Uncomplicated Newborn Care Flashcards
What is the significance of fetus circulation?
- Lung = pulmonary arterial constriction
- Low aortic systemic vascular resistance
- As gestation increases, blood vessels become more reactive to changes in oxygenation and acid-base levels
What must happen for a successful neonatal transition?
- Respiration begins and continues effectively
- Fluid is cleared from airways
- [As vascular resistance increases] FO & DA close and blood circulates through the lungs
How to ensure Respiratory Transition?
- The production of lung fluid decreases 2-4 days before labor, 80-100mls remain in the air passages of full term newborns
- Chest Compressions: chest recoils and air is sucked in
-Umbilical Cord Clamping: increases the systemic vascular resistance to now pass through PO&DA - Temperature: sensory in skin transmit impulses to the resp centre and stimulates respiratory effort [Handling and Drying]
What is the Newborn Care aft Delivery?
- Baby on maternal abdomen/chest
- Chest airway
- Provide stimulation
- Ensure first respiration (colour from blue to pink centrally)
- Provide warm (skin to skin) for the 1st hour
What is the newborn care 1 hour after delivery?
- v/s (HR, RR, T)
- Weight/head circumference, length
- head to toe exam
- Medication administration
What are the two medication given and the significance?
Erythromycin
1. Against neonatal conjunctivitis and ophthalmia neonatorum
2. Increased risk for infection in SK (Gonorrhea)
Vitamin K:
1. Supplement, important for ability to clot
2. Immature gut flora
How to assess for Sensory Ability?
- Vision: fixate on objects, highly contrasted objects
- Hearing: Prefer high sound and rhythmic sound, turn head in response
- Smell: Differentiate smell of mother’s breast
- Touch: Responds to touch as early as 2m gestation. Well developed
- Taste: Receptors at 16 weeks. Can discriminate
What is the activity transition for newborns?
1st period [Alert and Reactive]: 30-60mins, appears hungry
2nd Period [Reactivity] 4-6hrs after delivery, feeding time
What is the glucose metabolism in newborns?
- Supply terminated (from mother) after birth
- Issues with LGA, SGA, and preterm
- S/s of hypoglycemia: hypothermia, lethargic, resp distress, jitters, hypotonia, high pitched/weak cry
What is the hepatic system in newborns?
- Metabolism of bilirubin
- Bilirubin production is twice as much than adult because of high volume of RBCs and short life span
- Excreted in stool, some in urine. If high, absorbed in skin
- Cephalohematoma l/t jaundice (pooling blood)
- Jaundice baby is more tired
What is the Gi system in a newborn?
- Feeding in the first 30 minutes of birth
- Breastfeeding as soon as possible after birth
- Formula feeding within 6-8hours or sooner
First 24hours: 2-10ml
24-48hrs: 5-15ml
48-72hrs: 15-30ml
72-96hrs: 30-60ml
- Breastfed: feed 8-12 times/day
- u/o may be low in the first 2 days
- Mec: usually passes within 24hours
What is the immunology in newborns?
- Immature immunological response
- Occurs in utero through placental or during labor [contact or aspiration]
- After birth: from environment
- Can’t localize infection (not enough neutrophils)
- So signs of infection are diffused and non specific
How to assess the cardiac system?
- Normal rate: 110-160bpm
- Regular
- Murmurs, tachycardia, and bradycardia
How assess the respiratory system?
- 30-60 breaths/minute
- easy and unlabored
- Fine crackles may be present
- Respiratory sounds should not be decreased or asymmetrical
How to assess the Head?
Normal
- 2cm larger than chest
- Open fontanelles (flat)
- Overriding sutures (overlapping lines)
Abnormal:
- Cephalohematoma
- Caput Succedaneum
- Sutures fused
- Fontanelle (full, depressed, bulging)
