week 8 guided notes

Apgar Score

Structured assessment performed at 1 and 5 minutes after birth evaluating 5 categories: Appearance, Pulse, Grimace, Activity, Respiration.

Apgar Components & Signs

Appearance (Color), Pulse (Heart rate), Grimace (Reflex irritability), Activity (Muscle tone), Respiration (Breathing pattern).

Signs of Newborn Respiratory Distress

Tachypnea (RR > 60 breaths/min), nasal flaring, intercostal retractions, and grunting.

Caput Succedaneum vs. Cephalohematoma

Caput succedaneum is soft tissue scalp edema crossing suture lines; cephalohematoma is subperiosteal bleeding that does NOT cross suture lines.

Obligate Nose Breathers

Newborns primarily breathe through the nose, making nasal patency assessment clinically critical.

Two-Vessel Umbilical Cord Significance

Associated with potential renal or cardiovascular congenital anomalies.

Acrocyanosis vs. Central Cyanosis

Acrocyanosis (bluish hands/feet) is a benign, expected finding; central cyanosis (lips/mucous membranes) indicates hypoxia.

Babinski Reflex

Toes fan outward and dorsiflex when the lateral sole of the newborn's foot is stroked.

Primitive Newborn Reflexes

Rooting (turns toward mouth stimulus), Moro (arm extension to startle), Palmar grasp (fingers curl around object), Stepping (automatic walking motion).

First Period of Reactivity

Initial 30-60 minutes post-birth where newborn is awake, alert, and demonstrates strong reflexes.

Non-Physiologic Jaundice Timing

Jaundice appearing within the first 24 hours of life is abnormal and requires immediate evaluation.

Safe Sleep Recommendations (ABC)

Alone (no pillows/blankets/toys), Back (supine position), Crib (flat, firm surface), Room-sharing without bed-sharing.

Discharge Readiness Evaluation

Assesses newborn physiologic stability (vitals, feeding, elimination) and caregiver readiness (competence and safety plan).

Newborn Fever Threshold

Temperature ≥ 100.4°F (38.0°C) requires immediate provider contact due to risk of neonatal sepsis.

Dangers of Formula Over-Dilution

Leads to calorie deprivation, malnutrition, hyponatremia, and severe electrolyte imbalances.

Teach-Back Method

Educational verification strategy where caregivers explain or demonstrate care instructions in their own words.

Immediate Post-Birth Nursing Priority

Establishing and maintaining a clear airway and adequate breathing before all routine interventions.

Cold Stress Effects

Hypothermia causes non-shivering thermogenesis (brown fat breakdown), increasing oxygen consumption and risking hypoglycemia.

Vitamin K Prophylaxis

Single IM injection given after birth to prevent Vitamin K Deficiency Bleeding (VKDB) due to immature clotting factor production.

Newborn Stool Progression

Meconium (sticky, dark tarry) -> Transitional (greenish-brown) -> Breastfed (yellow, seedy) or Formula-fed (tan/green, formed).

Hunger Cues: Early vs. Late

Early cues include rooting, lip smacking, and hand-to-mouth movements; crying is a late, dysregulated cue.

LATCH Assessment Tool

Standardized acronym evaluating Latch, Audible swallowing, Type of nipple, Comfort, and Help needed during breastfeeding.