Ch. 20 Study guide
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each of the black spaces below before clicking
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| Grating sensation during palpation | Crepitus
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| "Crossed" eyes | Strabismus
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| Bluish color of hands & feet | Acrocyanosis
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| Sunken appearance | Scaphoid
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| Scrotal skin creases | Rugae
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| Pinkish color on a wet diaper | Brick dust stain
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| Cord around fetal neck | Nuchal cord
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| Abnormality of nasal septum causing obstruction | Choanal atresia
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| The 2 immediate newborn assessments after birth are for.... | Respiratory problems; obvious anomalies
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| Molding (Causes, Characteristics & teaching) | See p.469-470
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| Caput succedaneum (Causes, Characteristics & teaching) | See p.469-470
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| Cephalhematoma(Causes, Characteristics & teaching) | See p.469-470
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| Explain possible signifance of 2-vessel umbilical cord | Associated with other anomalies; assess infant carefully.
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| Explain possible signifance of simian crease or line | Single palmar crease that often occurs in infants who have chromosomal abnormalities such as Down syndrome.
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| Explain possible signifance of unequal gluteal creases | Suggests one leg is shorter than the other; often associated with developmental hip dysplasia.
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| Explain possible signifance of hair tuft on lower spine | May indicate spina bifida occulta, or failure of one or more vertebrae to close fully.
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| Explain possible signifance of ears below level of outer canthi of the eyes | Associated with chromosomal disorders.
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| Explain possible signifance of drooping of one side of the mouth | Indicates facial nerve injury during birth resulting in paralysis.
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| Normal measurements & possible cause for deviations | See p. 462 (Table 20-1)
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| List normal ranges for term neonatal VS & describe correct assessment technique for each | See p.467-468 & Procedure 20-1
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| 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.
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| 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
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| 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
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| 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.
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| 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.
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| 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. (
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| 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.
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| 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.
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| 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.
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| 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.
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| 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.
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| 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.
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| 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.
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