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NURS787 Exam 2 > Normal Newborn Management > Flashcards

Normal Newborn Management Flashcards

1
Q

normal NB Hgb

A

14.0-20.0

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2
Q

normal NB Hct

A

43-63%

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3
Q

normal NB WBC

A

10-30,000

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4
Q

normal NB platelet count

A

150-350,000

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5
Q

What is a concerning newborn blood sugar level?

A

<45-50 mg/dL

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6
Q

What can be expected of a NB’s blood glucose in the first 2h PP?

A

can fall to nadir of ~40 mg/dL

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7
Q

normal NB urinalysis

A
  • low specific gravity
  • no protein
  • no blood
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8
Q

direct vs indirect bilirubin

A

indirect = unconjugated = non-water-soluble –> direct = conjugated = water-soluble - can be excreted through urine and stool

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9
Q

What is a normal total bilirubin for a NB at day 1?

A

<5 mg/dL

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10
Q

When do bilirubin levels peak in NBs?

A

b/w 48-92h PP

average value = 7-9 mg/dL

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11
Q

What are the rare metabolic disorders included on the standard NB screen?

A

1) phenylketonuria (PKU)
2) maple syrup urine disease (MSUD)
3) galactosemia

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12
Q

What does the direct antiglobulin test (DAT)/direct Coombs test look for?

A

antibodies directly bound to NB’s RBCs

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13
Q

What does a negative direct Coombs test indicate?

A

normal!

positive = BAD!

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14
Q

What is the expected number of stools for the breastfed NB?

A

Once lactation is established, 3-4 stools/day

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15
Q

When should one be concerned about a NB’s elimination frequency?

A

If no BM or urine w/in 24-48h, call pediatric provider

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16
Q

What is the expected number of stools for the formula-fed NB?

A

2-4 stools/day in 1st month –> become less frequent (1-3/day) as infant gets older

17
Q

How does breastfeed NB stool look compared to the formula-fed NB?

A

formula-fed = firmer, darker, smellier

18
Q

How often should a NB urinate?

A

at least 6x/day

19
Q

How much formula should be given to NBs in the first weeks?

A

2-3 oz q3-4h

20
Q

How long should the first bath be delayed?

A

According to WHO, at least 6h

21
Q

How should cords be cared for?

A

just keep it dry!

22
Q

How should circumcisions be cared for?

A
  • cleanse daily w/ cotton balls dipped in tap water

- apply small amount of petroleum jelly to tip for first 2-3 days w/ each diaper change

23
Q

How long can NBs sleep?

A
  • 16-18h/day for first few days

- 8-20h/day at 4wks PP

24
Q

When is the soonest a NB will likely sleep more at night?

A

at 12wks

25
Q

true or false:

NBs do not know day from night

A

false-ish

NBs are less confused than they are not as governed by circadian rhythms

26
Q

Why do NBs sleep so much during the day?

A

sleep associated w/ eating

27
Q

What indicates a NB is overheated?

A
  • red skin
  • irritability
  • body warmth
  • lethargy
28
Q

What are danger s/sx in the NB and should be reported?

A

1) axillary temp > 99.3F or < 97.5F
2) tachypnea (>60 breaths/min) for > 1 min
3) periodic apnea (pauses >20s)
4) abnormal respirations (e.g retractions, wheezing)
5) umbilicus infection
6) eye infection
7) jaundice
8) GI: projectile vomiting, bile-stained vomit, no stools/urination since birth, taut/swollen abdomen
8) diarrhea (>6 stools/24h)
9) general signs of illness

29
Q

How can diaper rash be treated pharmacologically?

A

topical antifungals (miconazole) or topical steroids (hydrocortisone) applied at every diaper change until rash gone + 1-2 days after

30
Q

How can thrush be treated?

A
  • nystatin suspension PO 4x/day
  • gentian violet 1-2% aqueous sol’n applied 2x/day until 1-2 days after white patches gone
  • put sol’n on nipples if breastfeeding
31
Q

What are potential benefits of circumcision?

A

1) cleaner glans penis
2) lower chance for UTI
3) reduced incidence of penile cancer, phimosis, balanitis, adhesions, and occlusion of urethral meatus

NURS787 Exam 2 (8 decks)

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