unit 3 Flashcards
(132 cards)
1
Q
normal temperature for newborn
A
97.7-99.7
2
Q
normal respirations for newborn
A
30-60bpm
3
Q
normal glucose for newborns
A
50-140(can be down to 45 for first 24hr)
4
Q
what to do if there is an abnormal glucose
A
recheck in 30 min
if still low conduct interventions
5
Q
most accurate place to take a temperature for babies to 3 months
A
rectal
6
Q
how to take temperature for 3 months to 4 years
A
digital
rectal
axillary
7
Q
when can you use tympanic temperature
A
at 6 months
8
Q
why do baby’s struggle to regulate body temperature
A
-no fat storage (no insulation)
-lack of brown fat=cold stress
-blood vessels close to skin (lose heat)
-larger body surface to weight ratio
9
Q
what is thermoregulation
A
balance of heat loss and heat production
10
Q
how does muscle tone affect thermoregulation
A
affected by muscle tone
poor muscle tone=poor thermoregulation
11
Q
what is PKU
A
newborn screening test
12
Q
what does PKU do
A
-identify genetic diseases
-inborn errors of metabolism (thyroid problems, sickle cell)
13
Q
what screening does not require parental consent
A
PKU
(but if parents refuse its a no)
14
Q
what is important when having a PKU screening
A
-shouldnt be collected prior to 24hr of age
-timing of ample & amount is important
-results in 2 weeks
15
Q
what screening test is required by law in every US state
A
PKU (newborn screening)
16
Q
what other newborn screenings are important
A
hearing screen
critical congenital Heart Disease (CCHD)
17
Q
new born reflexes
A
-babinski
-moro
-tonic
18
Q
Babinski reflex
A
rub the bottom of baby’s foot
-toes should splay
19
Q
Moro reflex
A
lean back
-stretch arms out
20
Q
Tonic reflex
A
turn baby head
-fencing pose
21
Q
asymmetric Moro reflex
A
indicate a problem
-birth trauma
-fractured clavicles
22
Q
other reflexes
A
palmar grasp
plantar grasp
rooting/sucking
head righting
stepping
23
Q
what does an absent reflex mean
A
indicate an underlying problem
24
Q
Circumcision complications
A
decr urine output
bleeding
infection
revision
25
types of circumcisions
plastibell
yellen
Gomco
26
SGA
-small gestational age
-birth weight under 10th percentile
27
SGA causes
-preterm or term (any GA)
-hypoglycemia
-poor thermoregulation
28
SGA asymmetrical
head circumference WNL, weight less than 10th percentile
Head>body
-good head got needed nutrients
29
SGA symmetrical
head and weight less than 10th percentile
head=weight
-body and head got same nutrients (possibly underdeveloped)
30
LGA
-large for gestational age
-over 4000G (8lbs 13oz)
31
causes of LGA
larger parents
incr weight gain in pregnancy
diabetic mother
32
LGA effects
-hypoglycemia (hyperglycemic in utero)
-hypocalcemia
-tachypnea (respiratory distress syndrome)
-incr risk of perinatal asphyxia
-incr risk birth trauma
-incr risk of C section
33
why is Vitamin K important
coagulation occurs in liver, liver doesn't work right away, at risk of bleeding
-activates clotting factors
-coagulation deficiency 2-5 day of life
-prevent hemorrhaging
34
how to assess for congenital hip dysplasia
-assess hip fold
-Barlow Ortolani maneuver
35
signs and symptoms of hip dysplasia
-popping
-cracking
-decr ROM
-asymmetry of skin folds
36
what does asymmetry in femoral pulses
coarctation of aorta
37
38
what is considered delayed cord clamping
30-90 seconds
39
benefits of delayed cord clamping
-more blood (incr blood volume & BP)
-decr risk on intracranial hemorrhage
40
Cons of delayed cord cramping
-incr jaundice risk (hemolysis incr)
-cross blood brain barrier
(brain damage, seizure, death)
41
meconium
stool in lower intestines AT birth
42
what causes meconium
-stress
-post date (after 42wk)
-cord compression
-placenta break down
43
when should meconium be passes
8-48hr
44
what can meconium cause
aspiration pneumonia
45
post term babies
after 42weeks
46
characteristics of post term babies
-poor oxygenation
-wasting syndrome
-hypoglycemia
-LGA
-skin like parchment (peeling)
47
what is wasting syndrome
-skinny legs & buttocks
-normal head
48
complications of post term babies
-oligohydramnios
-cord compression
-birth trauma
-hypoglycemia
-meconium aspiration
49
characteristics of preterm babies
-immature organ systems
-lack adequate nutrient reserves
-head larger than chest
-poor muscle tone
-undesended testes
-poorly formed pinna
-fused eyelids
-soft skull suture
-few creases
-vernix
-lanugo
-thin skin
-SGA
-lack of lung surfactant
50
immature organ systems results
-jaundice
-temperature regulation issues
-small
-trouble feeding
51
breastmilk nutrition
-0.5oz/day
-complete nutrition (not Vit D & iron)
-eat every 2-3hr
-6-8 wet diapers/day
-poop once a week or after meals
-gain 0.5-1oz daily
-jaundice
52
breastmilk jaundice
-late onset 5-10days of age
-feeding well, weight gain
-peak 2nd week
-factors in breast milk
53
what happens to birth weight
lose 10% of birth weight, back to birth weight by 2 weeks
54
formula nutrition
-1oz/day
-iron fortified formula
-feed every 2-4hr
-foul odor stools
-BM multiple times/day
55
transitioning to solids
-4-6 months
-1 every 3 days
-sippy cup at 6 months
56
foods babies don't need
-juice never needed
-no whole milk till 1 yr
-no skim milk till 2 yr
-no honey until 1 yr
57
types of heat loss
conduction
evaporating
radiation
convection
58
convection
air/wind blows heat off the body
59
evaporating
baby is wet, loss of heat from liquid turning to vapor
60
conduction
loss of heat touching a cool surface
61
radiation
close to cool surface, heat radiates to it
62
result of cold stress
- incr RR
-respiratory distress
-acidosis
-oxygen diverted from Brian & growth & thermogenesis
63
thermogenesis
generates heat by increased muscle activity
64
signs & symptoms of a cold baby
-cry
-restless
-incr cellular metabolic activity
-dont shiver
-metabolize brown fat
65
where is brown fat metabolized
-axillae
-vertebral column
-kidneys
(depleted with cold stress)
66
signs & symptoms of respiratory distress
-grunting
-nasal flaring
-retractions
-color
(they only breathe like that for so long then they stop)
67
what causes respiratory distress syndrome
-prematurity (can affect some post term)
-lack of lung surfactant (less than 34wk less surfactant)(unstable chest wall, immature respiratory center)
68
causes of respiratory distress syndrome
-prematurity
-maternal diabetes
-acute antepartum hemorrhage
-asphyxia at birth
-males twice as often
69
respiratory distress prevention
-determine lung maturity
-administration of steroids (betamethasone/ dexamethasone)
70
resuscitation after delivery
-positive pressure ventilation
-compressions if HR less than 6-bpm
71
adjusting age
term - gestational age= weeks early
weeks early - weeks since birth= corrected age
72
physiological jaundice
-premies & term (delayed cord clamping)
-AFTER 24 hr
-incr eating resulting in urine & BM
-phototherapy
73
pathological jaundice
-ABO & RH factors
-BEFORE 24 hr
-can cause kernicterus, lethargy, poor feeding, hypotonia
-transfusion if phototherapy not work
74
thrush
-fungal infection
-sick, antibiotics, cleft lip, bottle feeder, pacifier users
-candida albicans
-topical/skin
75
candida albicans
-oral
-white/velvety
-DOESNT wipe off
76
topical/skin thrush
-red bumpy patches
-armpits, groin, trunk
77
treatment of thrush
-oral nystatin
-topical ointment/powder
78
vernix
-cheese like on skin
-protective/antimicrobial
-prevent fluid loss
79
acrocyanosis
-blue extremities (blood is going to vital organs)
-normal
80
central cyanosis
-cardiac/respiratory problem
-sepsis/toxins
-trunk is blue
81
mottling
-temporary
-vascular constriction (decr perfusion in vessels under skin)
-sepsis, cardiac defect, autoimmune
82
milia
-white dots on the face
-resolves
-common
83
mongolian spot
-common birth mark
-fades
-pigmented babies
84
erythema toxicum
-resolved in 2 weeks
-not sure why it happenes
85
telangiectatic nevus
-stork bite/angel kiss
-immature blood vessels
-fade
86
port wine stain
-swollen blood vessels
-dont go away
-neuro issues, glaucoma
87
nevus vasculosus
-vascular tumor
-can grow
-concerning on neck (compromised airway, bleeding)
88
risks for babies born from gestational diabetic mothers
-LGA
-hypoglycemia
-RDS
89
child life
-promotes coping
-therapeutic interventions
90
child life does NOT
-nursing process
-med administration
-invasive procedure
91
Necrotizing enterocolitis
-causes by asphyxia & hypoxemia injury in intestines
-necrotic injury to bowels (from decreased blood flow)
92
NEC sign
-behavior changes
-VS changes (temp, apnea, bradycardia/pnea)
-emesis
-abdominal growth(blood in stool)
93
treatment of NEC
-NPO
-bowel rest
-NG tube suction on low (mouth not nose till after 4weeks)
94
Apgar
-assess adaption from intruder to extrautero
-at 1 min and 5 min
(0,1,2)
95
categories of apgar
-respiratory (effort/crying)
-heart rate/ pulse
-muscle tone
-reflex/ irritability
-skin color
96
Apgar ranges
7-10 = normal (bulb suction)
4-6 = moderate distress(deep suction)
1-3 = severe distress (NICU, respiratory distress)
97
retinopathy
-high oxygen levels = vasoconstriction = stop in vessel growth = blindness & detached retina
98
who is at risk for retinopathy
-preterm/LWB
-anyone with O2 supplement
-2 3/4 lbs or less
-born under 32weeks
99
prevention of retinopathy
-low O2 concentration
-lower parameters (83-93%)
-early detection (ophthalmology)
-monitor ABG
100
retinopathy outcome
-90% resolve
-10% visual impairment
-laser surgery/cryotherapy (bad case)
-corective lenses
101
NICU care
-mimic uterine environment
-minimal stimulation(quiet, cluster care)
-skin to skin
-stimulate sucking reflex
-rice cereal in feed
102
STABLE
specialized NICU training
-sugar & safe care (fluids, correct glycemia)
-temperature regulation
-airway
-blood pressure
-lab work
-emotional support
103
NICU developmental care
-gentle handling
-temp stability
-minimal stimulation
-quiet/dark, cluster care
-sucking
-aids
-skin to skin
-parenteral involvement in care
104
car seat safety
-dont go home unless they have car seat
-rear facing as long as possible
-installed correctly
-45degree angel
105
sleep safety
-no swaddling (SIDs)
-baby on back to sleep
-tummy time when awake
-nothing in crib with baby
-GERD life head of entire crib
106
abstinence syndrome
-weeks to months to resolve
-encourage breastfeeding (helps with withdraw)
-symptoms--> methadone, phenobarbital
-babies are irritable, difficult to console, shaky
107
developmental milestone 4 months
roll belly to back
108
developmental milestone 6 months
roll back to belly
109
developmental milestone 7 months
start walking
110
developmental milestone 9 months
sit without support
pincer graps
crawling
111
developmental milestone 12 months
crawling
pulling up
causing on furniture
walking
one word
112
developmental milestone 18 months
6 words
walking
113
developmental milestone 2 years
20 words
two word sentences
114
developmental milestone 3-6 years
forming sentences
drawing basic shapes
115
developmental milestone 6-12 years
complex sentence structure
writing legible
116
developmental milestone 12+
concrete thoughts
words and meanings
manipulate objects
117
when should the first bowel movement occur
no later than 72 hr (obstruction, malrotation)
118
number one symptom of illness in neonate
change in mood (decr personality)
119
true apnea
-stop breathing longer than 20 sec
-Bradycardia (cardiovascular issues)
120
normal breathing
-breathe quick, stop, breathe slow
-learning how to breathe
-obligatory nose breather till 3-4weeks
121
abnormal breathing
-below 60, above 80
-seesaw breathing
-nasal flaring
-grunting
-retractions
-tachypnea
122
caput succedaneum
-MOVE across suture lines
-2-3 days resolve
-edema bruising
123
cephalhematoma
-DONT move across suture lines
-months to resolve
-can calcify
124
Erickson: infant(0-18mo)
trust vs. mistrust
-caregiver relationship
125
Erickson: toddler (18mo-3yr)
autonomy vs. shame & doubt
-independent from parent
126
Erickson: preschooler (3-6yr)
initiative vs. guilt
-purpose
-within family, exploring
127
Erickson: school-ager (6-12)
industry vs inferiority
-good with neighbors, friends
-please others
128
Erickson: adolescent (12-18)
identity vs. role confusion
-love, partners, friends
-their own person
129
Piaget: birth -2yr
sensorimotor
130
Piaget: 2-7yr
preoperational
131
Piaget: 7-11ye
concrete operational
132
Piaget: 12+
formal operational
