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M6 13-005

Exam 10: Normal Term Newborn

Physical Characteristics of the Newborn: Head Assessment Molding Suture Lines Fontanelles Caput Succedaneum Cephalohematoma
Caput Succedaneum A swelling formed on the presenting part of the head of a fetus during labor, resulting in edema and varying degrees of scalp hemorrhage.
Cephalohematoma a localized effusion of blood beneath the periosteum of the skull of a newborn, due to disruption of the vessels during birth
Physical Characteristics of the Newborn: Face Symmetry, features, movement, expression, transient asymmetry.
Physical Characteristics of the Newborn: Eyes Abnormalities, inflammation, symmetry, strabismus, color, pupils, tears, edema, acuity
Physical Characteristics of the Newborn: Ears Placement, overall appearance, position, hearing
Physical Characteristics of the Newborn: Nose Patency, discharge and septal deviation
Physical Characteristics of the Newborn: Mouth Visual and palpation, color, epstein’s pearls
Physical Characteristics of the Newborn: Neck and Clavicles Fractures
Physical Characteristics of the Newborn: Integumentary System -Color -Vernix, -Lanugo -Milia
Physical Characteristics of the Newborn: Respiratory System Oxygenation: -Rate -Accessory muscles -Color -Sounds
Physical Characteristics of the Newborn: Cardiac System Perfusion: -Rate -Abnormal Sounds -For rate: Always APICAL -Peripheral pulses -Capillary Refill
Physical Characteristics of the Newborn: Gastrointestinal Feeding: -Initial -Frequency and duration or amount Abdomen Stools -Meconium -Transitional -Breast vs Formula
Vernix thick white substance composed of sebum and desquamated epithelial cells that provides a protective covering for the skin of the fetus.
Milia Tiny white bumps that most commonly appear across a baby's nose, chin or cheeks.
Physical Characteristics of the Newborn: Genitourinary Urine: -First void by 24 hours -Frequency Genitalia: -Female: swollen, white discharge, pseudomenstration -Male: --Scrotum: palpate testicles, observe skin --Meatus location
Physical Characteristics of the Newborn: Neurological Reflexes: -Root -Suck -Moro -Plamar/Plantar Grasp -Babinski -Step -Tonic neck
Newborn Assessment: Measurements Length. Weight. Head circumference. Chest Circumference. Vital Signs: -Temperature -Heart rate -Respiratory rate
Newborn Assessment: Early Care -Stabilization -Vitamin K -Eye treatment
Newborn Assessment: Ongoing Assessments and care Cord care. Abduction prevention. Nutritional needs.
Newborn Assessment: Breastfeeding Colostrum Transitional Milk Mature Milk Later Bottle feeding
Newborn Assessment: Heat Loss Prevention -Predisposition to heat loss. -Methods of heat loss.
Newborn Assessment: Facilitate Bonding Bonding Attachment Maternal touch Verbal behaviors Nursing interventions
Lanugo The fine, soft hair that grows on a fetus and is present on a newborn.
Palmar grasping reflex when the infant’s palm is touched near the base of the fingers. Hand closes into a tight fist.
Plantar grasp reflex occurs when the area below the toes is touched; infant’s toes curl over the examiner’s fingers.
Tonic Neck Reflex supine position, the infant's head is quickly turned to one side, arm and leg will extend on that side, and opposite arm and leg will reflex; posture resembles a fencing position.
Babinski Elicited by stroking the lateral sole of the infant’s foot from the heel forward and across the ball of the foot. Causes the toes to flare outward with dorsiflexion of big toe.
Dance or stepping reflex Occurs when infants are held uprights with their feet touching a solid surface. They lift one foot and then the other, giving the appearance that they are trying to walk.
Average Length (a) 19-21 inches (48-53 cm). (b) Measure from the top of the head to the end of the outstretched leg.
Weight Range: 5 lb 8 oz to 8 lb 13 oz (2500-4000 gm).
Head Circumference: (a) 33-35.5 cm (13-14 inches). (b) Measure around the fullest part of the head, just above the eyebrows (frontal) and over the occiput.
Chest Size: (a) Averages 12 to 13 inches (30.5 to 33 cm). (b) Is 2-3 cm less than head circumference.
Temperature: (a) Axillary: 36.5-37.5 C (97.7-99.5 F). (b) Rectal 36.5-37.6 C (97.7-99.7 F). (c) Axilla is the preferred site.
Heart Rate: (a) Normal rate 120 to 160 beats/minute with normal activity. (b) May rise to 180 beats/minute when the infant is crying, or drop to 100 beats/minute during deep sleep. (c) Count apical pulse for a full minute.
Respiratory Rate: (a) Normal rate is 30 to 60 breaths/minute. (b) Chest should move symmetrically, although pattern and depth of respirations are irregular. Respirations should not be labored. (c) Count rate for 1 full minute for accuracy.
Early Care: Vitamin K Given to neonates because they cannot synthesize vitamin K in the intestines without bacterial flora.
Early Care: Providing Eye Treatment Given to prevent ophthalmia neonatorum, an eye infection due to exposure to maternal gonorrhea. Also prevents conjunctivitis due to chlamydia infection.
Cord Care Check bleeding or oozing hours after birth. Clamp must be secure. Assess for signs of infection.
Prevent Infant Abduction Teach parents how to recognize picture identification badges worn by birth facility personnel. Parents must be cautioned never to give infant to anyone who does not have proper identification.
Colostrum A thick yellow substance high in protein, minerals, fat soluble vitamins and immunoglobulins, which transfers some immunity to the infant. Its laxative effect speeds the passage of meconium.
Transitional milk Appears as the milk changes from colostrums to mature milk. Immunoglobulins and protein decrease, whereas lactose, fat, and calories increase.
Mature milk Established by two weeks after delivery. Bluish in color and not as thick as colostrum.
Preventing Heat Loss: Characteristics Skin is thin and blood vessels are close to the surface. Little fat to serve as a barrier to heat loss. Newborns have three times more surface area to body mass than adults do, which provides more area for heat loss.
Methods of Heat Loss Evaporation-Convection-Conduction-Radiation
Evaporation 1) Occurs when wet surfaces are exposed to air. 2) Drying the infant, especially the head, as quickly as possible at birth and after bathing helps prevent excessive heat loss.
Convection 1) Occurs when newborns come in direct contact with objects that are cooler than their skin. 2) Placing infants on cold surfaces or touching them with cool objects causes this type of heat loss.
Conduction 1) Occurs when heat is transferred to air surrounding the infant. 2) Air currents from A/C or people moving around increase loss of heat.
Radiation 1) Transfer of heat to cooler objects that are not in direct contact with the infant. 2) For example, infants placed near cold window lose heat by radiation.
Bonding Refers to the rapid initial attraction felt by parents soon after childbirth.
Attachment an enduring bond between a parent and child is developed through pleasurable, satisfying interaction.
Maternal Touch (a)Mom holds it in an en face position with the infant’s face in the same vertical plane as her own. (b)She may gently explore the infant’s face, fingers, and toes with her fingertips referred to as fingertipping (common during the early minutes).
Verbal Behaviors (a) Important indicators of maternal attachment, most mothers speak in a high-pitched voice. (b) Verbal behaviors may provide clues to a mother’s early psychological relationship with her infant.
Nursing Interventions allow parents to see and hold infant (dictated by the condition of the mother and baby); encourages parents to touch the baby
Created by: jtzuetrong