Week 7 - CH 16 Newborn Nutrition & CH 17 Complications Care

what are the five rights of patient teaching?

right time, right context, right goal, right content, and right method

when is teaching unlikely to be effective?

when the patient has severe pain, anxiety, exhaustion, intense emotions, distractions, or excitement about discharge

why is partner involvement important during breastfeeding?

partner support with infant care and household responsibilities helps the mother rest, conserve energy, and maintain lactation

what is the greatest advantage of human milk over formula?

it contains antibodies, active enzymes, and immune factors that protect against infections and establish healthy gut flora

which antibodies are especially abundant in human milk?

IgA and IgG

what maternal infections contraindicate breastfeeding?

active untreated tuberculosis, maternal HIV infection, and active herpes lesions directly on the breast of nipple

what maternal treatments contraindicate breastfeeding?

chemotherapy, antimetabolites, and diagnostic or therapeutic radioactive isotopes

what maternal substances contraindicate breastfeeding?

amphetamines, PCP, cocaine, cannabis, street drugs, ergotamines,and statins

what newborn condition contraindicates breastfeeding?

galactosemia because the infant cannot properly metabolize galactose

which vitamins are insufficient in human milk?

vitamin D and K

when is colostrum produced?

from the second trimester through postpartum day 2

what are the characteristics of colostrum?

it is thick, yellow, produced in small amounts, and high in protein and immunoglobulins

how does colostrum help the newborn eliminate meconium?

it acts as a natural laxative

when is transitional milk produced?

approximately postpartum days 3-8, sometimes continuing through day 12

how does transitional milk differ from colostrum?

protein decreases while fat, carbohydrates, and calories increase

when does mature milk usually appear?

around postpartum day 12

what is foremilk?

the watery milk released at the beginning of feeding that satisfies thirst

what is hindmilk?

the high-fat milk released near the end of feeding that satisfies hunger and promotes weight gain.

why should the infant empty one breast during feeding?

so the infant receives the high-fat hindmilk

which hormone produces milk?

prolactin

which hormone causes milk ejection or the let-down reflex?

oxytocin

how does skin-to-skin contact help breastfeeding?

it stimulates proactin and oxytocin and decreases stress for both mother and infant

What are early infant hunger cues?

lip smacking, rooting, licking, hands-to-mouth movements, and a quiet-alert state

what is the best indicator that an infant is ready to latch?

opening the mouth widely in response to rooting

is crying an early or late hunger cue?

a late hunger cue

during latching, should the mother bring the breast to the baby?

no. bring the baby to the breast when the mouth opens widely

how should the mother safely remove the infant from the breast?

insert a clean finger into the corner of the infant’s mouth to break suction first

what does LATCH stand for?

Latch, Audible swallowing, Type of nipple, Comfort, and Help required.

what finding shows effective milk transfer?

Audible swallowing or gulping

what nipple types may require assistance from a breast pump?

flat or inverted nipples

what is the desired maternal comfort finding during breastfeeding?

no significant pain or nipple skin breakdown

how should breastfeeding mothers clean their nipples?

with water only

why should soap and alcohol be avoided on nipples?

they remove natural oils and cause drying and cracking

what may be applied to sore nipples after feeding?

expressed breast milk

which breast should the mother offer first when one nipple is sore?

the less sore breast

what should be appled before feeding for engorgement?

a warm compress or warm shower to promote let-down

according to the course notes, how long may breast milk remain at room temperature

six to eight hours

according to the course notes, how long may breast milk remain refrigerated?

five to eight days in the coldest area at the back

how long may breast milk be stored in a standard freezer?

three to six months

how long may breast milk be stored in a deep freezer?

six to twelve months

where should breast milk never be stored?

on the refrigerator or freezer door

how should frozen breast milk be thawed?

overnight in the refrigerator or by placing the container in warm water

why should breast milk never be microwaved?

microwavving creates dangerous hot spots and destroys protevtibe immune components

what can happen when formula is over-diluted?

water intoxication, hyponatremia, cerebral edema, and seizures

what can happen when formula is under-diuluted?

dehydration, hypernatremia, and renal strain

what is the proper position for formula feeding?

hold the infant semi-upright with the head higher than the trunk

why should the bottle nipple remain filled with formula?

to reduce swallowed air

what should be done with formula left after feeding?

discard it.

why should a bottle never be propped?

bottle propping increases the risk of choking, tooth decay, and otitis media

what hydration teaching should be provided to a breastfeeding mother?

keep water nearby and drink while breastfeeding

which high-mercury fish should breastfeeding mothers avoid?

shark, swordfish, king mackerel, and tilefish

what is the ocrrect bulb-syringe sequence?

compress the bulb first, suction the mouth, and then suction eahc nostril

why is the mouth suctioned before the nose?

suctioning the nose first may stimulate inhalation and aspiration of oral secreions

how is newly circumcised penis protected from sticking to the diaper?

apply petroleum or use petroleum gauze after diaper changes

should petroleum be applied to a Plastibell circumcision?

no. Lubricant may displace the Plastibell

when should a Plastibell ring normally fall off?

in approximately one week

what is a normal circumcision finding?

a yellow exudate or crust over the site; it should not be removed

what circumcision findings require notifying the provider?

no urination within 24 hours or bleeding larger than a quarter

what methods can be used for circumcision pain?

acetaminophen and a sucrose pacifier

why is daily bathing with soap unnecessary?

soap removes protective skin lipids and can cause severe drynesss and irritation

what should be used to wash the newborn’s face?

plain water

should a newborn be bathed before or after feeding?

before feeding to reduce the risk of vomiting.

beginning around day 3-4, how many wet diapers are expected dialy?

6-8

beginning around day 3-4, how many stools are expected daily?

2-3

what elimination findings should be reported?

fewer than six wet diapers daily, constipation, or runny green stools

how should the diaper be positioned around the umbilical cord?

fold the diaper below the cord stump to prevent urine contamination

when is the cord clamp generally removed?

approximately 24 hours after birth

what is the “rule of threes” for infant colic?

crying for more than 3 hours per day, more than 3 days per week, for more than 3 weeks

what does PURPLE crying mean?

Peak of crying, Unexpected, Resists soothing, Pain-like face, Long-lasting, and Evening crying

what should an overwhelmed caregiver do when the infant will not stop crying?

place the infant safely on their back in the crib, walk away for 10-15 minutes, cam down, and contact a trsuted person if needed

what items should be excluded from the infant’s sleep space?

loose blankets, pillows, bumper pads, stuffed animals, and positioners

what item may reduce the risk of SIDS when offered at sleep time?

a clean, dry pacifier

when must swaddling be stopped?

as soon as the infant shows signs of attempting to roll.

what defines low birth weight?

birth weight below 2,500 g

what defines very low birth weight?

birth weight below 1,500g

what defines extremely low birth weight?

birth weight below 1,000 g

what gestational age is extremely premature?

less

what gestational age is very premature?

28-31 weeks

what gestational age is considered premature?

32-33 weeks

what gestational age is considered late premature?

34-36 weeks

what common problems occur in premature infants?

respiratory difficulty, poor temperature regulation, feeding difficulty, and unstable glucose

what physical findings are expected in a preterm infant?

extended posture, thin translucent skin, little subcutaneous fat, and increased lanugo

when does suck-swallow-breate coordination generally mature?

around 34 weeks’ gestation

what blood glucose level is desired in a preterm newborn?

provide a neutral thermal environment

why are preterm infants highly susceptible to cold stress?

they have limited brown fat and subcutaneous fat

what causes respiratory distress syndrome (RDS)?

immature alveoli and insufficient surfactant, resulting in alveolar collapse

what are the manifestations of RDS?

tachypnea, grunting, retractions, nasal flaring, cyanosis, and seesaw breathing

what prenatal test assesses fetal lung maturity?

the lecithin-to-sphingomyelin ratio obtained through amniocentesis

what prenatal medication accelerates fetal surfactant production?

intramuscular betamethasone administered to the mother

how is surgactant replacement administered after birth?

directly into the newborn’s lungs through an endotracheal tube

how does surfactant replacement improve breathing?

it decreases alveolar surface tension and prevents alveolar collapse

what causes bronchopulmonary dysplasia?

chronic lung injury from prolonged mechanical ventilation and oxygen therapy

are infants born with BPD?

no. it develops as a compication of respiratory treatment.

what is a key manifestation of BPD?

difficulty weaning the infant from oxygen or mechanical ventilation.

what are the nursing priorities for BPD?

restrict fluids, monitor daily weight and intake/output, and gradually wean respiratory support

what is the main difference between RDS and BPD?

RDS results from insufficient surfactant, BPD results from prolonged ventilation and ocygen exposure

what happens in patent ductus arteriosus?

the ductus arteriosus remains open, causing left-to-right blood flow from the aorta into the pulmonary artery.

what complications can result from PDA?

pulmonary overcirculation, congestive heart failure, and lung disease.

what complications can result from PDA?

pulmonary overcirculation, congestive heart failure, and lung disease.

what findings suggest PDA?

a continuous murmur at the upper left sternal bord