Newborn Adaptation and Nursing Care Flashcards

Flashcards for reviewing Newborn Adaptation and Nursing Care

What reflex triggers the first breath in a newborn?

Pressure changes, cold, noise, light, and tactile stimulation

What chemical triggers contribute to a newborn's first breath?

Cord clamping, increased PO2, increased PCO2, and decreased pH

What is the number one factor in controlling the closure of the Ductus Arteriosus?

Oxygen

What occurs in a neutral thermal environment?

O2 consumption and metabolism are minimal

List four methods of heat loss in newborns.

Conduction, Evaporation, Radiation, Convection

When are APGAR scores performed?

In the delivery room at 1 & 5 minutes (10,15 & 20 min PRN)

What do APGAR scores determine?

Success of neonatal resuscitation, the infant's general well being, and success of transition

What APGAR score indicates the need to start resuscitation?

Anything below a 7 at 1 or 5 minutes

What vital signs are assessed during the initial newborn assessment?

Respiratory rate, Heart rate, Blood pressure, Temperature

What are the normal respiratory rate range for a newborn?

30-60 bpm, periodic breathing apnea (<15 seconds)

What is the normal heart rate range for a newborn?

100-160 bpm

What is the normal axillary temperature range for a newborn?

36.5 – 37.2

What are common skin conditions observed in newborns?

Vernix caseosa, Lanugo, Rashes or lesions, Birthmarks

What is Molding?

“cone head” overriding suture lines so that the head will pass through the birth canal- will resolve within a week.

What is Caput?

Swelling and edema on the scalp from pressure of the birth process. **pushing for hours, vacuum delivery. Dissipates with in a few days.

What is Cephalhematoma?

Localized subperiosteal collection of blood confined by one cranial bone.

What is a potentially concerning finding related to the ears on a newborn assessment?

Ear problems may be indicative of renal dysfunction

What is the recommended nutrition for newborns?

Breastfeeding

What are some advantages of breastfeeding for the infant?

Decreased risk of: Ear infections, GI infections, Allergies, Obesity, Diabetes, SIDS, Leukemia, Crohn’s Disease, Ulcerative colitis, Asthma, Respiratory infections, Re-hospitalization, Diarrhea, Enhances brain growth & development, Enhances IQ, Enhances visual acuity, Bonding

What is Lactogenesis I?

Initially occurs with or without suckling by infant

What is Lactogenesis II?

Onset of copious amounts of milk

What can a mom do to increase milk supply?

Feed more frequently at the breast, Empty the breasts more thoroughly, Use massage/compression during feedings, Express milk after feedings, Skin to skin care with the baby

What are the Breastfeeding support and Initiatives?

Baby-Friendly Hospital Initiative, Texas Breastfeeding Coalition, Dallas Area Breastfeeding Coalition, International Lactation Consultants, Lamaze International, La Leche League International, Texas WIC

List some signs of a good latch during breastfeeding.

Flanged lips, Tongue may be visible when bottom lip is pulled down, Cheeks are rounded, Audible swallowing, Breast compression, Nipple is non-distorted, Emptying of the breast is noted, Infant ends feeding with signs of satiety

List some advantages of Expressed Breastmilk (EBM) for preterm infants

Protect from NEC, Infection prevention, Increase feeding tolerance, Decreases risk for allergies, Tailored for gestational age

List the Weight Divisions for Newborns

Low Birth Weight (LBW) (<2500g), Very Low Birth Weight (VLBW) (<1500g), Extremely Low Birth Weight (ELBW) (<1000g)

List Equipment commonly used in the NICU

Isolettes, Radiant Warmer, Open Crib, Suction, Oxygen

List common modes of Ventilation used in the NICU

Ventilators, HFOV (High flow oxygen ventilator), Conventional Ventilator, HFJV (High flow jet ventilator) vs. Oscillator, CPAP, NC, HFNC, (Nasal cannula, high flow nasal cannula

What is TTN?

Transient Tachypnea of the Newborn: Delayed reabsorption of the normal lung fluid – usually occurs within hours of birth, Generally seen in term/late preterm infants with history of C-section

What are common treatments for RDS?

Surfactant, CPAP- nasal/endotracheal, Ventilator- intermittent or synchronized, High frequency oscillation or jet ventilator, Oxyhood, nasal cannula, Inhaled Nitric Oxide: causes pulmonary vasodilation, but still experimental tx

What is MAS?

Meconium Aspiration syndrome: Passage of fetus’s first stool in utero, possibly from hypoxic event

What can MAS cause?

Blockage of airway leading to hypoxia inflammation of airways and chemical pneumonitis, decreases surfactant production

What is CLD/BPD?

Chronic Lung Disease/ Bronchopulmonary Dysplasia: “Chronic” phase of RDS, will see increased respiratory distress, Will see impaired gas exchange, Due to constant/recurrent lung injury

What is ROP?

Retinopathy of Prematurity: Develops in 84% of preterm infants less than 28 weeks. With increased oxygen, retinal vessels constrict and become necrotic. This causes a stimulation of vessels to proliferate to reestablish circulation.

List common complications for Infants of Diabetic Mothers (IDM).

Major risk of congenital malformation (Cardiac, skeletal, CNS, GI, GU), LGA – risk for birth traumas, shoulder dystocia, C/S birth, RDS, hyperbilirubinemia, Lethargic after birth, Risk for hypoglycemia

What is the treatment for Hyperbilirubinemia?

Phototherapy (conjugates bilirubin)-expose as much skin as possible, eye protection, turn q 2 hrs, monitor temp and I&O, daily weights, feed q 2-3 hours

What is NEC?

Necrotizing Enterocolitis: Acute inflammatory disease of the GI tract. Complications: sepsis, perforation. Occurs in 5% of infants of VLBW

What are common Assessment Findings of NEC?

Feeding intolerance, abdominal distention, bloody stools, lethargy, shock, cyanosis, respiratory compromise, metabolic acidosis

What are common symptoms of Late Preterm (Near term) Newborns?

Increased resp. distress, late onset sepsis, thermo-regulation issues, ^ Risk Hyperbilirubinemia, hypoglycemia, sepsis