CCAC NRN 102 Physiologic Adaptations of the Newborn, care, G&D
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| The first 6 to 8 hours after birth consisting of several phases | Transition period
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| The first phase of the transition period that lasts up to 30 minutes | First phase of reactivity
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| 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
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| Occurs roughly 4 to 8 hours after birth and lasts 10 min to several hours | Second phase of reactivity
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| Leukocytosis with WBC of 18,000 is normal at birth | True
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| What are the 4 modes of heat loss in the newborn | Convection, Radiation, evaporation, and conduction
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| What helps the newborn gaurd against heat loss | Flexed position
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| Why does hyperthermia occur more rapidly in newborns than adults? | Decreased ability to increase evaporative skin water losses.
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| What may result from inadequate clearance of lung fluid? | tachypnea
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| Whay are newborns given Aquamephyton? | Because they do not have normal flora needed to synthesize vitamin K
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| 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.
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| What is the first stool passed by the newborn and when does it normally occur? | meconium, first 12-24 hours
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| At what bilirubin level does jaundice usually occur? | Over 5mg/dl
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| Generalized, easily identifiable edmatous area of scalp | Caput succedaneum
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| Collection of blood between the skull bone and the periosteum | Cephalhematoma
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| Present at birth but not functioning (do not respond to increases in ambient or body temperature | Sweat glands
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| Bluish, black areas of pigmentation | Mongolian spots
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| Pink, easily blanched birth marks commonly found on the upper eyelids, upper lip, nose, lower occiput area | Telangiectatic nevi "stork bites"
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| Bluish color of hands and feet due to vasomotor instability and capillary stasis | Acrocyanosis
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| 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.
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| When should the newborn regain birth weight? | 10 to 14 days
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| 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.
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| What intervention is the most important for infants receiving phototherapy by overhead or bank ultraviolet lights? | Eye protection
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| After a circumcision, an infnat can not be discharged until | the infant has voided
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| 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
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| The cord stump is an area that is a site for infection | true
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| 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
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| Head to tail development is | cephalocaudal growth
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| When does birth weight triple? | By 1 year
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| When does a child double their birth length? | By 4 years
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| When children engage in play side by side in similar activities but not together it is called | parallel play
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| An example of cooperative play is | playing a board game
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| What is the single most important thing that influences growth? | nutrition
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| Transient rash found in term infants during the first 3 weeks | erythema toxicum "flea bite rash"
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| Why does a newborn look out of proportion? | Because of cephalocaudal development
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| In a term infant how much of the total length is made up of the head? | 1/4
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| Polydactyly | extra digits
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| Which reflex is elicited by stroking the outer sole of the foot upward from the heel across the ball of the foot? | Babinski
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| What requires glucose a form of energy | the Brain
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| When should voiding begin? | In the first 24 hours
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| Why is eye prophylaxis done and with what? | To prevent conjunctivitis from Chlamydia or gonorrhea, erythromycin ointment
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| What is the time frame for a complete physical assessment to be done on a newborn? | Within 24 hours
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| Why is gestational age assessment important? | Because perinatal morbidity and mortality rates are related to gestational age and birth weight.
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| 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.
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| 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)
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| What causes conjunctival and retinal hemorrhages in the newborn? | Increased pressure during birth
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| Why are heelsticks done on the outer aspects of the heel | to prevent damage to the bone and nerves
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| What is the correct site for administering an IM injection to a newborn? | The vastus lateralis, middle third of the anterior thigh
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