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Assessment at delivery
- gestation
- TPAL
- labor pattern
- ROM time
- Risk factors
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Stimulation for respiration
- tactile stim
- temperature change
- blood gas change: decrease pH, increase Co2, decrease O2
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Steps in respiration
- Take a breath
- Get air into lungs: big enough breath to push fluid out- if not, surface tension is created and lungs snap back together on exhale (unless surfactant)
- Keep air in alveoli- establish functional residual capacity
- Convert to adult circultation
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Ductious venosis
shunts blood away from liver
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Ductus arteriosis
shunts blood away from lungs
as 02 levels increase- will constrict
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Forman ovale
shunts blood from right side of heart to left
closes because of decreased pressure on right side and increased pressure on left
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Radiation
heat toward objects not touching
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Conduction
heat toward objects touching
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Evaporation
of water/AF from body
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Position of airway at deliver
position baby on back with neck straight
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Diaphragmatic hernia signs
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Choanal atresia
- tracheoesophageal fistula
- omphalocele
- cleft lip/palate
- Imperforated anus
- Syndactly
- spina bifida
- trauma-broken clavicle, bruising, caput
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Assess newborns vitals every
3-4 hours
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Newborn vitals
- R- 65 decrease to 40
- P- 160 decrease to 120
- temp- rises 96.6 to 98.6
- (Axillary recommended)
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When do you put the ID band on the newborn
Before you leave the room
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All newborns have a ______ deficiency and are at high risk for significant hemorhage
vit k
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when to give vit k
- 1 hour IM after birth to increase clotting factors
- 25 gauge needle
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can patients refuse vit k?
yes
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When to do comprehensive assessment?
first 4 hours (powerpoint)
Before 24 hours old (study guide)
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Eye prophalixis
Eye ointment/llotycin
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eye prophalixis prevents
When is it given?
gonorrhea and clamydia and is given within an hour
No proven SE
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is eye prophalaxis state mandated?
Yes, can have a waiver but must be before birth
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