The Normal Term Newborn
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| What is Molding? | Changes in the shape of the head that allow the newborn to pass through the birth canal.
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| Fill in the blanks: Seperation of the lobes may be the _________ result of molding or, if it persists or widens, may indicate ______ ________ ________ | Temporary, Increased Intracranial Pressure
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| What are the areas of the head where sutures between the bones meet? | Fontanelles
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| How quickly does Caput Succedaneum resolve? | 12 hours to several days
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| What is Caput Succedaneum result from? | as a result of pressure against the mother’s cervix during labor or from the use of a vacuum extractor
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| Cephalohematoma occurs in what percentage of births? | 1% - 2%
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| Does a cephalohematoma or a Caput Succedaneum cross suture lines? | Caput Succedaneum, Cephalohematoma does not cross suture lines
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| How quickly does a cephalohematoma resolve? | few weeks to months
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| An infant with a Cephalohematoma is at increased risk for what, and why? | Jaundice, Due to the breakdown of RBCs
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| What are you looking for in the newborn head exam? | *Molding *Seperation of skull bones *Fontanelles *Caput Succedaneum *Cephalohematoma
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| Where do cephalohematomas occure? | between the periosteum and the skull
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| What do you asses in the facial exam of a newborn? | *Assess for symmetry *Positioning of the facial features *Movement *Expression
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| True or False. Facial asymmetry can be temporary | True. A transient asymmetry from pressure may occur, lasting a few weeks of months
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| What are Epstein pearls? | protein-filled cysts on the gums or roof of the mouth, they are very common.
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| What infants generally have more lanugo? | Dark skinned infants
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| What is lanugo? | Fine hair that covers the fetus in utero
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| What are Milia? | White cysts, 1 to 2 mm in size over the forehead, nose, cheeks, and/or chin
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| What does milia result from? | Resulting from distention of sebaceous glands (oil glands) that are not yet functioning properly
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| How often should the newborns respirations be assessed? | Every 30 min
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| What is Choanal atresia? | Choanal atresia is a narrowing or blockage of the nasal airway by tissue. It is a congenital condition, meaning it is present at birth
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| What is the most common form of newborn respiratory distress? | Tachypnea
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| What respiratory rate is considered tachypneic in newborns? | >60 breaths/min
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| True or False: Tachypnea is a serious abnormal condition in the first hour post birth | False. Is not unusual during the first hour after birth and during the second period of reactivity, but continued tachypnea is abnormal
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| When are accessory muscle contractions during breathing common in the newborn? | Occasional mild retractions are common immediately after birth but should not continue after the first hour
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| What does cyanosis of the trunk indicate? | Indicates that not enough oxygen is reaching the vital organs and requires immediate attention
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| What may look like cyanosis in the newborn? | Bruising
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| How do you differentiate bruising and cyanosis? | To differentiate cyanosis from bruising, apply pressure to the area. A cyanotic area will blanch, but a bruised area remains blue
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| What can cyanosis on exertions or crying indicate? | A congenital heart defect
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| What are seesaw respirations? | the chest falls when the abdomen rises and the chest rises when the abdomen falls, causing a seesaw effect
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| When is BP taken on all extremities? | When the infant is quiet
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| What stools should occur the first 12 hours after birth? | stools that are dark greenish-black, tarry, odorless, but very tenacious material (meconium)
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| What is rooting? | When the side of the infants cheek near the mouth is stimulated and the infant turns head toward that side and opens the lips
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| What is the Moro Reflex (startle reflex) | Occurs when the infant’s head and truck are allowed to drop back 30 degrees when the infant is in a slightly raised position
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| How does the infant react to a moro reflex test? | Infant’s arms and legs extend and abduct, with the fingers fanning open and thumbs and forefingers forming a C position
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| What is the Palmar Grasping reflex? | Occurs when the infant’s palm is touched near the base of the fingers
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| How does the infant react to a palmar grasping reflex test? | Hand closes into a tight fist.
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| What is the Plantar Grasp Reflex? | Occurs when the area below the toes is touched
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| How does the infant react to a plantar grasp reflex test? | Infant’s toes curl over the examiner’s fingers
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| What is the Tonic Neck Reflex? | In a supine position, the infant's head is quickly turned to one side, arm and leg will extend on that side, and opposite arm and leg will reflex; posture resembles a fencing position.
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| What is the Babinski test? | Elicited by stroking the lateral sole of the infant’s foot from the heel forward and across the ball of the foot
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| How does the infant react to the babinski test? | Causes the toes to flare outward with dorsiflexion of big toe
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| What is the Dance or Stepping Reflex? | Occurs when infants are held uprights with their feet touching a solid surface
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| How does the infant react to the Dance or Stepping Reflex test? | They lift one foot and then the other, giving the appearance that they are trying to walk
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| What is the average newborn length? | 19-21 inches (48-53 cm)
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| What is the average newborn weight range? | 5 lb 8 oz to 8 lb 13 oz (2500-4000 gm)
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| What is the AVERAGE newborn weight? | 7.5 lb (3400g)
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| What is the weight changes in the newborn during the first 7-10 days? | They should lose less than 10% of the birth weight
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| What is the average newborn head circumference? | 13-14 in (33-35.5 cm)
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| What is the average newborn chest circumference? | 12-13 inches (30.5 to 33 cm), 2-3 cm less than head circumference
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| What is the prefered temperature site in newborns? | Axillary
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| What is the normal newborn respiratory rate? | 30 to 60 breaths/min
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| When and how is Vitamin K administered to a newborn? | One dose IM within the first hour after birth
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| What is Colostrum? | A thick yellow substance from the breast which is high in protein, minerals, fat soluble vitamins and immunoglobulins, which transfers some immunity to the infant
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| What are the three stages of breast milk production? | *Colostrum *Transitional *Mature
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