NRSG 328 Newborn

how many veins does the umbilical cord have?

1

how many arteries does the umbilical cord have?

2

what is the ductus venosus?

diverts some blood away from the liver as it returns to the placenta

connects the umbilical vein to the inferior vena cava, allows the most oxygenated blood to bypass the liver and travel to the heart

what is the foramen ovale?

diverts most blood from the right atrium directly to the left atrium

connects the umbilical vein to the inferior vena cava, allowing most of the oxygenated blood to bypass the liver and travel to the heart

what is the ductus arteriosus?

diverts most blood from the pulmonary artery into the aorta and also helps bypass the lungs

what happens to the foramen ovale after birth?

closes

what happens to the ductus venosa and ductus arteriosus after birth?

convert to ligaments

what does the ductus arteriosus convert to after delivery?

ligamentum arteriosum

what does the ductus venosus convert to after delivery?

ligamentum venosum

what are the 2 chemical stimuli of resp/cardiac in transition to extra-uterine life?

cessation of umbilical cord flow

stimulation of aortic and carotid chemoreceptors

what are the 4 mechanical stimuli of resp/cardiac in transition to extra-uterine life?

compression of the chest during birth removes fluid from the neonates lungs

air replaces fluid in lungs during re-expansion at birth

further lung expansion from cries

inc intrathoracic pressure helps to open and fill alveoli with air

what are the 3 newborn transition considerations after birth

skin to skin

timing of umbilical cord cutting

routine suctioning

what is normothermia range for babies?

36.5 to 37.5

what does APGAR stand for?

activity

pulse

grimace

appearance

respiration

what is the score system for activity?

0 points: absent

1 point: arms and legs flexed

2 points: active mvmt

what is the score system for pulse?

0: absent

1: below 100

2: over 100

what is the score system for grimace?

0: flaccid

1: some flexion of extremities

2: completely flexed

what is the score system for appearance?

0: blue and pale

1: body pink, extremities blue

2: completely pink

what is the score system for respirations?

0: absent

1: slow, irregular

2: vigorous cry

what apgar score indicates severely depressed?

0-3

what apgar score indicates moderately depressed?

4-6

what apgar score indicates excellent condition?

7-10

what is the moro reflex?

the startle reflex where the nurse holds the baby and lets it "drop" in her hands and the baby's legs and arms move up in a startle motion/crying

what is the palmar reflex?

a baby grasps an object placed in the palm of its hand

what is the plantar reflex?

curling toes

what is the babinski reflex?

fanning out of toes

what is rooting?

turning the head and opening the mouth in the direction of a touch on the cheek

what is tonic neck?

when baby head is turned to one side the arm on that side stretched out and the opposite arms bends at the elbow

what is fencing?

tonic neck reflex

day 1 newborn elimination

meconium poo

sticky, green-black

day 2 newborn elimination

soft green-black poo

day 3 newborn elimination

green brown poo

day 4 newborn elimination

brown yellow poo

can have seedy or grainy texture

day 5 newborn elimination

yellow mustard color

what are the 4 newborn identification and safety?

bracelets for ID

security bands

rooming in w parents

safety on surfaces, heat

what are the newborn meds?

vitamin K

erythromycin eye prophylaxis for ophthalmia neonatroum

what is vit K for?

activates coagulation factors

prevents hemorrhagic disease

what is erythromycin eye prophylaxis fpr ?

prevents ophthalmia neonatorum

CPS does not recommend universal prophylaxis

review prenatal records for STI screening

what is ophthalmia neonatorum for?

gonorrhea corneal ulceration

chlamydia-conjunctival

corneal scarring

when should you admin Vit K?

administer within 6 hrs of birth

what are the 3 newborn routine procedures?

hearing screening

metabolic screening card-27 disorders

congenital heart disease screening: pulse oximetry

what does the metabolic screeding test screen for? (4)

metabolic: PKU, galactosemia

endocrine: congenital hypothyroidism

blood: sickle cell anemia

cystic fibrosis

what can pulse oximetry screening identify?

cyanosis

detection rate of 50% of infants w CCHD

What is CCHD?

critical congenital heart disease

when should term and late preterm infants be screened?

24-36 hrs

what extremities does the POS test use?

right hand and one foot

what is jittery like in a newborn?

jittery when you hold the arm and the shaking stops

what is seizure like in a newborn?

seizures will cont even when the arm is held

what are the risk screening algorithm for newborn safety?

risk of sepsis

GBS/Guillain-Barré syndrome: rupture of membranes >18 hrs, maternal fever

neonatal hypoglycemia

Hepatitis B

HIV prophylaxis

car seat test

vital signs and symptoms of NAS/Neonatal Abstinence Syndrome for SSRI use

when should you give the baby their first bath?

at least 24 hrs after birth

when should you remove the cord?

clean and dry

what is the weight loss initally?

up to 10%

what are newborn infections

resp distress

temp instability

tachycardia

seizures

hypotonia

lethargy

poor peripheral perfusion

hypotension

acidosis

what are the SS of resp distress

inc RR

inc WOB

grunting

nasal flaring

retractions: intercostal, subcostal, tracheal tug

cyanosis

what is purple crying?

The time period when babies cry and they are inconsolable.

do not shake your baby

what are the 8 discharge teachings?

feeding cues/patterns

safe sleep/SIDS prevention

injury prevention: car seats, burns, falls

plagiocephaly prevention

attachement/bonding

vitamin D

routine immunization

what is plagiocephaly

when a baby develops a flat spot on one side of the head or the whole back of the head