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parent/child: ch 22
| Question | Answer |
|---|---|
| What initiates breathing? | Result of the combination of chemical, mechanical, thermal, & sensory factors |
| What are the baby’s lungs lined with that helps them with breathing? | Surfactant |
| What are the signs of respiratory distress? | Nasal flaring, intercostal or subcostal retractions (in-drawing of tissue between the ribs or below the rib cage), or grunting with respirations |
| Acrocyanosis | The bluish discoloration of hands & feet, a normal finding in the first 24 hours after birth |
| What is the normal heart rate? | 120 - 160 beats/min |
| What kind of heart sounds would you hear? | S1: louder & duller than S2 S2: sharp 3rd & 4th heart sounds: not audible in newborns |
| What is normal blood pressure? | At birth: 75 - 95/37 - 55 12 hours: 50 - 70/25 - 45 96 hours: 60 - 90/20 - 60 Matches gestation |
| What are the different types of heat loss & examples? | Convection: the flow of heat from the body surface to cooler ambient air (ex: swaddles & caps worn when in bassinet) Radiation: loss of heat from body surface to a cooler solid surface that’s in relative proximity (ex: bassinets are away from windows) |
| What are the different types of heat loss & examples? | Evaporation: loss of heat that occurs when a liquid is converted to a vapor (ex: failing to completely dry a baby after a bath) Conduction: loss of heat from the body surface to cooler surfaces in direct contact (ex: baby is placed in a not warmed bed) |
| Thermoregulation | Maintenance of balance between heat loss & heat production |
| Hypothermia | Caused from excessive heat loss |
| Do newborns have brown fat to keep them warm? | Yes, this is unique to the newborn & helps with nonshivering thermogenesis |
| How much should a newborn void? | During the first few days, term infants generally excrete 15 to 60 mL/day |
| What is the color of urine? | Normal urine during early infancy is usually straw colored & almost odorless. Sometimes pink-tinged uric acid crystals or “brick dust” appear on the diaper (normal during the first week) |
| Respirations | 30 - 60; irregular, shallow, look @ abdomen to observe breaths; periodic breathers: can go up to 20 sec without breathing (> 20 sec = apnea) |
| Diapers | Baby should have 6 - 8 wet diapers per day |
| Prolonged cord clamping | = increased blood volume |
| What are some feeding behaviors? | Sucking, swallowing, & breathing |
| Intestinal flora | Gut microbiota; established within the first week after birth, & normal intestinal flora help to synthesize vitamin K, folate, & biotin |
| How can you minimize GER (gastroesophageal reflux)? | Avoiding overfeeding, burping, & positioning the infant with the head slightly elevated |
| What is the first stool that a baby will pass? What is the difference between that & transitional stools? | Meconium: dark, olive green in color; viscous & sticky (like tar), almost odorless Transitional stools: greenish brown to yellowish brown; thin & less sticky; can contain some milk curds |
| Signs of GI probs | Failure to pass meconium can indicate bowel obstruction |
| Jaundice | The visible yellowish color of the skin & sclera, is likely to appear when the total serum bilirubin (TSB) level exceeds 6 - 7mg Pathologic: occurs in 1st 24 hrs; emergency; phototherapy Physiologic: post 24 hrs; resolves without treatment; sunlight |
| Vernix caseosa | A cheeselike, whitish substance that is fused with the epidermis & serves as a protective covering |
| Milia | Distended, small, white sebaceous glands noticeable on the newborn face |
| Where is a Mongolian spot located? What color is it? | Most commonly on the back & buttocks, but can appear over any part of the exterior surface of the body; bluish black |
| Nevi | Result of superficial capillary defect & occurs in up to 80% of newborns; they are usually small, pink, & easily blanched |
| What are some issues that are normal for female infants that may surprise mothers? (Reproductive system) | An increase in estrogen during pregnancy followed by a drop after birth causes female newborns to have mucoid vaginal discharge & even some slight bloody spotting |
| What’s commonly seen in male infants? (Reproductive system) | Small, white, firm lesions called epithelial pearls at the tip of the prepuce |
| Reproductive system | Swelling is often seen in breached babies |
| Caput succedaneum | Generalized, easily identifiable edematous area of the scalp, most often on the occiput (*pg. 525) |
| Cephalhematoma | Collection of blood between a skull bone & its periosteum; it does not cross a cranial suture line (*pg. 525) |
| Subgaleal hemorrhage | Bleeding into the subgaleal compartment (*pg. 525) |
| How do we assess for developmental dysplasia of the hips? | Barlow test & the Ortolani maneuver |
| Rooting & sucking reflex | Rooting: looking for nipple Sucking: putting gloved finger in baby’s mouth |
| Swallowing reflex | Occurs without gagging, coughing, apnea, or vomiting |
| Palmer reflex | Infants’ fingers curl around examiner’s finger |
| Plantar reflex | Toes curl downward around examiner’s finger |
| Tonic neck or “fencing” reflex | With infant facing left side, arm & leg on that side extend; opposite arm & leg flex (turn head to right, & extremities assume opposite postures) |
| Moro reflex | Sharp hard clap -> “scarecrow” position |
| Stepping or “walking” reflex | Hold infant vertically, allowing one foot to touch table surface -> infant will stimulate walking |
| Crawling reflex | Place newborn on abdomen -> newborn makes crawling movements |
| Babinski reflex | Stroke foot -> all toes hyperextend, with dorsiflexion of big toe |
| Sleep-wake states | Variations in the state of consciousness of infants |
| Two sleep states | Deep sleep & light sleep |
| Four wake states | 1) drowsy 2) quiet alert - optimal state of arousal 3) active alert 4) crying |
| What do we know about stimuli | Environmental events & stimuli affect the infant’s behavioral responses; the newborn responds to animate & inanimate stimuli |
| Sensory behaviors | From birth, infants possess sensory capabilities that indicate a state of readiness for social interaction |
| Temperament | Refers to individual variations in the reaction pattern of newborns |
| Habituation | Protective mechanism that allows the infant to become accustomed to environmental stimuli |
| Orientation | Quality of alert states & ability to attend to visual & auditory stimuli while alert |
| Motor performance | Quality of movement & tone |
| Range of state | Measure of general arousal level or arousability of infant |
| Regulation of state | How infant responds when aroused |
| Autonomic stability | Signs of stress (ex: tremors, startles, skin color) related to homeostatic adjustment of the nervous system |
| Reflexes | Assessment of several neonatal reflexes |
Created by:
tatianalopez03
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