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OB > the normal newborn > Flashcards

the normal newborn Flashcards

1
Q

what is the importance of surfactant in the initiation of breathing?

A

it’s necessary for lung compliance (ability to open up alveolar sacs in the lungs so that oxygenation can take place)

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2
Q

intrauterine fetal breathing movements

A
  • fetus practices breathing movement while still in utero
  • the purpose of this is so the lungs will be compliant when the baby comes out, it also exercises the chest muscles
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3
Q

baby’s first breath

A

inspiratory gasp from CNS response to mechanical, reabsorptive, chemical, thermal, and sensory changes

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4
Q

normal newborn respiratory rate

A

30-60/min

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5
Q

what are some potential signs of respiratory distress?

A
  • increased resp rate
  • GFR (grunting, retracting, flaring)
  • color change (cyanotic)
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6
Q

ductus venosis

A

allows blood from the umbilical vein to bypass the liver and enter the right atrium

closes at 4 weeks

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7
Q

foramen ovale

A

allows blood flow from right atrium to left atrium to bypass the lungs

closes at 30 months

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8
Q

ductus arteriosis

A

allows blood flow from pulmonary artery to aorta; allows blood to bypass lungs

closes at 2 months

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9
Q

what is the normal fetal pulse ox?

A

50%

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10
Q

what is rhogam?

A

IM injection given to prevent antibody formation against subsequent pregnancies

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11
Q

when is rhogam given?

A

given intra/postpartum, after abortions, and any situation where fetal and maternal blood will mix

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12
Q

methods of heat loss

A
  • convection
  • radiation
  • evaporation
  • conduction
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13
Q

convection heat loss

A

air current (like a fan) and baby would lose heat

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14
Q

radiation heat loss

A

baby would lose its heat because there’s a surface or something around it that’s colder

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15
Q

evaporation heat loss

A

baby is moist and dry air makes it cold

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16
Q

conduction heat loss

A

baby loses its heat to a surface
ex: putting baby on cold scale

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17
Q

normal temp for a newborn

A

36.4-37.2

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18
Q

neutral thermal environment

A

allows for optimal oxygen use, metabolism, and internal temperature because of thermal balance

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19
Q

interventions for hypothermia

A
  • verify temp reading
  • double swaddle/place hat
  • kangaroo care (skin to skin w/ mom or dada)
  • radiant warmer or isolette
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20
Q

role of liver in newborns

A

**immature
- iron storage (make more RBCs)
- carbohydrate metabolism (baby’s blood glucose is lower than mom’s)
- conjugation of bilirubin (if not excreted = severe damage to organs like the brain)

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21
Q

what is jaundice?

A

a normal biologic response of a newborn d/t increased bilirubin levels

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22
Q

interventions for jaundice

A
  • elevated transcutaneous bili level? –> follow up w/ a serum
  • ensure hydration for excretion
  • phototherapy (transfers through skin to excrete bili)
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23
Q

kernicterus

A

long term, irreversible brain damage

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24
Q

what can excess bilirubin lead to?

A

kernicterus

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25
Q

breastfeeding jaundice

A

associated with poor feeding and inadequate fluid intake

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26
Q

interventions for breastfeeding jaundice

A

encourage frequent feedings and lactation support

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27
Q

breast milk jaundice

A

begins after day 7; r/t breast milk causing reabsorption of bilirubin from intestine

some women contain breast milk that can inhibit conjugation

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28
Q

interventions for breast milk jaundice

A

there may be an order to stop breastfeeding

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29
Q

when can we expect the first bowel movement?

A

within the first 48 hours but typically happens in the first 8-24 hrs

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30
Q

what is the normal frequency of bowel movements?

A

can range from one BM every 2-3 days up to 10 BM in one day; typically see more BMs than less

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31
Q

meconium stool

A

formed in utero; contains amniotic fluid, intestinal secretions, and mucosal cells

tarry thick dark green

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32
Q

transitional stool

A

lasts 1-2 days

greenish, may look like it has raspberry seeds in it

33
Q

formula stool

A

typically more formed than breast fed

34
Q

when do we expect the first void?

A

within the first 24 hrs

35
Q

at what point can children fully concentrate urine by?

A

by 3 months of age, because a newborns kidneys aren’t able to dispose of water rapidly (they have a lower GFR than adults)

36
Q

nursing care of circumcised newborn

A
  • pain assessment (NIPS)
  • pain meds (topical cream, tylenol)
  • monitor active bleeding
  • beefy red and raw
  • liberally applied petroleum jelly
  • monitor ability to void
  • teach parents about care
37
Q

first period of reactivity

A

prime time for bonding and breastfeeding

  • HR and RR elevated
  • alert from birth-30 min
38
Q

period of inactivity

A

should reassure mom that this is normal

  • HR and RR decrease
  • may sleep up to 4 hrs
39
Q

second period of reactivity

A
  • HR and RR may increase
  • awake and alert for 4-6 hrs
40
Q

deep sleep

A
  • eyes closed, no eye movement, breathing regular
  • HR 100-120 bpm
41
Q

light sleep (REM)

A
  • irregular RR, sucking motions, minimal activity
42
Q

drowsy but awake

A

open or close eyes with fluttering eye lids

43
Q

quiet alert

A

alert and may fixate on attractive object

44
Q

active alert

A

eyes are open and motor activity is intense

45
Q

crying alert state

A

intense state of being alert

46
Q

grasping reflex

A

put finger in palm of baby’s hand and will close hand around finger

47
Q

rooting reflex

A

lightly stroke cheek and will move towards it, in attempt to suck

disappears by 4 months

48
Q

stepping reflex

A

hold baby up right over flat surface, makes stepping/walking motion

disappears at 4-8 weeks

49
Q

babinsky reflex

A

gently stroke sole of foot –> fans and extends toes

50
Q

tonic neck reflex

A

turn head to one side while infant lays on back, arms extended on side that infant faces, opposite arm and leg are flexed

51
Q

what does the average baby weigh at birth?

A

7 lbs 8 oz.

52
Q

large for gestational age

A

larger than the 90th percentile

53
Q

small for gestational age

A

smaller than the 10th percentile

54
Q

why do we administer erythromycin eye ointment?

A

protects against gonorrhea and chlamydia

55
Q

erythema toxicum

A

newborn rash

56
Q

milia

A

little acne, white heads

don’t pick or put any meds

57
Q

stork bites

A

common around nape of neck or forehead and become brighter when baby cries

often fades away w/ time

58
Q

port wine stain

A

typically doesn’t fade away w/ time

59
Q

mongolian spots

A

seen on darker skin tones; similar to bruising

60
Q

anterior fontanel

A

larger, diamond shape, closes at 18 months

61
Q

posterior fontanel

A

smaller, triangle shape, closes at 8-12 weeks

62
Q

what do bulging fontanels indicate?

A

increase intracranial pressure

63
Q

what do sunken fontanels indicate?

A

dehydration

64
Q

molded head

A

asymmetrical appearance of the head caused by sutures overriding each other during birth process d/t compression

65
Q

caput

A

soft edematous area on the scalp caused by long labor or vacuum extraction

more superficial swelling that may cross suture line

66
Q

cephalhematoma

A

collection of blood b/w the surface of the cranial bone and the periosteal membrane

67
Q

what are our concerns with cephalhematomas?

A
  • will the hematoma absorb itself? –> most do
  • increased # of broken down RBCs –> liver immature = risk for jaundice
68
Q

what does not cross the suture line?

A

cephalhematoma

69
Q

strabismus

A

poor eye muscle control that will develop by 3-4 months of age

70
Q

doll’s eyes

A

turn baby’s head R or L and baby’s eye will go opposite direction

71
Q

epstein’s pearls

A
  • hard white marks in the mouth
  • non significant and disappear within a couple of weeks
72
Q

when assessing the baby’s neck, what would indicate an abnormality?

A

webbing

73
Q

when assessing the baby’s abdomen, we want to ensure that…

A

it’s soft with no distention noted

74
Q

ortolani’s maneuver

A

knees together and move legs back, assess for hip click to see that baby’s hips are intact

75
Q

club foot

A

do the feet turn inward? this could be positional; from position when baby was in utero

76
Q

when assessing the baby’s back, what can indicate an abnormality?

A
  • be sure it’s fully closed (no open neural defect)
  • assess for hair in this area = indicator of abnormality
77
Q

jitteriness in newborn

A

could be a sign of low blood sugar or other issues

78
Q

when assessing neuro status, what could be a concern?

A

high pitched cry

79
Q

what kind of cry do we expect?

A

strong, lusty, and medium pitched

OB (8 decks)

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