1
Q
what is most important to assess (palpate) for on the neck of the NB?
A
- clavicles evacuated of evidence of fractures as they can happen spontaneously during birth or with shoulder dysphasia
- normal finding is smooth
- also assess for ROM, masses, lymph nodes
2
Q
why do you need to support babies head?
A
- due to a head lag bc the baby has no neck muscles
3
Q
when assessing a NB you notice that there is not symmetric movement of the arms what may that be due to? what needs to be assessed next?
A
- assess the clavicle as it the most broke bone during birth and there could be a brachial plexus nerve injury
4
Q
what needs to be assess for the NB chest?
A
- ribs flexible
- throat is cylindrical and symmetric at birth
5
Q
why do NB’s get engorged breast after birth?
A
- engorged breast are common at birth in both males & females bc the skin absorbs some fluid
- the extra fluid gets reabsorbed and urinated out
6
Q
what does a normal NB abdomen look like?
A
- cylindrical, protrudes slightly
- no cyanosis
- no distension
7
Q
what do you assess on the NB abdomen?
A
- palpation for softness, tenderness, masses, ect
- assess the umbilical cord
8
Q
what does the normal umbilical cord look
A
- initially white and gelatinous, 2 arteries and 1 vein
9
Q
what is different about the umbilical cords vasculature compared every other vascular in the body?
A
- the umblical cord has two arteries and one vein (AVA)
- the arteries are smaller and care DEOXGENATED BLOOD AWAY FROM THE BODY
- veins are bigger and give OXYGENATED blood to the baby
- meaning that blood flow in the fetus is opposite to blood flow in the rest of the body
10
Q
when does the umbilical cord fall off?
A
- umbilical cord is an open wound technically directly into the body so it needs to stay clean and dry
- dry, shriveled, blacked in 2 - 3 days
- falls off 7 - 10 days
11
Q
what are abnormal findings for the umbilical cord?
A
- cord bleeding and foul smelling drainage is abnormal and needs to be reported asap
12
Q
define hypospadias?
A
- urinary orifice or opening is positioned at the underside of the penis
13
Q
define epispadias
A
- urethral opening at the top side of the penis, not the tip
14
Q
what is supposed to be inspected for the male scrotum?
A
- inspect for size, symmetry, and if they have descended
- not all will be descended, which is normal, may take 3 wks
15
Q
what is to be assessed on the female genitals in the NB?
A
- note labia
- note clitoris
- discharge is normal, along with psudomenstruation
16
Q
what is to assessed on the anus?
A
- verify patent anus
- note passage of meconium (babies first poop)
17
Q
what needs to be assessed on the back?
A
- baby prone on back for exam
- palpate that the spine is straight and flat by running your fingers down for summitry
18
Q
what is a pilonidal dimple? and why does it need to be assessed?
A
- dimple on the lower back that as a nurse you need to assess to make sure it isn’t attached to the spinal canal
- note any discharge and if so report asap
- would be occult spinal diffida
19
Q
define polydactyly?
A
- extra toe, digit, finger
20
Q
define syndactyly
A
- webbing b/t fingers and toes
21
Q
define brachial palsy
A
- biracial nerve plexis injury
- non symmetrical arms
22
Q
define talipes equinovarus
A
- club foot
- needs surgical repair
23
Q
what is a normal assessment of the legs look like?
A
- legs equal, symmetric skin folds
- assess for hip dislocation & instability by the Barlow or Ortolani maneuver
24
Q
what is the Barlow or Ortolani maneuver?
A
- assessing for hip dislocation
- bring fetus knees up & put thumbs on socket & do abduction and adduction of the hips, will feel if hips abnormal
25
when assessing muscle tone what does NB tremors/ jitteriness indicate?
- babies can't shiver bc of their immature CNS and muscle tone so if it looks as they are shivering they are likely HYPOGLYCEMIC which is BAD
26
how can NB tell difference between people?
- developed olfactory so they can smell different people and parents specifically
27
define rooting reflex?
- stroke babies check and the baby should turn their head for food stimuli
28
define sucking reflex?
- baby should suck on your finger, good sign of neuro function
- during this time also feel the inside of the mouth for false teeth and an uneven pallet
29
what is the moro reflex?
- when babies get startled or "dropping" a baby
30
what is the palmer grasp reflex?
- when you put your finger in their hand and they wrap their fingers around yours
31
what is the Babinski reflex?
- you run your finger along the foot and have the toes curl
32
what is the trunk incurvation reflex?
- lay the baby prone and stroke one side of the baby and the baby will curve to the side you touched
33
when assessing comfort and latch what does the nurse need to look for?
- is the baby latching at the tip of the nipple or the whole nipple
- make sure the baby is eating comfortably
34
is weight loss normal for NB?
- yes, 5 - 10% weight loss is normal, over 10% requires evaluation and treatment
- birth weight loss regained by 2 weeks
- weight at same time every day on the same scale
35
how or why is fetal breathing movements seen on US by 17 to 20 wks?
- bc the fetal lungs are filled with 20 to 30 ml/kg of fluid as they are the primary organ system to make amniotic fluid, so you see that on ultrasound
36
when does alveolar tissue develop?
- 21 to 24 weeks, however preemies delivered at this time have a hard time surviving bc there is limited surfactant and w/o surfactant babies are in resp distress and die
37
what are the chemical stimuli to make the NB take it's first breath?
- vaginal birth itself
- when cord is clamped and cut prostaglandins s start being produced and that helps the baby take their first breath
38
what stimuli is responsible for the NB first breath?
- cord clamping, temp change, sensory of cleaning off the baby, vaginal birth itself
- massive surface tension should be overcome for first breath
39
describe fetal circulation and why it bypasses certain organs
- fetal circulation prioritizes oxygenated blood to vital areas like the heart and brain and shunts blood away from less important organs such as the lungs or liver bc the placenta takes over the function of the lungs & liver in fetal life
40
what is the Ductus arteriosus
the shunt that bypasses blood from the lungs to the descending aorta
- once the baby takes the first breath this closes but some babies it closes later so they have a murmur for a while
41
what is the ductus venosus?
- the shunt that bypasses the liver and then becomes the inferior vena cava that shuts after birth bc pressure in the lungs that allows the baby to breathe
42
when the cord is clamped how does that change NB cardio system?
1. placental circulation is eliminated, systemic pressure increases, ductus venosus closes
2. first breath is taken and pulm pressure decreases and pulm blood flow increases
3. increased left atrial pressure causes foramen ovule to close
4. o2 presence & decreased prostaglandins trigger ductus arteriosus to close
43
describe fetal blood flow
- umbilical vein takes 02 rich blood from placenta to the liver & thru the ductus venosus (bc placenta takes over function of liver)
- then blood goes to IVC to right atrium
- then some blood is shunted thru the foramen ovule to left ventricle where its routed to the brain & upper extremities
- then the rest of the blood goes to right ventricle & pulm artery
- small amount goes to nonfunctioning lungs and the rest is shunted through the ductus arteriosus to the aorta to supply the rest of the body
OB
flashcards
Decks in class (23)
# Cards
-
terminology33
-
Newborn 1 lecture55
-
newborn 2 lecture43
-
newborn 3 lecture45
-
Newborn at risk 141
-
Newborn at risk 2; at risk conditions for all newborns38
-
HITEC6
-
Teratogens, sexually transmitted infections, infertility67
-
pregnancy adaptations & nutrition37
-
Nutrition in pregnancy16
-
Prenatal care & fetal wellbeing assessment (1st & 2nd trimester)38
-
fetal wellbeing assessment (3rd trimester) and EFM38
-
Labor 1 lecture47
-
Labor II lecture52
-
pain management30
-
EFM (decelerations)25
-
birth related procedures I10
-
birth related procedures II0
-
postpartum care I32
-
postpartum care II13
-
postpartum at risk I14
-
postpartum at risk II24
-
pregnancy at risk I7
