T3-Newborn Nursing Care Flashcards
(77 cards)
1
Q
What is suctioned first: mouth or nose?
A
Mouth before nose!
2
Q
What is the respiratory interventions?
A
- Support baby with head to side
- Use bulb syringe and suction mouth, then each side of nose
- Deeper suction can be done with DeLeeX (5 sec or less per insertion)
3
Q
When do we assess the temp of newborn baby?
A
Immediately after birth and q30 min till stable
4
Q
What do we attach over upper quadrant of abdomen? Why?
A
Tranistor probe to keep infant temp 36.5-37C
5
Q
Where should infants crib be away from?
A
Walls and windows
6
Q
Where do we perform exams?
A
Under heat panels
7
Q
When do we give newborn bath?
A
After temp is stable
8
Q
What eye prophylaxis is done? Why?
A
Erythromycin eye ointment to prevent inflammation r/t gonorrhea infection
9
Q
What kind of injection is Vit. K? Where is it administered?
A
IM -.5-1 mg w/in one hour of birth; administered in vests lateralis
10
Q
What is umbilical cord care?
A
- Clamp cord after delivery
- Assess # of veins and arteries
- Assess for infection
- Clean cord with H20
- No tub bath till cord separates
11
Q
When does the umbilical cord usually separate?
A
~10-14 days
12
Q
What is the goal of cord care?
A
To prevent hemorrhage and/or infection
13
Q
Preterm?
A
Born less than 37 weeks
14
Q
Late preterm?
A
34.0-36.6 weeks
15
Q
Early term?
A
37.0-38.6
16
Q
Full term?
A
39.0-40.6
17
Q
Late term?
A
41.0-41.6
18
Q
Post term?
A
42.0 weeks and over
19
Q
Post mature?
A
Over 42 weeks with placental insufficiency effects
20
Q
General characteristics of neonate: Length?
A
17.7-21.7 inches
21
Q
General characteristics of neonate: Weight?
A
5.5-8.8 lbs
22
Q
General characteristics of neonate: Normally loses ____ of birth weight within one week of birth
A
5-10%
23
Q
Collection of blood
A
Cephalhematoma
24
Q
Collection of fluid
A
Caput succudanum
25
How are sutures and fontanelles?
Open and palpable
26
What if fontanelles are depressed?
Dehydration
27
What if fontanelles are bulging?
Fluid overload
28
Anterior fontannel is ___ cm and is ___ shape
5 cm and is diamond shaped
29
Posterior fontannel is ___ shaped
Triangle
30
What is smaller: anterior or posterior fontannel?
Posterior is SMALLER than anterior
31
Chest is approx ____ in smaller than head
0.5 cm
32
Legs and arms are normally ____
Flexed
33
Feet and hands may exhibit ____
Acrocyanosis
34
What is polydactaly?
More than 5 digits
35
What is syndactaly?
Webbing
36
Where do babies want to breath from: nose or mouth?
Nose
37
Ears: Pinna in line with ______
Outer canthus of eye
38
T/F: Genitalia may be enlarged
True
39
Discharge may be present in female neonates. This is pseudo menses and is hormonal. What color may discharge be?
Pink or white
40
Testicles are _____ in male neonates
Descended
41
Excess breakdown of RBC= ?
Ex?
Jaundice
Hematoma, bruising
42
Liver immaturity=?
Not enough of enzyme glucornyltransferase
43
Poor sucking ability=?
Doesnt consume enough food to introduce intestinal flora so bill is not conjugated to direct (conjugated) form that can be excreted
44
Can cold stress cause jaundice?
Yes
45
Describe what you do for phototherapy for hyperbilirubinemia.
- Under lights in mini diaper
- Cover eyes, testes, ovaries
- Monitor and maintain temp with skin probe
- Monitor insensible water loses
- Provide fluids
- Provide stimulation
46
Treatment for hypothermia?
- Swaddle in double warm blankets
- If temp doesnt respond go back to radiant warmer per protocol
- Observe for resp. distress
- Observe for signs of hypoglycemia
47
Hypothermia treatment--why do we observe for resp distress?
Cold stress increases O2 need
48
Hypothermia treatment--Why do we observe for signs of hypoglycmia?
Cold stress uses up glucose on board
49
What is prevention for hypoglycemia?
Feed early and frequently and maintain safe glucose levels
50
For high risk infants, when do we check glucose?
Within 2-3 hours of birth
51
What are symptoms of hypoglycemia?
Jittery
High pitched cry
Eye rolling
Seizures
52
Plasma glucose level in full term infant: Less than ___ requires intervention?
Less than 45
This is from ppt, I thought she said in class less than 43 ... ?
53
What has a longer lasting supply of glucose?
Milk
54
If mom doesn't breastfeed, what are other ways infant can get glucose?
Bottle feed D5W
| NGT or IV glucose
55
Can infant be fed before circumcision?
No, hold feeding before procedure
56
Yellen and Mogen clamp procedure makes procedure ____
Blodless
57
Can ointment be put on after Yellen procedure? Mogen? Plastibell?
Yellen: yes
Mogen: yes
Plastibell: no
58
What do we document after circumcision?
First voiding past procedure
59
What procedure has the bell fall off in diaper?
Plastibell
60
If we see yellow exudate, what do we do?
DO NOT clean it off!
61
What should we teach about the petroleum gauze?
To watch for strings that could wrap around penis and cause necrosis
62
If infant is getting enough to eat, how many times should they pee? What color is urine? What if no voiding in first 24 hours?
6-8X/d
Pale; poorly concentrated
Notify MD
63
Breast fed babies should be offered first feeding during _____.
How can we place them after feedings to encourage stomach emptying?
Stage 4 (recovery)
Right side
64
Breastfeeding: What is secreted first 2-3 days?
Colostrum
Less fat and sugar; more protein and antibodies
65
When is there traditional milk?
3rd day of/1st week
66
Breastfeeding promotes ____
Bonding
67
What are conditions in which breastfeeding should be avoided?
- Active TB
- Hep B or C
- HIV
- Cancer
- Maternal drug abuse
68
- How should milk be stored?
- Refrigerated for ...?
- Frozen milk attached to fridge is good for ____.
- Frozen milk in deep freezer is good for ___.
- Rigid, plastic containers
- 48-72 hrs
- 1 milk
- 6-12 months
69
What newborn screening test are required by all tests? How do you get it?
PKU and hypothyroid; blood sample from infant heel
70
What is important about PKU test.
Infant needs to have ingested milk in adequate amounts before test...done 24 hours later
71
What do accumulates of phenylketonuria result in?
Severe MR
72
Glactosemia: Absence of enzyme result in damage to ___, ___, and ___.
What is treatment?
Liver, brain, eyes
Treatment is elimination of milk from diet and you cannot safely breastfeed; work with mom to find commercial formula
73
What is bathing home care?
Diapering home care?
Crying?
- Sponge bath till cord falls off; clean cord with water after each diaper change and keep diaper off cord
- Diaper: clean infant with warm water after voiding and stools
- Crying will happen when hungry, wet, or bored
74
Signs of sick infant: how is sleep?
Lethargy or difficult to wake
75
Signs of sick infant:
| Temp above?
100F
76
Signs of sick infant:
| How is digestion?
Vomiting or green, liquid stools
Refusal of 2 feedings in a row
77
Signs of sick infant:
How ar fontanels and mucous membranes?
Fontanels: Depressed
Mucous membranes: Dry, sticky
