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Newborn Care:
Assessment, care, nurtri needs, circumcision, and discharge teaching
| Question | Answer |
|---|---|
| What are the five assessments in Apgar scoring? | heart rate, RR, muscle tone, cry, color |
| When are Apgar scores given? | scores given at 1 and 5 minutes of life. |
| What is the New Ballard Scale? | infant rating maturity scale that assesses neuromuscular and physical maturity. |
| What is lanugo? | fine down hair on newborn |
| What is milia? | small raised white spots on chin, nose, or forehead of newborn. |
| What is telangiectactic nevi (stork bites)? | flat pink/red marks that easily blanch on newborn's eyelids, back of neck, or forehead. |
| What is erythema toxicum? | pink rash that appears suddenly anywhere on newborn body during first 3 wks; no treatment required. |
| How larger should the head be to the chest circumference? | 2-3 cm larger |
| What is caput succedaneum? | localized swelling of soft tissues of scalp caused by pressure on head during labor, may cross over suture line, usually resolve in 3-4 days with no treatment. |
| What is cephalohematoma? | collection of blood between periosteum and skull bone, does not cross suture line, resolves in 3-6 wks. |
| What do newborn have tearless crying? | because of immature lacrimal glands |
| What is true? | Neonates are obligate nose breathers. |
| How many vessels should the umbilical cord have? | - 2 arteries - 1 vein |
| In what time frame should first urine and stool be passed? | Within 24 hrs after birth |
| What is Moro reflex? | spreading of the arms when startled or falling backward, disappears after 3-4 mo. |
| What is Tonic neck reflex? | fencer position by turning head to one side |
| What is Babinski reflex? | toes fan out when the foot is stoked upwards |
| What are normal RR and HR for neonate? | RR: 30-60/min HR: 110-160/min |
| What is phenylketonuria (PKU)? | defect in protein metabolism with amino acid accumulation that can lead to mental retardation. |
| Where on the foot should a heelstick blood sample be collected? | on the outer lateral aspect of the heel. |
| Where should nurse bulb suction first? | suction infant's mouth first to prevent gasping inhalation of pharyngeal secretions. |
| Heat can be loss through what four mechanisms? | conduction, convection, evaporation, radiation |
| What kind of bath should be given until the cord falls off? | Only sponge bath |
| What medication is given right after birth to prevent eye infection? | Erythromycin 0.5% ointment |
| How to administer Eryhtromycin ointment? | - apply to lower conjucnctival sac, from inner canthous outward - close eye for 5 sec, wipe excess after 1 min - adverse reaction is conjunctivitis that will resolve on its own |
| What is Vit K IM given? | to prevent hemorrhagic disorders |
| How to assess for sucking and swallowing reflexes prior to bottle feeding? | give a few sips of sterile water |
| How long does AAP recommend for exclusive breastfeeding of infant? | 6 months |
| What is colostrum? | mother's small amt of breast milk with IgA, secreted 1-3 days postpartum |
| How frequent should newborns be fed? | breastfeed: q 1.5-3 hr bottlefeed: q 3-4 hr |
| When are solid food introduced to infant? | at 6 months |
| What are some benefits of breastfeeding? | natural antibodies, easily digestible, high nutrition, improves calcium and phosphorus regulation |
| What is true? | Uterine cramps are normal during breastfeeding (resulting from oxytocin) |
| How long on the breast should mothers be encouraged to breastfeed their newborn? | 15+ min on each breast, to ensure infant gets rich hind milk |
| How to avoid nipple confusion in breastfeeding infant? | avoid pacifier and supplemental formula feeding |
| How long can breast milk be safely refrigerated after expression? | 48 hr |
| How long can breast be stored in the freezer? | up to 1 yr |
| How to thaw frozen breast milk? | - in fridge for 24 hr - under running or container of lukewarm water |
| How often should newborn be burped? | - after each breast, or - q 1oz of bottle feeding |
| How can parents know if their infant is adequately fed? | 6-9 wet diapers/day |
| What is true? | During bottlefeeding, the nipple should be kept full of formula. |
| Infant bottle feeding is best when held at what angle? | 45 degree angle |
| How much weight is normal for newborn to lose during the first 24 hr? | 5-10% loss from birth weight |
| What are contraindications to circumcision? | - hypospadias and epispadias - HO of bleeding tendencies in family - infection |
| What is true? | Anesthesia is mandatory for all circumcisions |
| What is the first action to active bleeding from circumcised area? | apply pressure with sterile gauze |
| What should be done if yellow exudate is noted around the head of the penis on a circumcised infant? | Nothing. It is part of the granulation process and healing of circumcision. |
| What is the priority in post circumcision care? | observe for bleeding q 15 min for 1 hr, then q 1 for 12 hr. |
| What is petroleum gauze applied to site for 24 hr in clamp circumcision procedure? | to prevent skin from sticking to the diaper |
| When will infant sleep through the night without a feeding? | at 4-6 mo. |
| How often should a newborn be bathed a week? | 2-3 times with mild soap/wk (start with cleanest to dirtiest part of infant's body) |
| What is the general rule to dressing an infant? | dress the infant as how you would dress yourself |
| In what direction should a car seat be facing for newborn to 1 year of age? | rear-facing car seat |
| How often are well-infant check-ups? | - at 2-6 weeks of age and - q 2 mo. until 6 mo. of age |
| What are some signs of illness parents should report? | temp >100.4 or <97.7, poor feeding, labor breathing, lethargy, eye drainage, decreased urination, forceful or frequent vomiting |
| Does AAP recommend routine circumcision? | No |
Created by:
odbal24
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