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Newborn
OB Exam 4
| Question | Answer |
|---|---|
| APGAR scores are done at ____ and ____ and again at _____ if poor | 1 minute, 5 minutes, 10 minutes |
| _____ fills the lungs, stretches lung tissue and stimulates alveoli growth | amniotic fluid |
| normal respiratory rate for a NB is ___ | 30-60 bpm |
| respirations should be evaluated for ___ | 1 full minute |
| newborn _____ tend to be shallow and irregular, with pauses/periods of apnea | respirations |
| newborns are obligatory ___ breathers | nose |
| a rare congenital condition where a bony or membranous obstruction blocks the back of a newborn's nasal passage, causing severe respiratory distress or cyclical cyanosis is known as ____ | choanal atresia |
| blueish coloration of the hands and feet is known as _____ and is normal | acrocyanosis |
| circumoral or central cyanosis is blueish coloration of the mouth and is _____ | abnormal |
| tachypnea nasal flaring grunting retractions apnea lasting longer than 20 seconds are all signs of ____ | respiratory distress |
| normal NB heart rate | 110-160 (100 if sleeping) |
| the ____ pulse should be assessed for 1 full minute | apical |
| cardiac ___ are often present in the initial NB period as they transition from fetal to neonatal circulation | murmurs |
| it would be abnormal for murmurs to be heard in a NB after ____ hours | 24 hours |
| the ____ / ____ the infant, the higher risk they are at for inadequate temperature | smaller/younger |
| a ____ has a limited supply of subcutaneous fat and a large amount of skin surface area | NB |
| heat loss through warm body and cool air currents like the body being exposed is an example of _____ | convection |
| heat loss through warm body and direct skin contact from tables, stethoscopes or hands is an example of _____ | conduction |
| heat loss through warm body and cooler surfaces NOT in physical contact like the walls of the crib or incubator is an example of ____ | radiation |
| heat loss through warm body and and evaporation to vapor like amniotic fluid, baths, and expired air is an example of ____ | evaporation |
| cold stress, even for a full term NB can be ____ | lethal |
| bathing for a NB should be delayed unless the mom has an ____ | infection |
| ____ is the ideal food source for a neonate | colostrum |
| encourage breastfeeding/bottle feeding on demand, related to feeding cues every ____ hours | 2-3 |
| normal NB glucose level is ___ | > 40, >45 after 4 hours of birth |
| poor feeds can be an early sign of ___ and can lead to hypoglycemia with long-term consequences | sepsis |
| stool is meconium for the first ___ hours | 24 ish |
| feeds should be measured in CCs for ____ and minutes for ____ | bottle feeds, breastfeads |
| babies usually poop after every feed due to the ____ | gastrocolic sphincter |
| a one day old baby should have ____ diaper a day | 1 |
| a two day old baby should have ___ diapers a day | 2 |
| a three day old baby should have ___ diapers a day | 3 |
| it is normal to see a small amount of ___ discharge from a newborn female's vagina | bloody |
| the term for undescended testes is known as ___ | cryportochidism |
| if a newborn has hypospadius or epispadius, ____ should be delayed | circumcision |
| the inability to retract the foreskin over the glands over the penis is termed ___ and is normal | phimosis |
| ____ urine is normal for the first few days but not after a week and due to uric acid crystals | brick dust |
| ____ is a surgical procedures on the prepuce of the penis are separated and excised, permitting exposure to the glands for easier cleaning | circumcision |
| a ____ is not performed if a NB is extremely premature unstable has a known bleeding problem is born with a genitourinary defect has not received a vitamin K injection has not voided yet | circumcision |
| symmetrical abduction and extension of arms and legs, and then legs flex up against the trunk is known as the __ reflex | moro "startle" |
| neonate assumes a “fencing” position with arms and legs extended in the direction in which the head was turned is known as the __ reflex | tonic |
| the neonate turns the head toward the direction of the stimulus and opens the mouth is known as the __ relfex | rooting |
| sucking motion occurs and is known as the ___ relfex | sucking |
| the neonate grasps fingers tightly. If the neonate grasps the examiner’s fingers with both hands, the child can be pulled to a sitting position is known as the ___ reflex | palmar grasp |
| toes flex tightly down in a grasping motion is known as the ___ reflex | plantar grasp |
| involuntary, primitive response in newborns where they make stepping motions when held upright with their feet touching a solid surface is known as the ___ | stepping |
| hyperextension and fanning of toes is known as the ___ reflex | babinski |
| NB immune's system is ____ | immature |
| ____ is the leading cause of morbidity and mortality during neonatal life | infection |
| lethargy/irritability color changes temperature instabilities feeding intolerance jaundice initial tachycardia followed by bradycardia/apnea could all be signs of ____ | sepsis |
| normal NB temperature is ___ | 97.7-99.5 |
| normal NB SpO2 after 30 min of life ___ | 95+ |
| normal NB hemoglobin | 15-24 |
| normal NB hematocrit | 45-70 |
| normal NB WBC | 9,000-30,000 |
| normal NB total bilirubin | < 12 |
| it is normal for a NB to lose ____ to ____ % of their body weight within the first few days | 5-10% |
| ____ should be taken at the same time everyday | weight |
| ___ is used as a protective barrier against amniotic fluid | vernix |
| temporary, often cone-shaped elongation of a baby's skull caused by pressure on soft cranial bones during vaginal birth is known as ____ | molding |
| harmless, tiny white or yellowish cysts (1–2 mm) that appear on the skin of up to 50% of newborns, primarily on the nose, cheeks, and chin is known as _____ | milia |
| a common, often harmless blotchy, lace-like pink-blue pattern, usually caused by cold temperatures as immature circulation responds to temperature changes is known as ____ | mottling |
| harmless pink or red birthmarks found on over 30-50% of newborns, caused by dilated blood vessels is known as ____ | stork bites |
| a soft, fine hair covering a fetus in the uterus, often present on newborns, especially premature ones—as a natural, temporary protective layer is known as _____ | lenugo |
| a very common, harmless, and temporary rash appearing in healthy newborns is known as _____ | erythema toxicum |
| the ____ fontanel is diamond shaped and closes around 12-18 months | anterior |
| the ____ fontanel is triangular shaped and closes around 6-8 weeks | posterior |
| ____ is caused by a collection of fluid that crosses the suture lines | caput succedaneum |
| ___ is a collection of blood between the cranial bones and posterior membrane that does NOT cross the suture lines | cephalohematoma |
| ___ teeth should be removed at birth due to being a choking hazard | precocious |
| common, harmless, small white or yellow keratin cysts found on the roof of the mouth or gums are known as ____ | epstein pearls |
| the ____ is a systemic assessment of physical and neurological signs to determine the degree of maturity of the NB and is completed within 4 hours of birth | ballard gestation age assessment |
| ____ is a mandatory test that measures phenylalaline protein levels to determine NB metabolism and is tested using a heel stick blood draw | PKU (phenylketonuria) |
| if a NB fails their hearing test they are ___, if they fail that then they are sent for further testing/specialists | rescreen |
| cyanosis detectable murmur tachycardia tachypnea diaphoresis hepatomegaly cardiomegaly are all s/s of ___ | critical congenital heart disease |
| ____ a non-invasive and cost effective procedure performed AFTER 24 hours of age by placing a pulse ox on the ___ hand and either foot | CCHD test, right |
| if a NB fails the ___ test, follow up with an echocardiogram | CCHD |
| NB pass the CCHD test if both pulse ox read ___% or more | 95 |
| ____ is a universal screening tool used to test for serum bilirubin levels in the blood (transcutaneous or heel stick) | hyperbilirubinemia (jaundice) |
| extreme levels of ___ in the blood can lead to encephalopathy or kernicterus (permanent brain damage) | bilirubin |
| ____ ointment prevents neonatal conjuctivitis and opthalmia neonatorium | erythromycin |
| vitamin ___ promotes clotting factors | K |
| NB guts are _____ at birth and are unable to synthesize for 6-8 weeks | sterile |
| IM injections like vitamin K are given in the ____ muscle | vastus lateralis |
| if mom is hep b negative, the first dose of the vaccine is given at ____ | birth |
| if mom is hep b positive, the infant will receive the vaccine and ____ | hepatitis b globulin |
| immediately after birth rapid respirations increase in HR wide awake, then relaxes and falls asleep 2 hours to several hours after birth is during the ____ reactivity period | first |
| newborn awakens hyper-responsive to stimuli increase in HR occur during the ___ period of reactivity | second |
| infants have a poor ability to localize ___ which leads to easier spread of infection compared to older children/adults | infection |
| infants at risk for sepsis should ____ | schedule a CBC monitoring |
| symptomatic infants for sepsis should get a ____ | stat CBC |
| green to black stained amniotic fluid could indicate ____, and the nurse should be prepared to deep suction | meconium |
| retractions, nasal flaring, grunting see-saw breathing respirations > 60 central cyanosis inability to maintain temp fine rales diminished breath sounds are all signs of ____ | respiratory distress |
| ____ support should be avoided due to NB becoming dependent and unable to wean off of it | ventilatory |
| ___ therapy can lead to retinopathy | O2 |
| ___ is the leading cause of blindness in premature infants | O2 administration |
| tremors jitteriness apnea respiratory distress cyanosis seizures are s/s of ___ | hypoglycemia |
| ___ can cause serious and lifelong neurological deficits | hypoglycemia |
| do not provide ____ feedings to a NB with a blood sugar lower than 30-35 with respiratory distress or to a NB that is unstable | enteral |
| ____ is used to treat hypoglycemia and is absorbed through the mucosal tissue and not digested by the GI system | glucose gel |
| ____ is the changing of bilirubin to an excretable water-soluble form | conjugation |
| ____ bilirubin is fat soluble, non-excretory and a potential toxin | unconjugated |
| the longer bilirubin stays in the gut, the higher chance it becomes ____ | unconjugated |
| an ___ liver in NB decreases the ability to conjugate bilirubin which increases susceptibility to jaundice | immature |
| ___ is broken down hemoglobin | bilirubin |
| a + coombs test increases the risk for ___ | jaundice |
| ___ jaundice occurs within the first 24 hours and may be due to the destruction of RBCs, an Rh incompatibility, or errors in metabolism | pathologic |
| ___ jaundice is a normal process within the first week due to normal breakdown of RBCs | physiologic |
| unconjugated bilirubin in the basal ganglia of the brain can lead to ____ | kernicterus (permanent brain damage) |
| bili lights promote ____ | conjucation |
| ____ is the exposure of newborn to high light intensity, and changes unconjugated bilirubin into conjugated water-soluble bilirubin to be excreted, which decreases total bilirubin levels and jaundice | phototherapy |
| crying poor sleep moro reflex tremors convulsions yawning nasal stuffiness nasal flaring tachypnea retractions poor feeding vomiting abnormal stooling are all s/s of _____ | NAS (neonatal abstinence syndrome) |
| SGA / LGA is determined by ____ | gestational age and weight |
| ___ is being less than 10% in size on growth charts | SGA |
| ___ is being above 90% on growth charts | LGA |
| a NB that is >4000g is considered ____ | macrosomic |
| ____ NBs are at increased risk for asphyxia poor feedings/hypoglycemia polycythemia jaundice hypothermia respiratory issues | SGA |
| ___ NBs are at increased risk for injury and hypoglycemia | LGA |
| ___ NBs are at increased risk for respiratory distress syndrome (decreased surfactant levels) intraventricular hemorrhage jaundice bowel/gut issues infections/sepsis | premature |
| ____ NBs are at increased risk for meconium aspiration asphyxia polycythemia | post term |
| _____ NBs are at a reduced risk for GI disease, RSV, otitis media, NEC, and SIDS | breastfed |
| ____ is contraindicated for patients with metabolic disorders of carbohydrates active/untreated TB active herpes simplex lesions on breasts radiation treatment/exposure chemotherapy treatment illicit drug use HIV+ | breastfeeding |
| ___ mothers have a decrease blood loss in PP period decreased risk of infections increased weight loss | breastfeeding |
| breastfeeding works through supply and ____ | demand |
| Ready-to-feed formulas should be thrown out ___ hour(s) after opening unless refrigerated (up to ___ hours) | 1, 24 |
| do NOT prop bottles microwave freeze | formula |
| a NB should have ____ wet diapers after 1 week of age | 6-8 |
| more than ____ days without stooling would be considered concerning for a NB | 3 |
| NB return to their birth weight by ___ days old | 14 |
Created by:
gnitti