Normal Newborn

until baby has had admission bath

must wear disposable gloves

interventions immediately after delivery

placed on mothers chest

tactile stimulation

bulb suction

cord may be clamped

care within first hour

vs, assessment, breastfeeding

times to assess apgar

1,5, 10 if needed

resuscitate if apgar

< 8

APGAR categories

Appearance - color

Pulse - heartrate

Grimace - reflex irritability

Activity - muscle tone

Respiratory effort

three meds to give to baby immediately after birth

erythromycin

vitamin K

hepatitis b

only check blood glucose on baby if

small or large for gestational age

preterm

apgar <7

diabetic mom

regular neonate bg

40 mg/dl

assessments post birth

weight, lengths, circumferences

gestational age assessment

reflexes

rooting (cheek)

sucking (tongue)

tonic neck (fencing)

palmar grasp

moro reflex (startle)

babinski (foot)

neonate vision

8-12 inches

high contrast colors - red, black, white

neonate sleep schedule

sleep 2-4 hours at a time for 15-20 hours/ day

swelling that crosses suture lines

caput

collection of blood beneath the skin that does not cross suture lines

cephalohematoma

normal eye findings

-grey sclera and edematous

neonate takes first breath

when cord is clamped

neonate breathing

periodic (<10 second pause)

signs of respiratory distress

cyanosis (full body)

regular rhythm

rate > 60

retractions

grunting

fetal shunts begin to close after cord clamped. if failure to close

cyanosis

murmurs (innocent or pathological)

thermoregulation interventions

skin to skin

keep head covered first 24H

delay bath for 8-48H

cold stress

<36.5 C

results of cold stress

acidosis, hypoglycemia, respiratory distress

neonate vitals

HR 110-160

RR 30-60

Temp 36.5-37.5 C

asymmetrical hip folds indicate

congenital hip dysplasia

red skin

ruddy

types of birthmarks

telangiectatic nevi (stork bites)

congenital dermal melanocytosis

strawberry hemangioma

normal skin findings

milia

peeling skin

erythema toxicum (newborn rash)

peak bilirubin level (causes brain damage above this)

10-12 mg/dl

pathologic jaundice

first 24 hours

result of blood incompatibility or trauma

physiological jaundice

2-3 days post birth and resolves with in 5-7 days

brain damage and lethargy cause by high bilirubin levels

kernicterus

jaundice treatment

feeding and phototherapy

amount of voids for neonates

1-3 in 24h and at least 6 by 4th

amount of bms for neonates

1-5 in 24h

frequency of feeding

breast - Q 2-4 hours

bottle - Q 3-4 hours

refluxing may indicate

overfeeding, formula intolerance, anatomical defect

how to prevent refluxing

keep upright 20-30mins

burp frequently

newborn must receive ___ 24h prior to test

protein feeding

conditions tested in newborn screen

PKU

maple syrup urine disease

congenital hypothyroidism

sickle cell disease

cystic fibrosis

screenings before discharge

hearing

CCHD

SIDs risk factors include

2-4 months

sleeping on stomach

thick blankets/pillows

overheating

smoking

lower risk of SIDs

breastfeeding

pacifier

back sleeping