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NSG 309 OBNB
Quiz 3+4 Study guide
| Question | Answer |
|---|---|
| APGAR Score | [Activity - Pulse - Grimace - Appearance - Respiration] - Excellent = 7-10 - Moderately depressed = 4-6 - Severely depressed = 0-3 |
| Transition to extrauterine life (Phase 1) | - 1st 1-2 hours post-birth - Optimal breastfeeding + bonding time - Assess vitals and appearance (color) - Infant awake and alert |
| Transition to extrauterine life (Phase 2) | - Quiet/Sleep phase - May sleep for several hours - Gradual stabilization of vitals - Cont. thermoregulation support for infant |
| Transition to extrauterine life (Phase 3) | - 2-8 hours (transition period ~6-8 hrs after birth) - Meconium passed + feeding cue emerges - Complete full assessment |
| Infant Respirations Post Birth | - Normal RR 30-60 breaths/min - Irregular, shallow, unlabored breathing - Apnea <15 seconds is normal |
| Breathing Triggers of Birth | - Chemical: Hypoxia + acidosis from labor - Mechanical: Birth canal squeeze fluid from lung + crying absorbs remaining (C-section risk for respiratory issue) - Thermal: warm to cool = stimulation - Sensory: Touch/light/sound overload |
| Surfactant | - Surface tension reducing lipoproteins - Prevent alveolar collapse after breath - Production begin @ 24 weeks gestation (preemies high risk) |
| Signs of Respiratory Distress in Infants | - Grunting (sound on expiration = alveolar collapse) - Central cyanosis (bluish around mucus membrane + lips) - Apnea >15 sec - Nasal flaring (increased work of breathing) - Retractions (skin pulling @ rib/sternum/neck) - Stridor (high pitch sound on inspiration = obstruction) |
| Foramen Ovale | - R. Atrium -> L. Atrium opening (helps bypass lungs) - ↑ pulmonary blood flow → ↑ left atrial pressure → valve closes within minutes - Becomes fossa ovalis |
| Ductus Arteriosus | - Pulmonary artery -> aorta (divert blood away from lung) - Increase O2 levels @ first breath = constriction + closure within 10-15 hr to weeks post birth - Becomes ligamentum arteriosum |
| Ductus Venosus | - Umbilical vein -> IVC (bypass liver -> ICV) - Cord clamping + decrease blood flow = functional closure - Becomes ligamentum venosum |
| Nursing Interventions to Prevent Cold Stress | - Dry infant immediately - Skin to skin contact + warm blanket + hat - Preheat warmers + avoid fans/drafts - Delay first bath until stable temp - Assess temp Q1hr until stable - Normal Temp 36.5-37.5 C (97.7-99F) -> axillary vs temporal |
| Cold Stress Classic SIgns | - Decreased temp - Nasal flaring/grunting - Hypoglycemia - Leethargy |
| Newborn Liver Function | - Gradual gains functionality after birth - Iron storage, carbohydrate metabolism, blood coagulation, bili conjugation - Jaundice risk d/t poor early bili conjugation |
| Vitamin K Injection | - Sterile newborn gut = unable to produce Vit K - Important in coagulation - IM Vitamin K 0.5-1 mg (within 6 hrs of birth) |
| Newborn GI function | - Stomach capacity 5-10 mL (at birth) -> ~60 mL by week 1 - Meconium passed within 24 hr - 4-8x daily - Breastfed = yellow/seedy; formula fed = more formed brown - Wt loss of 5-10% in first 3-5 days (regain within 2 weeks) |
| Newborn IgG | - Transfer via placenta - Temporary immune protection against pathogens gestating parents were exposed to - 3 months expiration |
| Newborn IgM | - First Ab produced in response to infection by fetus - Destroy foreign substances |
| Newborn IgA | - Tears, blood, saliva, mucus membranes - Acquired via breastmilk (not present @ birth) - Protect GI tract from pathogens |
| Post-birth immediate Nursing Interventions | - Maintain airway patency (bulb syringe) - APGAR scoring @ 1 min + 5 min - Matching ID bands on infant/parents - Vitamin K within 6 hrs - Erythromycin eye ppx - Hep B vaccine (w/ or w/o IVIG tx) - Thermoregulation -> skin to skin + dry + blanket |
| Ballard Scale | - Assess within 12-48 hrs to evaluate gestational maturity - Physical maturity: Skin, lanugo, plantar creases, breasts, eye-ear, genitalia - Neuromuscular: Posture, wrist, Arm recoil, Scarf Sign, Heel-Ear |
| Newborn Physical Assessment | - Normal HR 110-160/min; RR 30-60/min, 36.5-37.5 C - Chest circumference 2-3 cm smaller than head - Graph weight chart for weight/length/head/chest circumference - Arm/legs flexed + fisted = normal posture - Symmetrical and barrel shaped chest - Top of ears align w/ eyes |
| Molding | Elongated shaping of fetus head thru birth canal - Resolves within 1 week post birth w/o tx |
| Caput Succedaneum | Localized edema on scalp - d/t pressure from birth process Sx: poorly demarcated soft tissue swelling crossing suture line w/ pitting edema + overlying petechiae and ecchymosis - Resolve within 3 days w/o tx |
| Cephalohematoma | Localized blood on skull confined by 1 cranial bone - d/t prolonged labor vs forceps/vacuum extraction Sx: well demarcated swelling w/o discoloration, firm - Risk for hyperbilirubinemia/jaundice -> RBC breakdown - Appears after 2-3 days after birth - Resolves in weeks to months |
| Moro Reflex | - Startle reflex - Arms extend outwards then embrace - Gone in 3-6 months |
| Tonic Neck Reflex | - Fencer reflex - unilateral limb extension = opposite unilateral flexing - Gone by 3-4 months |
| Rooting Reflex | - Head turns toward stimulus and opens mouth - For feeding - Gone by 4-6 months |
| Babinski Reflex | - Toes fan outwards (opposite of adult) - Gone by 12 months |
| Extrusion Reflex | - infant sticks tongue out - Gone by 4 months |
| Breastfeeding Frequency | - 8-12 feed/daily - Feeds on demand (crying = late hunger cue) - Feed when rooting/sucking/smacking |
| Breast feeding Benefits | - Optimal infant nutrition - IgA from mother -> infant (immunoprotective) - Reduced SIDS/obesity risk for infant - Faster uterine involution - Reduced breast/ovarian CA risk - Bonding |
| Poor latching Signs | - Nipple pain vs crescent shaped brusing - Clicking sounds - Infant frustration - No infant weight gain |
| Formula feeding education | - NO bottle propping (aspiration/AOM/caries risk) - Hold w/ head elevated - Discard leftovers - 2-3 oz Q3-4hrs in first weeks by demand - Respect satiety cues - Less frequent stool patterns + more formed |
| Solid food introduction | - Start @~6 months - Formula until age 1 - Whole cows milk @ age 1 - Wean from bottle by 12-15 months |
| Hypoglycemia |
Created by:
sleepingbear