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N113 Newborn

N113 - Newborn care & assessment

QuestionAnswer
What are normal head circumferences? 13-14 inches, 1 inch larger than chest circumference.
What are normal chest circumferences? 12-13 inches
What is normal heat to heel length? 19-21 inches
What is normal birth weight? 6-9 pounds, loss of 10% of weight in first week, will regain in 10-14 days
What is a normal temperature? 97.9*-100.4* rectal - anything below or above is considered abnormal. If temp is low, put on hat & wrap in warm blanket and recheck temp
What is a normal heart rate? 120-140 beats per minute, crying will increase HR, sleep will decrease HR
What are normal respiration? 30-60 breaths per minute, crying will increase RR, sleep will decrease RR
What posture should a newborn have? Flexion of head and extremities, which rest on chest & abdomen.
How is a frank breech different? Extended legs, abducted and fully rotated thighs, flattened occiput, extended neck
How should the skin look in a newborn? Bright red, puffy & smooth at birth. Second to third day, pink, flaky & dry. Vernix caseosa will be present, more in preterm, less in past due infant.
What is acrocyanosis? Cyanosis of the hands and feet.
What is milia? Distended sebaceous glands that appear as tiny white papules on cheeks, chin & nose.
How should the anterior fontanel appear? Should be diamond shaped, sunken fontanel is a sign of dehydration, closes at approx 18 mos
How should the posterior fontanel appear? Should be triangular, closes earlier than anterior fontanel
What is caput succedaneum? Swelling that crosses the midline of the cranium
What is cephalhematoma? Hemorrhage of blood between the periosteum & skull bone - doesn't cross midline
What is the pilonidal cyst or sinus? Small dimple near tailbone. Make sure its not an actual opening.
What can quivering or momentary tremors indicate? Can be sign of low blood sugar or something more serious.
What are the important reflexes? Sucking, gag, rooting, grasp, babinski, Moro, Startle, Asymmetric tonic neck, Dance or step.
What is the sucking reflex? Sucking movements in response to stimulation, persists throughout infancy even without stimulation such as during sleep.
What is the rooting reflex? Stroking the cheek causes infant to turn head toward that side and begins to suck. Should disappear around 3-4 months, but can remain until 12 months.
What is the grasp reflex? Touching palms of hand or soles of feet causes digits to flex, palmar grasp lessens after 3 months - replaced by voluntary movement. Plantar grasp lessens by 8 months of age.
What is the babinski reflex? When stroking the sole of the foot causes toes to hyper extend - disappears after age of 1
What is the moro reflex? Sudden jarring or change in equilibrium causes sudden extension & abduction of extremities and fanning of fingers, disappears after age of 3-4 months
What is the startle reflex? A sudden loud noise causes abduction of the arms with flexion of the elbows, hands remain clenched, disappears by 4 months
What is the aysmmetric tonic neck? When infant's head is turned to one side, arm and leg extend on that side & opposite arm & leg flex. Disappears by age 3-4 months replaced by symmetric positioning.
What are the neonatal signs of low blood sugar? Jitteriness, tremors, twitching, weak or high pitched cry, lethargy, limp
What is routine circumcision care? Post-circumcision, check for bleeding q15 min for 1st hour, then q 1 hour x 4 hours
What is the recommended way to breast feed? Chest to chest, chin to breast - use pillows for support.
How do you know the baby is getting enough to eat? 6 to 10 wet diapers & 1 bm per day
How is LATCH used in charting breastfeeding? L - latch, A - audible swallowing, T - type of nipple, C - comfort (breast/nipple), H - hold (positioning)
What teaching should be given for non-breastfeeding mothers? Do not stimulate or manipulate breasts, avoid warm water on breasts, do not let shower water hit breasts, wear well-fitting supportive bra, no supply, demand will dry up.
What should the mother do when the milk comes in? Use breast binder, ice packs, Tylenol
What are some warning signs for a newborn? No urine in first 24 hours, no bm in first 48 hours, temp, rapid breathing over 60 per/min, retractions, wheezing, odor, drainage or bleeding from ublilical stump, yellow coloring
Created by: jrb265 on 2009-02-08



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