Flashcards in OB Test 2: Newborn Nursing Care Deck (43)
What are the goals of nursing care?
Physical well being of neonate
Promote family development
What are neonatal risk factors?
Prenatal record: happens before birth, record late D-cells
Labor and birth records
Condition of newborn
When is the neonatal transition period?
First 4 hours
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
Circulation: check skin color
Glucose: if LGA (larger then gestational age) then hyperglycemia
How can you incorporate thermoregulation for the newborn?
Kangaroo care: skin-to-skin contact
What are precautions for the newborns first bath?
Stable vital signs: once temperature stabilized
Warmth: only expose 1 area at a time
What are the first 4 medications given to newborn?
Hepatitis B vaccine
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
Where do you inject vitamin k?
In Vastus lateralis
When do you give the hepatitis b vaccine, what teaching do you do?
Not live virus
Get 3 doses
Don't take if allergic to yeast
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
What assessment are done before first feeding?
Need to be alert
Good time if rooting or sucking
When and why do you breast feed
Easier digested, more nutrition and has what baby needs
When do you have the first bottle feeding and what is a negative side effect?
In second period of reactivity
Have more fluid
What are two negative reactions to feeding?
Tracheal esophageal defect
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
What are some ongoing nursing care?
How do you monitor I&O?
Document how often and long breast feed
Why is the newborn weight loss?
Upto 10% in 1 week
How do you position the newborn?
Sleep on back
Lift head off crib after eating
What are specific tests we give the newborn?
How do you practice newborn safety?
Prevent cross contamination
Preventing abduction by alert and security system
How can you prevent cross contamination?
Don't put shared items in crib
3 feet apart in all directions
Isolation if infection suspected
How can the nurse promote attachment?
En face positioning: eye contact before separation
Model care: how to hold or bathe
Rooming-in and breast feeding
What are signs of distress in newborn?
Flaring and grunting
Retraction: sub costal and substernal
T instability: infection or sepsis
Why would the newborn be jittery?
What is physiologic jaundice?
After 24 hours
Is a "well baby"
Labs: indirect and direct bilirubin
Blanch test: cephalocaudal
Why do you do phototherapy?
Because bilirubin is in skin and UV breaks it down
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.