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OB chapter 10,11,12

the newborn

How should you assess a newborn’s heart rate observe the rise and fall of the abdomen
Normal vital signs Pulse:110-160 bpm; RR:30-60breaths/min; T:97.7F (36.5C); BP:60-80 systolic, 40-50 diastolic
Vernix caseosa thick, white, cheesy substance covering the skin of the newborn
Milia pearly white pinpoint papules on the face and nose of the newborn
Normal circumference of head 13-14 inches (33-35.5cm)
Caput succedaneum localized swelling of soft tissues of the scalp that is caused by pressure on the head during labor
Newborn’s breathing pattern (full-term infant) irregular, movement of the chest and abdomen are synchronized, periodic breathing is normal
Fontanelle closure anterior by 18 months; posterior by 2-3 months
Newborn sight and what they like to look at simple, highly contrasting colors and formed image
rooting reflex baby turns toward touch when lightly stroked on cheek
Assessment findings that you would call the Dr. (crepitus in clavicles) can be from shoulder dystocia
Moro’s reflex extension and abduction of extremities in response to being startled
Plantar reflex when the sole of the newborn’s foot is stimulated, the toes curl downward
Which is the most desirable state to test an infant quiet alert
Congenital hip dysplasia click sound when newborns’s legs are flexed and abducted laterally toward the mattres; knees not of equal length and thigh folds should are asymmetric
Cephalhematoma a collection of blood between the periosteum and the cranial bone; the swelling does not cross the suture line; no treatment is indicated
Reason for newborn screening and testing performed before discharge enable early intervention if a possible health problem exists
Mongolian spots dark blue or slate gray discolorations most commonly found in lumbosacral area in babies of dark skinned parents
Reason for elongation of newborn’s head fontanelles allow the fetal head to mold in order to fit through the birth canal causing an elongated appearance of the head
Depressed fontanelles is a sign of? late sign of dehydration
Acrocyanosis cyanosis of the hands and feet in the first week of life is caused by a combination of a high hemoglobin level and vasomotor instability
Imperforate anus a closed anus
Thrush in newborn (symptoms) gray-white patches on the tongue and mucous membranes that cannot be quickly removed
Vaginal discharge or blood in newborn pseudomenstration, smegma
Negative tonic neck reflux and concerns absence or asymmetry in term newborn indicates neurologic problem
Coarctation of the aorta a constriction of the aortic arch or of the descending aorta; symptoms may not develop until later childhood; high BP and bounding pulses in upper extremities and weak pulses in the cool lower extremities, signs of CHF
Best state to check hearing active sleep
Congenital cataracts indicated by an absence of the red reflex in the retina
Extrusion reflex present until 4 months of age
Sleep states quiet sleep; active sleep
First nursing action to prevent heat loss dry the newborn
Normal axillary temp between 36.5-37.5C/97.7-99.5F
cord assessment within the 1st hour assess for bleeding
Reasons for vit K injections newborns cannot synthesize vitamin K due to lack of normal flora in intestines, must be given as a prophylaxis to assist in clotting
Infant care following circumcision a sterile gauze with petroleum jelly or A&D ointment is applied to the penis; observe for bleeding every 15 minutes for the first hour and then every 30 minutes for the next 2-4 hours
what area of the newborn is most susceptible to infection cracks in the skin, particularly on the newborn’s hands, feet, and umbilical cord
what is the most preventable method from spreading infection handwashing (3 minute scrub up to elbow) or use of hand sanitizer
bathing until cord falls off give sponge baths until the cord stump falls off
What symptoms should be taught to parents to report in a breastfeeding infant how long and how hard infant sucks; whether spitting up occurs and if it is projectile or forceful
Why should the nurse have parents tell about cultural practices related to infant care to ensure they aren’t harmful
changing diapers after circumcised a sterile gauze with petroleum jelly or A&D ointment is applied to the penis
early indicator of infection poor feeding, lethargy, and periods of apnea
proper bulb suctioning the bulb is compressed before insertion, then released to create sufficient suction to remove mucus
how to properly burp infant
purpose of eye ointment after birth prevent infection
proper car seat safety should not move more than 1 inch in any direction, and the harness strap should be snug at armpit level of child
following a circumcision when can an infant go home after he voids
where are infant IMs given thigh, middle third of the vastus lateralis muscle
risks of propping bottles potential for spitting up, aspirating, choking and otitis media
Hep B administration first injection within 12 hours of birth; second injection at 1 month of age; third dose at 6 months of age
care of uncircumcised penis avoid forceful retraction of foreskin, clean with water during infancy, smegma is normal
signs to report to Dr. related to temperature fever greater than 100.4
signs to report to Dr. related to breathing dyspnea or apnea greater than 20 seconds
signs to report to Dr. related to skin color dusky appearance, blueness around mouth, or whites of eyes appearing yellow
signs to report to Dr. related to cord appearance discharge, bleeding, redness or foul odor
signs to report to Dr. related to eyes redness, swelling, or discharge
signs to report to Dr. related to feeding more than one episode of forceful or frequent vomiting; refusal to feed for two or more consecutive feedings
signs to report to Dr. related to stools two or more green, watery stools or hard and infrequent stools
signs to report to Dr. related to wet diapers no wet diapers in 18 hours or fewer than six voiding in a 24 hour period
signs to report to Dr. related to crying inconsolable, quieting techniques not effective or continuous high-pitched cry
Created by: laotracuata