the newborn
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| How should you assess a newborn’s heart rate | observe the rise and fall of the abdomen
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| Normal vital signs | Pulse:110-160 bpm; RR:30-60breaths/min; T:97.7F (36.5C); BP:60-80 systolic, 40-50 diastolic
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| Vernix caseosa | thick, white, cheesy substance covering the skin of the newborn
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| Milia | pearly white pinpoint papules on the face and nose of the newborn
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| Normal circumference of head | 13-14 inches (33-35.5cm)
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| Caput succedaneum | localized swelling of soft tissues of the scalp that is caused by pressure on the head during labor
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| Newborn’s breathing pattern (full-term infant) | irregular, movement of the chest and abdomen are synchronized, periodic breathing is normal
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| Fontanelle closure | anterior by 18 months; posterior by 2-3 months
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| Newborn sight and what they like to look at | simple, highly contrasting colors and formed image
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| rooting reflex | baby turns toward touch when lightly stroked on cheek
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| Assessment findings that you would call the Dr. (crepitus in clavicles) | can be from shoulder dystocia
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| Moro’s reflex | extension and abduction of extremities in response to being startled
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| Plantar reflex | when the sole of the newborn’s foot is stimulated, the toes curl downward
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| Which is the most desirable state to test an infant | quiet alert
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| 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
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| Cephalhematoma | a collection of blood between the periosteum and the cranial bone; the swelling does not cross the suture line; no treatment is indicated
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| Reason for newborn screening and testing performed before discharge | enable early intervention if a possible health problem exists
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| Mongolian spots | dark blue or slate gray discolorations most commonly found in lumbosacral area in babies of dark skinned parents
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| 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
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| Depressed fontanelles is a sign of? | late sign of dehydration
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| 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
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| Imperforate anus | a closed anus
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| Thrush in newborn (symptoms) | gray-white patches on the tongue and mucous membranes that cannot be quickly removed
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| Vaginal discharge or blood in newborn | pseudomenstration, smegma
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| Negative tonic neck reflux and concerns | absence or asymmetry in term newborn indicates neurologic problem
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| 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
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| Best state to check hearing | active sleep
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| Congenital cataracts | indicated by an absence of the red reflex in the retina
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| Extrusion reflex | present until 4 months of age
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| Sleep states | quiet sleep; active sleep
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| First nursing action to prevent heat loss | dry the newborn
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| Normal axillary temp | between 36.5-37.5C/97.7-99.5F
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| cord assessment within the 1st hour | assess for bleeding
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| 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
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| 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
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| what area of the newborn is most susceptible to infection | cracks in the skin, particularly on the newborn’s hands, feet, and umbilical cord
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| what is the most preventable method from spreading infection | handwashing (3 minute scrub up to elbow) or use of hand sanitizer
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| bathing until cord falls off | give sponge baths until the cord stump falls off
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| 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
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| Why should the nurse have parents tell about cultural practices related to infant care | to ensure they aren’t harmful
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| changing diapers after circumcised | a sterile gauze with petroleum jelly or A&D ointment is applied to the penis
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| early indicator of infection | poor feeding, lethargy, and periods of apnea
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| proper bulb suctioning | the bulb is compressed before insertion, then released to create sufficient suction to remove mucus
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| how to properly burp infant |
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| purpose of eye ointment after birth | prevent infection
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| 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
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| following a circumcision when can an infant go home | after he voids
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| where are infant IMs given | thigh, middle third of the vastus lateralis muscle
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| risks of propping bottles | potential for spitting up, aspirating, choking and otitis media
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| Hep B administration | first injection within 12 hours of birth; second injection at 1 month of age; third dose at 6 months of age
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| care of uncircumcised penis | avoid forceful retraction of foreskin, clean with water during infancy, smegma is normal
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| signs to report to Dr. related to temperature | fever greater than 100.4
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| signs to report to Dr. related to breathing | dyspnea or apnea greater than 20 seconds
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| signs to report to Dr. related to skin color | dusky appearance, blueness around mouth, or whites of eyes appearing yellow
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| signs to report to Dr. related to cord appearance | discharge, bleeding, redness or foul odor
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| signs to report to Dr. related to eyes | redness, swelling, or discharge
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| 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
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| signs to report to Dr. related to stools | two or more green, watery stools or hard and infrequent stools
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| 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
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| signs to report to Dr. related to crying | inconsolable, quieting techniques not effective or continuous high-pitched cry
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