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NRN 102 (CH24, 25)

CCAC NRN 102 Physiologic Adaptations of the Newborn, care, G&D

The first 6 to 8 hours after birth consisting of several phases Transition period
The first phase of the transition period that lasts up to 30 minutes First phase of reactivity
Describe the infant during the first phase of reactivity HR increases to 160 to 180 beats/min then falls to 100 - 120, respirations are irregular, may have fine crackles, alert, spontaneous startles, crying, and movement of head from side to side
Occurs roughly 4 to 8 hours after birth and lasts 10 min to several hours Second phase of reactivity
Leukocytosis with WBC of 18,000 is normal at birth True
What are the 4 modes of heat loss in the newborn Convection, Radiation, evaporation, and conduction
What helps the newborn gaurd against heat loss Flexed position
Why does hyperthermia occur more rapidly in newborns than adults? Decreased ability to increase evaporative skin water losses.
What may result from inadequate clearance of lung fluid? tachypnea
Whay are newborns given Aquamephyton? Because they do not have normal flora needed to synthesize vitamin K
When discussing the GI system of a newborn, what are they able to do? Swallow, digest, metabolize, absorb proteins and simple carbohydrates and emulsify fats.
What is the first stool passed by the newborn and when does it normally occur? meconium, first 12-24 hours
At what bilirubin level does jaundice usually occur? Over 5mg/dl
Generalized, easily identifiable edmatous area of scalp Caput succedaneum
Collection of blood between the skull bone and the periosteum Cephalhematoma
Present at birth but not functioning (do not respond to increases in ambient or body temperature Sweat glands
Bluish, black areas of pigmentation Mongolian spots
Pink, easily blanched birth marks commonly found on the upper eyelids, upper lip, nose, lower occiput area Telangiectatic nevi "stork bites"
Bluish color of hands and feet due to vasomotor instability and capillary stasis Acrocyanosis
Loss of fluid through feces, lungs, increased metabolism, and limited fluid intake can aresult in how much weigth loss? 5 to 10% of birth weight.
When should the newborn regain birth weight? 10 to 14 days
Apgar scores are done at least at 1 and 5 minutes regardless of what the scores are, they may need to be done at 10 min if the 5 min is less than 7.
What intervention is the most important for infants receiving phototherapy by overhead or bank ultraviolet lights? Eye protection
After a circumcision, an infnat can not be discharged until the infant has voided
Nurses wear gloves when handling a newborn until after it is bathed for what reason? Part of standard precautions to protect the nurse from contamination
The cord stump is an area that is a site for infection true
If the newborn screen for PKU and other inborn errors in metabolism is done before 24 hours of age False positive results and should be repeated at 1 to 2 weeks
Head to tail development is cephalocaudal growth
When does birth weight triple? By 1 year
When does a child double their birth length? By 4 years
When children engage in play side by side in similar activities but not together it is called parallel play
An example of cooperative play is playing a board game
What is the single most important thing that influences growth? nutrition
Transient rash found in term infants during the first 3 weeks erythema toxicum "flea bite rash"
Why does a newborn look out of proportion? Because of cephalocaudal development
In a term infant how much of the total length is made up of the head? 1/4
Polydactyly extra digits
Which reflex is elicited by stroking the outer sole of the foot upward from the heel across the ball of the foot? Babinski
What requires glucose a form of energy the Brain
When should voiding begin? In the first 24 hours
Why is eye prophylaxis done and with what? To prevent conjunctivitis from Chlamydia or gonorrhea, erythromycin ointment
What is the time frame for a complete physical assessment to be done on a newborn? Within 24 hours
Why is gestational age assessment important? Because perinatal morbidity and mortality rates are related to gestational age and birth weight.
When should the gestational age assessment be completed? In infants less than 26 weeks, it should be done within the first 12 hours, infant sover 26 weeks it should be done within the first 48 hours.
How are infants classified according to gestational age and birth weight? LGA (large for gestational age), AGA (appropriate for gestational age), and SGA (small for gestational age)
What causes conjunctival and retinal hemorrhages in the newborn? Increased pressure during birth
Why are heelsticks done on the outer aspects of the heel to prevent damage to the bone and nerves
What is the correct site for administering an IM injection to a newborn? The vastus lateralis, middle third of the anterior thigh
Created by: JayneAnn