OB Test 2: Newborn Nursing Care Flashcards Preview

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Flashcards in OB Test 2: Newborn Nursing Care Deck (43)
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0

What are the goals of nursing care?

Physical well being of neonate
Promote family development

1

What are neonatal risk factors?

Prenatal record: happens before birth, record late D-cells
Labor and birth records
Condition of newborn
Parent-newborn interaction

2

When is the neonatal transition period?

First 4 hours

3

What are the 4 main care areas during the transition period?

Airway: clean mouth then nares, in mouth do cheek pockets first, suction no longer then 5 seconds and no longer then 50
Breathing
Circulation: check skin color
Glucose: if LGA (larger then gestational age) then hyperglycemia

4

How can you incorporate thermoregulation for the newborn?

Kangaroo care: skin-to-skin contact

5

What are precautions for the newborns first bath?

Gloves
Stable vital signs: once temperature stabilized
Warmth: only expose 1 area at a time

6

What are the first 4 medications given to newborn?

Eye prophylaxis
Vitamin K
Hepatitis B vaccine
Vitamins

7

Why do we do eye prophylaxis medication, when and what dose?

Prevent blindness caused by gonorrhea or chlamydia
Done at 2 hours post-birth
0.5% erythromycin ophthalmic

8

Where do you inject vitamin k?

In Vastus lateralis

9

When do you give the hepatitis b vaccine, what teaching do you do?

12-24 hours
Not live virus
Get 3 doses
Don't take if allergic to yeast

10

What cord care is done?

Care providers order
Monitor s&s of omphalits: red around cord
Artery sticks up
Put in triple dye and wash with water
Fall off at day 10

11

What assessment are done before first feeding?

Need to be alert
Good time if rooting or sucking

12

When and why do you breast feed

Q2-3 hours
Easier digested, more nutrition and has what baby needs

13

When do you have the first bottle feeding and what is a negative side effect?

In second period of reactivity
Have more fluid

14

What are two negative reactions to feeding?

Esophageal atresia
Tracheal esophageal defect

15

What is a tracheal esophageal defect? When do you feed and how much can they hold?

Fluid directly in lungs
Feed 3-4 mL
Hold 30-90 mL

16

What are some ongoing nursing care?

Vitals
Assessment
Weight
I&O
Skin care
Positioning

17

How do you monitor I&O?

Document how often and long breast feed

18

Why is the newborn weight loss?

Upto 10% in 1 week

19

How do you position the newborn?

Sleep on back
Lift head off crib after eating

20

What are specific tests we give the newborn?

Hearing screen
Lab exams

21

How do you practice newborn safety?

Hand washing
Prevent cross contamination
Identification bands
Preventing abduction by alert and security system

22

How can you prevent cross contamination?

Hand washing
Don't put shared items in crib
3 feet apart in all directions
Isolation if infection suspected

23

How can the nurse promote attachment?

En face positioning: eye contact before separation
Observe interactions
Teach
Model care: how to hold or bathe
Support
Rooming-in and breast feeding
Cultural difference

24

What are signs of distress in newborn?

Tachypnea: R>60
Flaring and grunting
Retraction: sub costal and substernal
Excessive mucous
Cyanosis
T instability: infection or sepsis
Jittery
Early jaundice

25

Why would the newborn be jittery?

Hypoglycemia
Hypocalcemia
Narcotic withdraw

26

What is physiologic jaundice?

After 24 hours
Is a "well baby"
Labs: indirect and direct bilirubin
Blanch test: cephalocaudal

27

Why do you do phototherapy?

Because bilirubin is in skin and UV breaks it down

28

What do you do if the Bilirubin is above 12

Take out 5-10cc of blood and put in 5-10 cc of donor blood until all of the blood is replaced.

29

What causes physiological jaundice?

rH antigens