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98 Cards in this Set
- Front
- Back
_ are newborns during the first 28 days of life
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Neonates
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What is the most critical time for the neonate?
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the first 24 hours |
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Neonates
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1. Assitst with the conversion from fetal to adult type circulation 2. Empty the lungs of liquid 3. Establish neonatal lung volume and function in the newborn. |
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How long before the baby's respirations stabilize after birth?
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The baby's respirations may not stabilize for about 2 hours after birth |
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After 2 hours of birth, the baby's respiratory rate should be less than _ breaths per minute. |
less than 60 |
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How does the circulatory system abruptly change when the umbilical cord is clamped and then cut? |
the foramen ovale, ductus arteriosus, and ductus venosus must close to allow blood to flow to the heart, lungs, and liver. |
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The first breath expands the air passages and the _A_. The healthy newborn has enough _B_ to allow the sacs to remain open, rather than collapsing after each breath. This means the next breath will not require as much effort.
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A- alveoli B. surfactant |
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_ is a chemical that stabilizes the walls of the alveoli.
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surfactant |
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_ are grape-like sacs where gas exchange occurs in the lungs.
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alveoli |
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The changes in the neonates respiratory system is _ with the changes in the circulatory system.
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interrelated |
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What are the three ways the baby maintains temperature? |
shivering (which is not very efficient); muscle movements (which has only little benefit); and production of heat caused by using stored brown fat. |
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What ways can heat loss occur in an infant? |
conduction, convection, evaporation, and radiation |
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What are the four main nursing goals for a newborn? |
2. Provide warmth and prevent hypothermia 3. Provide a safe environment and routine preventive measures 4. Promote maternal- infant attachment |
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What are the five criteria of the Apgar score?
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Appearance pulse grimace activity respiratory effort |
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What is the purpose of the Apgar score?
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it provides a quick and accurate means to assess the newborn's physical condition at time of birth. |
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When is the Apgar score determined?
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1 minute and again at 5 minutes after birth |
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Apgar Score If the total score is 10, what? |
the newborn is in the best possible condition |
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If the total score is 7 to 9, what?
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the newborn usually does not need resuscitation |
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If the total score is 4 to 6, what? |
the newborn is in danger |
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If the total score is 0 to 3, what? |
the newborn needs emergency resuscitation |
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Permanent brain damage can occur if the newborn is without oxygen for __ |
more than approx. 4 minutes |
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Because the baby emerging from the mother's warm body may lose a lot of heat (going into a cold room and still wet from amniotic fluid), what is a good intervention that will not only help maintain the neonates warmth, but also encourage bonding?
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Lifting the newborn onto the mother's bare stomach or chest, perhaps even before the cord is clamped or cut, lets the heat of the mother's body transfer to the newborn. |
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What other measures do you do after the baby's birth to help maintain warmth? |
-quickly dry the baby and replace wet towels with dry towels -place a cap on the head -use radiant warmer, pre-warmed mattress, and warm instruments while doing your assessment |
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How many Kelly clamps are placed on the umbilical cord?
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2 |
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After the cord is clamp, what happens to the infant?
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the infant must obtain oxygen through its own respiratory effort. |
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What portion of the cord is a blood sample usually obtained from?
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the portion of the cord still attached to the placenta |
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Where do you apply the plastic clamp?
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1 to 2 cm above the umbilicus then you remove the Kelly clamp |
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What will happen if you remove the Kelly clamp before you put the plastic clamp on? |
the infant will lose blood through the cord stump |
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Where are the bands placed on the mother and infant after birth and what do they each have in common?
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-The each have the same exact info |
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-creates and alarm if the baby is taken off the obstetrical unit without being deactivated by hospital personnel.
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Electronic Bracelet |
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Some hospitals use maternal _ and newborn _ as means of identification and they become part of the permanent record.
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fingerprints and footprints |
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What items must be documented before the newborn leaves the delivery room? |
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What type of precautions are used during delivery?
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standard precautions |
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What ointment is used to protect the newborn from blindness due to gonorrhea or chlamydia infection? |
Erythromycin Ointment |
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How is Erythromycin ointment applied to the neonates eyes? |
applied along the conjuctival sac from inner to outer canthus |
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Why is Vitamin K administered to neonates?
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The lack of intestinal bacterial flora means the newborn is unable to produce adequate amount of vit K, and is at high risk for bleeding problems during the first week of life.
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What is the first vaccination the newborn receives?
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hepatitis B |
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It is safe for the mother to breastfeed, even if she is a hepatitis carrier. |
True if the baby has been immunized |
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_ is when the mother and baby heads align as they look at each other.
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en face position |
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What is the average wt of a healthy newborn? |
5.5 to 9.5 lbs |
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What is the avg length of a health newborn? |
18 to 22 inches, boys are usually 1/2in longer |
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The avg newborn head circumference?
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13 to 14 inches |
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The avg newborn chest circumference? |
10 to 12 |
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Which is bigger on a newborn chest or head? |
The head is usually 1 to 2 inches larger than the chest
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If the newborn was delivered vaginally, the head may show temporary _
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molding (elongation) |
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What causes molding? |
overlap of skull bones during the birth process |
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_results from an accumulation of fluid within the newborn's scalp. |
Caput succedaneum |
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_is an accumulation of blood between the bones of the skull and the periosteum, the membrane that overs the skull. |
Cephalohematoma
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What causes Caput Succedaneum?
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Swelling causes by pressure to the head during delivery. The fluid causes the scalp to be puffy and edematous, and the edema crosses the midline of the baby's scalp. |
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How long does Caput Succedaneum normally last? |
The condition normally disappears within a few days |
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What is an important teaching you should do for the parents of a neonate with Cephalohematoma? |
reassure them that the fluids will eventually reabsorb |
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AKA "soft spots"
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fontanels |
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_are formed at the junction of the individual skull bones. The bones do not infuse completely before birth, so that the head can mold to fit through the mother's birth canal.
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fontanels |
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During the first several weeks, why aren't baby's able to produce tears? |
bc the lacrimal glands aren't yet functioning |
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T or F (newborn) Engorgement of the breasts is uncommon for the first 2 or 3 weeks of life in both boys and girls. |
It's common and is the result of no longer being under the influence of hormones from pregnancy |
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What is "witch's milk" and an important nurse teaching for the family?
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When the baby's breast produce a small amount of fluid --Teach the family that it's common and trying to express the milk may result in the complication of infection |
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_ is when the genitals of the female infant may be enlarged and have a mucoid, white, or blood-stained discharge.
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Pseudomenstration
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another name for "foreskin"
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prepuce |
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If the opening of the foreskin is so small that it cannot be pulled back at all, the condition is called _ |
phimosis |
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If it is located on the underside of the penis (near the scrotum), it is termed __
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hypospadias |
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A less common location is on the upper side of the penis; this is called
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epispadias |
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because of slowed peripheral circulation, the newborn's arms and legs may appear cyanotic; this condition is called - |
acrocyanosis |
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Another word for "peel"
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desquamate |
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The nose and cheeks may have pinhead-sized white spots, caused by unopened oil and sweat glands. These spots are called __
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milia |
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White or gray bumps on the mouth's hard and soft palate are known as
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Epstein's Pearls |
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A mark that often appears on the newborn's eyelid or forehead is called __ |
stork bite |
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A __ is a flat, purple -red area with sharp borders; this is a permanent birthmark. |
port-wine stain |
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The skin of some newborns is sensitive; many newborns develop a red raised rash known as _
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erythema toxicum |
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_ are small purplish dots on the skin and are due to pressure caused by labor and will fade. |
petechiae |
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__ are dark blue areas of discoloration on the buttocks, lower back, or upper legs of nonwhite babies. |
Mongolian spots
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How should the ears of a newborn set?
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The top of the ear should be at or above an imaginary line drawn from the inner canthus of the eye to the outer canthus. |
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Fine, downy hair that may be seen on the face, shoulders, and back, is called
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lanugo |
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A white, thick, cheesy material may cover the skin,called |
vernix caseosa |
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What is the vernix composed of? |
it is composed of epithelial cells and the secretions of glands. |
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What is the purpose of vernix caseosa?
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It protects the skin from the drying effects of amniotic fluid in utero |
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How is the neonates physical maturity assessed? |
the birth attendant observes the infant's posture, tests flexibility and reflexes, and identifies specific physical characteristics to determine the newborn's physical maturity. If the scores are too low, the newborn is treated as premature.
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When stroked on the lip or cheek, the newborn reacts by turning the head toward the direction of the stimulus.
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Rooting reflex |
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The newborn tightly grasps a finger or other object placed into his or her hand. this reflex disappears as the newborn grows older. |
palmar grasp reflex |
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Sudden noises or jarring movements cause the newborn to throw out the arms and to draw up the legs |
Moro's or startle reflex |
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When the newborn is lying ton the back and turns the head to one side, the leg and arm of that side extend, and those of the opposite side flex. |
Tonic neck reflex |
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Hold the newborn's foot and stroke up the lateral edge and across the ball of the foot. The big toe fans out and hyperextends in a positive response. |
Babinski's reflex |
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The newborn steps with one foot, and then the other, when held upright with the feet touching a surface. |
Stepping reflex |
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As the newborn grasps the nipple with the lips, sucking should be automatic. |
Sucking reflex |
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How often do you take v/s after birth? |
an hour or two immediately after birth and then every 4 hours for the first 24 hours. |
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what is the normal hemoglobin in a newborn is _-
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15 to 18 g/100 ml blood |
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what is the normal hematocrit for the newborn |
45% to 60% |
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If the hemoglobin and hematocrit results are lower than the normal rate, what could it mean
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it may indicate anemia |
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What is the newborns normal glucose
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40 to 45 mg/100ml |
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_ is an inherited disorder caused by the body's inability to digest protein normally. |
PKU (phenylketonuria) |
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_ a hereditary disease in which the newborn cannot digest galactose, a certain type of sugar. |
galactosemia |
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What is the normal newborns blood pressure? |
50 to 80 mm Hg- diastolic/ 30 to 50 mm Hg- systolic |
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excess secretions and dead skin cells that collect beneath the foreskin
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smegma |
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when part or all of the foreskin is removed |
circumcision |
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When the opening of the foreskin (prepuce) is very small, a condition know as |
phimosis |
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prepuce
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foreskin |
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What should be placed over a new circumcised baby's penis? |
a sterile dressing for the first 24 to 48 hours so the diaper doesn't stick |
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How often should you check a newly circumcised penis? |
every 15 minutes for the first 4 hours for excess bleeding |
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