

How many diapers a day

8-10

58

Discharge teaching

Safety, cord care, feeding, circumcision care

59

Symptoms to report to dr with newborn

Temperature over 100 axillary, respiratory distress