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Newborn 2

Ch. 20 Study guide

QuestionAnswer
Grating sensation during palpation Crepitus
"Crossed" eyes Strabismus
Bluish color of hands & feet Acrocyanosis
Sunken appearance Scaphoid
Scrotal skin creases Rugae
Pinkish color on a wet diaper Brick dust stain
Cord around fetal neck Nuchal cord
Abnormality of nasal septum causing obstruction Choanal atresia
The 2 immediate newborn assessments after birth are for.... Respiratory problems; obvious anomalies
Molding (Causes, Characteristics & teaching) See p.469-470
Caput succedaneum (Causes, Characteristics & teaching) See p.469-470
Cephalhematoma(Causes, Characteristics & teaching) See p.469-470
Explain possible signifance of 2-vessel umbilical cord Associated with other anomalies; assess infant carefully.
Explain possible signifance of simian crease or line Single palmar crease that often occurs in infants who have chromosomal abnormalities such as Down syndrome.
Explain possible signifance of unequal gluteal creases Suggests one leg is shorter than the other; often associated with developmental hip dysplasia.
Explain possible signifance of hair tuft on lower spine May indicate spina bifida occulta, or failure of one or more vertebrae to close fully.
Explain possible signifance of ears below level of outer canthi of the eyes Associated with chromosomal disorders.
Explain possible signifance of drooping of one side of the mouth Indicates facial nerve injury during birth resulting in paralysis.
Normal measurements & possible cause for deviations See p. 462 (Table 20-1)
List normal ranges for term neonatal VS & describe correct assessment technique for each See p.467-468 & Procedure 20-1
Why should RN avoid taking rectal temp on newborns? Taking a rectal temperature on newborns may irritate the mucosa or perforate the rectum, which turns at a right angle 3 cm (1.2 inches) from the anal sphincter.
List at least 5 signs that suggest neonatal respiratory distress. tachypnea (sustained); retractions that continue after the first hour; nasal flaring after the first hour; cyanosis involving the lips, tongue, and trunk (central cyanosis); grunting; seesaw respirations; asymmetry of chest expansion
List signs that suggest neonatal hypoglycemia. Jitteriness, poor muscle tone, sweating, respiratory signs (dyspnea, apnea, cyanosis, tachypnea, grunting), low temperature, poor suck, high-pitched cry, lethargy, seizures, eventually coma; some show no signs of hypoglycemia
Descibe normal assessment of female genetalia. Labia majora darker than surrounding skin and completely covering the clitoris and labia minora; white mucous discharge or pseudomenstruation; hymenal or vaginal tags; patent urinary meatus and vagina.
Descibe normal assessment of male genetalia. Pendulous scrotum that is darker than surrounding skin and covered with rugae; testes palpable in the scrotal sac; meatus centered at the tip of the glans penis; prepuce covering the glans and adherent to it.
State possible significance of ruddiness on skin. Is any special care needed? Suggests polycythemia; may cause higher bilirubin levels as the excessive erythrocytes break down, so observe for more severe jaundice and emphasize to parents. (
State possible significance of green-tinged discoloration of skin & vernix. Is any special care needed? Indicates meconium passage in utero; observe infant for associated respiratory difficulties resulting from aspirated meconium.
State possible significance of red,blotchy areas w/ white or yellow papules in center on skin. Is any special care needed? Erythema toxicum; differentiate from infection; teach parents that rash is self-limiting.
State possible significance of Blue-black marks over the sacral area on skin. Is any special care needed? Mongolian spots; more common in dark-skinned infants; most disappear during early years; teach parents who are unfamiliar with these.
State possible significance of flat, purplish area that does not blanch w/ pressure on skin. Is any special care needed? Nexus flammeus (port-wine stain); permanent; large or obvious ones can later be removed by laser surgery.
State possible significance of red, raised, rough lesion on head. Is any special care needed? Nevus vasculosus (strawberry hemangioma); grows larger for 5 to 6 months, then gradually disappears.
State possible significance of light brown spots on skin. Is any special care needed? Café-au-lait spots; 6 or more spots or spots larger than 0.5cm are associated with neurofibromatosis and should be reported to the physician.
What facial marks may be present if infant had a nuchal cord? Petechiae on the face or upper body are often present when the infant had a nuchal cord at birth.
Created by: L.moore