Download (2026): Newborn Care and more Lecture notes Medicine in PDF only on Docsity!
Q 2-3 hours
What is a newborn? • • A "new"ly born patientBirth to 28 days of life
Factors contributing to the need for neonatology (6) • • (^) Gestational ageBirth weight
- • Physical/genetic disordersEnvironmental influences/exposures
- • Maternal factorsPregnancy complications
Preterm less than 37 weeks
Choose an answer 1 What is a newborn? 2 Functional residual volume 3 Term gestational age 4 How often should newborns breast feed? Don't know?
Late preterm 34-37 weeks Term gestational age 37-41 weeks Postterm >42 weeks Weight measured in kg Length measured in • • (^) Top of head to heel of flexed footMeasured in cm
Occipitofrontal head circumference (OFC) • • (^) Circumference of the head around the occiput to frontal boneMeasured in cm
What does surfactant reduce? Surface tension Surfactant develops at 36 weeks Surfactant keeps alveoli from collapsing Functional residual volume volume of air remaining in the lungs after a normal expiration What is the initiation of respirations? Increase in CO2 stimulates baby to breathe Oxygen causes the lungs to Vasodilator Oxygen causes peripheral vessels to vasoconstrictor When does the foramen oval close? 1-2 hours When does the ductus arteriosus close? 1-2 days Newborn pulse oximetry >92% 5-10 minutes to achieve Acceleration of the heart rate if followed by what? • • (^) 120-160 beats per minuteReturn to normal rate
What is periodic breathing? Irregular pattern of rapid respirations followed by no respirations (15 seconds orless)
Periodic breathing should not affect gas exchange or heart rate How long apnea (pause in breathing)? >20 seconds Newborn blood pressure 31-61 mmHG
How many wet diapers per day? 8- The first stool should occur within 48 hours How many stools per day? Regular & soft stool pattern What are some feeding cues? (2) • • (^) Stress cuesHunger cues: mouth opening, turning head, hand to mouth
Newborns cannot ____ urine at birth • • concentrateDecreased amino acids, bicarbonate, glucose, and sodium
New born urine output 15-25 ml/kg/day Urine should appear Straw colored & odorless "Brick dust spots" means Excess urnates in the urine How many calories do term newborns require? 120 calories/kg/day Normal weight loss in a newborn is 5-10% How does a newborn's stool vary? • • May range from multiple stools per day to one stool every 2-3 daysRegular
- Transition of color How does Gestational Diabetes effect newborns? (5) - Large for gestational age- Poor glucose regulation
- Poor feeding- Respiratory distress
- Prolonged hospitalization What does homeopathic mean? Attempt to stabilize their core temperature Characteristics leading to heat loss (3) • • Little subcutaneous fatBlood vessels close to the surface
- Greater surface area How do infants lose body heat? • • (^) ConductionEvaporation
- • ConvectionRadiation
Why does evaporation happen? • • Baby is wetBirth & first bath
What is conduction? Contact with cold surface (scale or mattress) What is convection? Cold air
What is radiation? Near a cold surface What is the goal for thermoregulation in the newborn?(3) • • Neutral thermal environmentMinimize oxygen consumption
- Minimize energy expenditure What is cold stress? • • Period of inadequate temperature regulationIncreased metabolism
- Increased O2 consumption Signs & symptoms of cold stress (5) • • LethargyPallor
- • Poor FeedingHypoglycemia
- Respiratory Distress What is thermogenesis? (4) • • Increase basal metabolic rateMuscular activity
- • (^) VasoconstrictionFlexion
What is non shivering thermogenesis (NST)? (3) • • (^) Stimulation of sympathetic nervous systemInitiated by skin receptors
- Utilization of brown fat When can a newborn have a bath? • • Delay 4-6 hoursDelayed until "temp stable"
- • Clamp removal at 24-48 hours of ageKeep dry and open to air
- • (^) Water temperatureNo indication for alcohol or antibiotic solutions
- • SupervisionSwaddle bathing
Where is iron stored? Liver The iron supply at birth lasts how long? 5 months What is bilirubin? • • Product of RBC breakdownNewborn liver must begin to conjugate bilirubin
- Bilirubin excreted in the stool What is the carbohydrate metabolism like in newborns? • • CHO reserves are low1/3 stored as glycogen
- • End of maternal glucose supplyRapid consumption of "energy"
What are clotting factors activated by? Vitamin K
Ophthalmic antibiotic ointment (2) • • (^) TetracyclineErythromycin
- Administer within 1 hour What is Vitamin K for? • • ClottingAbsence of normal intestinal flora: Alters production of Vitamin K
- • (^) Administered as IM injection (vests lateralis)Risk for bleeding/hemorrhage
Why do newborns get circumcised? (4) • • HygieneDecreased risk of infection
- • Cultural/religious preferencePhysical appearance
What are risks of circumcision? (6) • • HemorrhageInfection
- • (^) Cosmetic concernsImpaired elimination
- • Pain & discomfortUrethral damage
How to care for newborn with circumcision (4) • • Pain managementPetroleum jelly for 24 hrs. (or longer)
- • Cleanse with warm waterAssess every 30 min.
What to teach parent about circumcision (4) • • (^) Signs/symptoms of infectionDiaper care
- • Management of bleedingPain management
Newborn screening (5) • • Metabolic State ScreenHepatitis B
- • Carseat safety (<37 weeks it is required)Congenital heart disease screen (2x pulse ox)
Discharge planning (4) • 48 hours after vaginal birth, 72 hours after cesarean birth PINK, SWEET, & WARM
- • Vital signs WNL, feeding well, stable temp, passage of urine and stoolAll teaching and testing complete
- Safe Sleep What is SIDS? Sudden death of an apparently healthy infant When does the majority of SIDS related deaths occur? 2-4 months What is the Etiology of SIDS? (4) 1) Brainstem abnormality2) Stressors: Sleep position (on belly) & Sleep environment
- Critical development period4) NOT associated with apnea or immunization
What are risk factors for SIDS? (9) • • Sleep positionBed space (Soft surface)
- • Sleep environmentTemperature
- • Co-beddingExposure to smoke: Prenatal & 2nd hand smoke
- • (^) AgeFamily history of SIDS
- #1: Native American Race #2: African American#3: Caucasian
- Prematurity/Low birth weight What are clinical manifestations of SIDS? • • (^) 1st symptom is cardiopulmonary arrestNO warning signs
- secretions Post-mortem findings: Evidence of change in position & Frothy, blood-tinged
- Most SIDS deaths are unobserved What are preventions for SIDS? • • (^) Tummy time for play"Back to Sleep"
- • Cuddle time for lovingCease smoking
- • ImmunizationsUse bedding that is firm
- • Avoid co-beddingAvoid overheating
- • PacifierEducate all caregivers
What reflex does a pacifier trigger? Suck, swallow, breathe reflex
