Newborn Adaptations
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| What is the neonatal period | birth to 28th day of life
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| what are 2 phases of transition period for neonate | 1st/2nd periods of reactivity
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| what happens in 1st period of reactivity | lasts up to 30 min. after birth, HR incr to 160-180, then falls to 100-120.
May have crackles, grunting, nasal flaring, retractions of chest (all signs of resp distress usually)
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| what is 2nd period of reactivity | 4-8 hrs after birth, tachy/tachypnea, meconium passed, incr muscle tone, color, spitty/gaggy
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| what are normal respirations for newborn | 30-60 b/min with periodic breathing(pauses), apnea(stop 5-15sec)
nose breathers, suction mouth first
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| what are 4 causes of respiration in NB | chemical: pH more acidic, incr CO2, decr O2
mechanical:squeeze in vag canal (C-sect not, so hard to get pink)
Thermal: shock stimulates to breath
Sensory: lights, smells, snds, touch, gravity
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| what is surfactant and how help lungs | keep alveoli walls from being sticky and collapsing, lowers surface tension, so less inspiratory pressure needed to keep alveoli open
Peaks - 35 wks
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| what is Functional Residual Capacity | Air that resides in lung to keep open
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| What happens to HR in baby | birth: 110-140
cry: 175-180
sleep: 80-90
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| How asses NB HR | ascultate 1 min., murmurs normal if stay pink
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| Normal NB BP | NB: 60/40, 80/50
1st hour: drop 15mm
10 days: 95/45, 100/75
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| How does circulation change to neonate | 300ml with 100ml incr. Preterm > term b/c > plasma vol.
Late clamping of cord incr volume
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| what are lab values for NB | Hb: 14-24, Hct: 44-64%, then drops
WBCs 1st day incr (23,000-24) then drop to 11,500
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| what are signs of resp distress | >160, retractions, flaring of nares, cyanosis, grunting, seesaw resp, asymmetry
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| why a risk of hemorrhaging and clotting deficiency | No Vit K at birth, casue gut is sterile adn made from intestinal bacteria. Give IM of Vit. K
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| what is normal blood glucose | 40-60mg/dl
adult: 70-110
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| what is thermogenesis | non-shivering, how does baby keep warm, brown fat adn incr metabolic activity in brain, heart, liver
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| what does cold stress do to baby | vasoconstricts, decr 02 to lungs and perfusion to tissues, anaerobic glycolysis then acidosis = hypoglycemia
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| what are four methods of heat loss | conduction: heat loss w/ contact, warmed crib
Convection: heat loss from air mvmt, cap/blanket
radiation: heat loss, no contact, away from windows
evaportation: dry after bath
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| what is TNZ, thermal neutral zone for full term | 89.6-93.2F, lower for adults, higher for preterm
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| what enzymes are not produced in NB | lipase, pancreatic amylase (6mos), amlase(3mos)
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| when is meconium seen | 1st 24-48 hours, sterile
3rd day - transitional stools
4th - milk stools
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| Sucking reflexes are coordinated wtih swallowing by when | after 33wks
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| what is jaundice | manifestation of bilirubin in tissues above 5mg/dl
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| when is iron stored for NB | stored in utero
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| what is kernicterus | yellow staining of brain cells lead to bilirubin encephalopathy.
s/s: CNS depression/excite, lethargy, seizures
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| what is normal values of unconjugated bilirubin | 0.2 - 1.4
jaundice not good if before 24 hrs
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| what is caput succedaneum | swelling of scalp, cross suture line
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| what is cephalhematoma | blood underneath, not cross suture line, may cause jaundice
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| what is subaleal hematoma | Bleeding beyond bone
vital to early detect, monitor LOC and decr Hct
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| what is telangiectatic nevic | stork bite, fades
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| what is erythema toxicum | newborn rash
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| what is vernix caseosa | cheese like coating after birth
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| what is milia | sebaceous glands (white pearls)
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| what is nevus flammeus | port wine, permanent
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| what is desquamation | peeling, sign of post maturity
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| what determines term infant in reproductive system | F: vag discharge, not as edematous
M: rugae on scrotum, lgr,
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| what do signs of asymmetry of folds of skin in legs indicate | hip dysplagia, do Ortolani Test
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| what is polydatyly? syndactyly? | poly: xtra digits
syn: fused digits
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| Know these reflexes | moro(startle), plantar grasp, Babinski(foot), rooting, suck, fencing(tonic neck), stepping when upright, crossed extension
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| These help determine term or preterm | posture: flexed/extended
square window: bend hand/not
arm recoil, popliteal angle, scarf sign, heel to ear: term fights
plantar creases: lots/smooth
ear boing!
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| what is witche's milk | baby discharge from breast
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| what is optimum awake state | quiet alert
others: drowsy/active alert/crying
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| what is habituation | expose to same stimuli, decr response
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