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NST?
nonshivering thermogenesis - burn brown fat to produce heat - can increase need for O2 and cause resp distress
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Erythrocytes and HgB of newborns?
have more RBC and HgB than adults, hemolysis can cause jaundice b/c rbc don't live as long, have fetal HgB with greater affinity for O2
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WBC count of baby at birth?
9100 to 34000
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Why do newborns get vit K injection?
they don't have normal intestinal flora to synth vit K
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Stomach capacity of a newborn?
6ml/Kg
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Gastrocolic reflex?
stim when the stomach fills, causing increased intetinal peristalsis -
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Normal newborn BG?
day 1 - 40 - 60
after day 1 - 50-90
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Bilirubin cycle?
released from hemolyses RBC -> conjugated to water soluble form by the liver -> excreted in urine and stool
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Major diff b/t pathologic and physiologic (nonharmful) jaundice?
pathologic can occur in the first 24 hours after birth
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2 factors that coagulation factors need?
liver function to create them and Vit K to activate them
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Where is iron stored during pregnancy?
liver and spleen
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Kidney filtering ability is like adults at what age?
1 to 2 years
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newborns are at risk for what pH imabalance?
metabolic acidosis b/c they lose more bicarb and decreased ability to reabsorb it
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If a newborn has an infection what may occur?
may not have fever or increased WBC because immune system is immature
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Assessment imm after birth?
assessed for cardiopulm probs and obvious anomalies
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Perferred site and normal temp of NB?
axillary - 36.5-37.5
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Normal NB heart rate?
120-160 BPM
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PMI of NB heart?
3rd to 4th intercostal space lateral to the midclavicular line
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3 pulses to check for with NB?
brachial, femoral, and pedal
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Normal resp rate for NB?
AVg resp rate?
30-60 BPM
avg is 40-49 BPM
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Normal respirations in NB?
irregular, shallow, unlabored, symmetrical,
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Avg BP for NB?
65/30 - 95/60
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Why may a NB have white discharge from nipples?
mother's hormones withdrawing from them
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When should meconium and first urine be passed?
meconium in first 12 - 48 hours and urine in 12 -24 hours
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Respiratory assessment frequency?
assess q 30 minutes until stable for 2 hours after birth
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Apnea?
pause that lasts more than 20 sec., or that is accompanied by cyanosis, pallor, bradycardia, or decreased muscle tone
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Breath sounds in first couple of hours?
may have wet sounds b/c of amnio fluid
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S/S of resp distress in NB?
- 1. tachypnea - may occur for short periods but should not be prolonged
- 2. retractions
- 3. nasal flaring
- 4. cyanosis - lips, tongue, mm, and trunk
- 5. grunting
- 6. seesaw or paradoxical respirations - chest and stomach don't move together
- 7. asymmetry
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Choanal atresia?
nasal passages blocked by bone or tissue
NB is nasal breather for first 4 to 6 weeks and this can cause resp distress
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Pallor may indicate ___ or____.
hypoxia or anemia
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Ruddy color indicates ____.
polycythemia which causes increased risk for jaundice
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HR assessment frequency?
should assess q 30 minutes until NB has been stable for 2 h
Once stable check q 8 to 12 h or according to agency policy
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BP cuff for NB?
should be 40-50% of the circumference of the leg or 25% - 50% wider than the diameter of the limb
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Assessing cap refill in NB?
press skin over chest, abd, or extremeity until it blanches - color should return in 3 to 4 sec
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Assessment frequency of temp?
q 30 min until stable for 2 h after birth then at 4 h after that then q 8 h
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Craniosynostosis?
premature closure of the sutures
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How to palpate fontanels?
infants head should be elevated
anterior should be 4 to 5 cm and
should be soft and flat or slightly depressed
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Caput succedaneum?
area of localized edema that appears over vertex of head due to pressure against mother's cervix in labor
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When may cephalhematoma occur?
24 to 48 h after birth - has clear edges that end at suture lines (caput succedaneum crosses suture lines)
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Assessment of infant hips?
Place fingers over infant's greater trochanter and thumbs over femur and flex knees and hips
2. barlow test: adduct hips and apply gentle pressure down and bakc with the thumbs - will feel move out of acetabulum if displaced
3. ortolani test - abduct the thighs and apply gently pressure forward over the greater trochanger - will feel clunking if dysplasia
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Assessment of ear placement?
horizontal line from outer canthus of eye should be even with area where the ear jhoins the head
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Hearing assessment?
infants reaction to sudden noise
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What eye prob may occur but be normal?
transient strabismus- eye crossing due to weak eye muscles
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Normal NB response to bright lights?
blink or close eyes
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3 causes of tremors in infants?
- 1 hypoglycemia
- 2 low calcium
- 3 drug use of mom
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Moro reflex?
AKA startle reflex - when infant's head and chest are allowed to drop 30 degrees arms are thrown out and fingers fan out and make a c
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Palmar grasp reflex?
touching palm below fingers should cause baby to close hand around object
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Plantar grasp reflex?
same as palmar but with toes
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Babinskin reflex?
stroke up from heel on outside of foot and across ball of foot- toes should fan out and big to should dorsiflex
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Rooting reflex?
cheek is touched near the mouth the head turns toward the side that has been stroked
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sucking reflex?
when mouth or palate is touiched by nipple or finger the infant begins to suck
assess for presence and strength
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Tonic neck reflex?
posture assumed by newborns when in a supine position - infant extneds arm and leg on side where head is turned & flexes extremities on the other side - AKA fencing reflex - looks like they are fencing
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Stepping reflex?
infant is held upright with feet toucing surface - will lift one foot then other like they are trying to walk
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Cry that indicates neuro disorder?
catlike or high pitched
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How to assess for jaundice?
press on end of nose or sternum
will begin at head and move down so areas affected should be documented
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Normal NB position?
flexed hips, knees, and ankles
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Square window test?
flex palm toward forearm- closer palm gets to forearm closer to full term baby is- if can't get close = preterm
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Arm recoil test?
hold arms fully flexed at the elbows for 5 seconds and then pull hands straight down to the sides & quickly release them - degree of flexion is measured as arms return to normally flexed posotion
preterm infants may move arms slowly or not at all
full term = quick return
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Popliteal angle test?
newborn's lower leg is folded against the thigh with thigh on the abd . Then lower leg is straghtened just until resitance is met. angle at popliteal space is scored when resitance is first felt
preterm will extend leg farther than full term
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