OB Exam 2 > Ch 17 > Flashcards

Ch 17 Flashcards

(60 cards)

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1
Q

When does the most dramatic physical change occur for the newborn?

A

Neonatal period

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2
Q

6 Factors that help initiate breathing

A
  • Chemical factors of the Labor effort
  • Labor Squeeze
  • Crying
  • Cold Environments
  • Handling and Drying
  • Lights and Sounds
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3
Q

Newborn RR Range

A

40-60

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4
Q

Is it normal for newborns to be periodic breathers?

A

Yes, it is normal to have 5-10 seconds of Apnea

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5
Q

Transient Tachypnea of Newborn (TTN)

A

Delayed fluid clearance from the lungs resulting in RR that is > 60

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6
Q

Why is blood flow from the placenta cut off?

A

Umbilical cord gets clamped and cut causing the blood to reverse and go back to the heart

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7
Q

PDA closure depends on what

A

The amount of oxygen in the blood

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8
Q

Normal HR for Newborns:

A

110-160 bpm

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9
Q

How long do we delay clamping of umbilical cord?

A

For 30-60 seconds

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10
Q

What is special about Newborn RBCs?

A

Larger and break down at a higher rate and have a shorter lifespan

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11
Q

What does breakdown of rbcs cause?

A

Bilirubin

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12
Q

What does high level of bilirubin cause?

A

jaundice

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13
Q

Newborns 3 Jobs:

A

Staying Warm, Breathing, Eating–Affecting one will affect the other 2

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14
Q

Nonshivering Thermogenesis Def

A

Their primary way of heat production and staying warm: breaking down brown fat and glucose

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15
Q

What is Brown Fat?

A

Fat produced in the 3rd Tri, after birth the fat is metabolized to create heat

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16
Q

How do babies get glucose?

A

Early initiations of feedings are important

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17
Q

When do early initiations of feeding start?

A

Within 1st hour of life

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18
Q

Temp Ranges in Newborns

A

97.9 to 99.7 F or 36.5 to 37.5 C

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19
Q

First Line Tx for Hypothermia

A

Skin to Skin and adding a Hat and Blanket

If this is not enough we put the baby under a radiant warmer

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20
Q

4 Mechanisms of Heat Loss

A

Conduction
Convection
Evaporation
Radiation

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21
Q

Conduction Def

A

Heat lost due to contact with direct surface
Ex: When a baby lies down on a cold scale to get weighed

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22
Q

Convection Def

A

When the newborn loses heat to cooler air
Ex: If the baby is near an open window or the baby is in front of a fan

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23
Q

Evaporation Def

A

When the newborn loses heat because of a liquid on the surface of their skin turns to water vapor
Ex: When babies are wet or moist right after birth or after a bath

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24
Q

Radiation Def

A

When the baby loses heat to a colder surface that they are not in contact with

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25
Cold Stress Def
Excessive heat loss that requires a newborn to use a compensatory mech to maintain core body temp
26
Why are preterm babies highest risk of cold stress?
Due to the lack of brown fat and because they do not eat as well
27
Cold Stress 7 Sxs
* Fussiness * Skin is cool to touch specifically in the skin folds in the neck * Skin is mottled * Central cyanosis appears due to not presenting good respiratory effort * Decreased responsiveness/lethargy * Jittery due to Hypoglycemia and Withdrawal from opioids/nicotine/meds * Tachypnea
28
Why are newborns prone to overheating?
Bc they do not sweat and are dependent on the environment
29
Overheating Tx
Take off the layers (Hats/Blankets)
30
What are 3 functions of neutral thermal environments?
* Promotes Growth of Baby * Conserves Energy * Minimizes Heat and Water loss
31
What are 6 NM to maintain a neutral thermal environments?
* Prewarming blankets and hats * Drying newborn right after birth * Performing Skin to Skin * Promote early breastfeeding or formula to provide fuel/energy * Using and Keeping Radiant warmers charged * Delay Bath
32
Why do we delay the bath for newborns?
When we give newborns a bath, we are cooling them down--if the baby has low temps after delivery, it is necessary to delay the bath till they are medically stable
33
Why is iron important?
We need it for Hgb and Hgb is important for O2 transport, this is why it is beneficial to delay clamping so they get more O2 circulating
34
How do infants get iron?
Infant’s iron supply for first 6 mo of life is dependent on the Mom’s diet during pregnancy
35
What happens if the mom is anemic?
If the mom is anemic, she should be on iron supplements
36
What if the baby does not get the iron needed?
If the baby does not have iron, the baby is at risk of failure to thrive
37
How do Infants get glucose originally and why can we not do that anymore
* Comes from the mom through the placenta and umbilical cord * But we clamp and cut off the cord-essentially cutting off baby’s glucose supply
38
Why are babies susceptible to hypoglycemia?
Bc the Baby’s body is still producing insulin at the same rate even though the baby's glucose supply was cut off when the cord was cut off
39
Body's Tx of Hypoglycemia for the Newborn
* Glycogen is released by the liver to mitigate hypoglycemia * This is why early feeding is important, because these stores are limited
40
Indirect Bilirubin Def
The fat soluble bilirubin created when RBCs break down
41
Indirect Bilirubin Process to Direct Bilirubin (4)
* Is fat insoluble--but body cannot get rid of fat soluble bilirubin, needs liver * Liver takes it and conjugates it to make it water-soluble, so the liver takes indirect bilirubin and makes direct bilirubin * The body can get rid of water-soluble bilirubin through urine and feces * But those urine and feces are only produced if the baby eats, so babies that do not eat have higher levels of bilirubin, higher levels of bilirubin lead to jaundice
42
Physiologic vs Pathologic Jaundice
Physiologic: * Appears after first 24 hours of life * Normal bc the liver is immature Pathologic: * Appears before 24 hours of life * Can be from trauma * Sxs: Yellowing of sclera and skin shows the liver is overwhelmed
43
What is the best source of colonizing the GI tract
Breastfeeding
44
How big is the babies stomach?
Baby’s stomach is very small for the first 24 hours---It only holds 30 mL
45
How much do babies get fed
* Only 10-15 mLs for first couple of feedings for bottle feeding parents * Only a few drops of colostrum for breastfeeding parents
46
Why are babies prone to spitting up and reflux?
Due to an immature cardiac sphincter
47
What is Meconium
Baby's poop first day, tarry green color
48
Baby's poop color if formula is given
Green and pasty
49
Baby's poop color if breastmilk is given
Yellow and seedy
50
Should newborns lose or gain weight in first 24 hours
LOSE WEIGHT
51
When do we see first void?
Should be within 24 hours
52
How do we tell if baby is hydrated?
By looking at the diaper count, number of voids should equal days of life
53
Development follows a ____ pattern
Cephalocaudal and proximal to distal pattern
54
Most sensitive body parts for baby
Faces/Hands/Soles of Feet
55
What can babies taste?
Babies can distinguish and taste sour and sweet--they like sweets (Breastmilk is Sweet)
56
First Period of Reactivity for Newborn
Birth to 30 Minutes Great time to facilitate bonding and feed babies--early feeding is important!! This period should be protected just for the direct families, not extended families
57
Period of Decreased Responsiveness for Newborn
30 Minutes to 2 Hours Baby is sleepy/zonked out/disengaged Great time for mom to get OOB, clean her, care for her, transport her A time for the extended family to visit
58
Second Period of Reactivity for Newborn
2 hours to 8 hours of Life Baby is awake, ready to eat, and ready to go--interested in things/stimuli
59
What are the 5S of how to console the baby
* Shushing - Loud shushing * Swaying - Very soothing * Swaddling - Helps baby be contained, stimulate the womb for them * Sucking - Sucking is comfortable to the baby, pacifiers are good * Side-Line Position - Putting baby in a side-line position, this should be monitored as side line position should be in the mom’s arm as sleeping on the back is the best not on the side
60
Will all babies respond well to cuddling?
No, Some babies will not respond well to cuddling or loving/touching behaviors, but some others will respond well Babies have an innate personality, there is a spectrum of normal behavior
OB Exam 2
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