nur 1030 comp 4

Convection

Heat loss from the newborn's body to cooler surrounding air currents (e.g., drafts from an open door).

Conduction

Heat loss from the newborn's body directly into a cooler solid object in contact with the skin (e.g., a cold stethoscope or scale).

Radiation

Heat loss from the newborn's body to cooler solid objects nearby that are NOT in direct contact (e.g., a cold window).

Evaporation

Heat loss occurring as moisture on the skin turns to vapor. (e.g., immediately after birth when covered in amniotic fluid). Intervention: Dry infant immediately!

Normal Newborn Respiratory Rate

30 to 60 breaths per minute. Short pauses (<20 seconds) known as periodic breathing are normal.

Normal Newborn Heart Rate

110 to 160 beats per minute. Assessed by listening to the apical pulse for a full minute.

Caput Succedaneum

Localized swelling of the soft tissues of the scalp that CROSSES the cranial suture lines. Results from pressure during labor. Resolves in a few days.

Cephalohematoma

A collection of blood between the periosteum and the skull bone that DOES NOT cross the suture lines. Increases the risk of jaundice as the RBCs break down.

Barlow and Ortolani Maneuvers

Physical exam techniques used to assess the newborn's hips for developmental dysplasia (looking for a dislocation "clunk").

Moro Reflex (Startle Reflex)

When startled by a loud noise or being dropped slightly, the infant's arms will symmetrically extend and then abduct back in.

Babinski Reflex

Stroking the lateral sole of the newborn's foot causes the toes to fan upward and out. This is a normal finding in infants up to 1 year of age.

APGAR Score (Components)

Appearance (Color), Pulse (Heart Rate), Grimace (Reflex irritability), Activity (Muscle tone), Respirations (Effort).

APGAR Scoring System

Scored 0-2 per category. Total of 10. Done at 1 and 5 minutes of life. A score of 7-10 is excellent/normal.

Acrocyanosis

A normal, benign finding in the first 24 hours of life where the newborn's hands and feet appear blue/cyanotic, while the core body remains pink.

Erythema Toxicum

A benign, transient "flea-bite" rash with pustules on an erythematous base that appears in the first few days of life. Requires no treatment.

Lanugo

Fine, downy hair that covers the body of a fetus/newborn. More abundant in premature infants.

CCHD Screening (Pulse Oximetry)

Done at 24 hours of life to screen for Critical Congenital Heart Defects. SpO2 must be >95% in right hand AND one foot, with <3% difference between the two.

Heel Stick Procedure

Puncture must be made on the outer lateral aspect of the heel to avoid hitting the plantar artery or the bone (preventing osteochondritis).

Phytonadione (Vitamin K)

IM injection given in the vastus lateralis at birth to prevent hemorrhagic disease of the newborn, because the infant's gut is sterile and cannot produce it.

Erythromycin 0.5% Ophthalmic Ointment

Applied to the lower conjunctival sac of both eyes shortly after birth to prevent Ophthalmia Neonatorum (blindness caused by maternal gonorrhea/chlamydia).

Hepatitis B Vaccine

Given IM within 24 hours of birth to induce active immunity against the Hepatitis B virus. Requires parental consent.

Hepatitis B Immune Globulin (HBIG)

Given IM within 12 hours of birth ONLY if the mother is Hepatitis B positive. Provides immediate passive immunity.

Nirsevimab

A monoclonal antibody given in the first week of life to prevent severe Respiratory Syncytial Virus (RSV) disease.

EMLA Cream

A topical anesthetic (Lidocaine/Prilocaine) used to numb the skin prior to circumcision. Must be applied 1-2 hours before the procedure.

Sacral Dimple / Hair Tuft

Physical assessment findings on the lower back that are a red flag for neural tube defects like spina bifida occulta or a tethered cord.