Newborn Flashcards

Question

NEWBORN - GENITALIA AND ANUS ( NORMAL)

Answer 1

* Female: discharge of blood or mucus * Male: descended testes into the scrotum

Answer 2

* Anus: imperforate anus * Males: - Hydrocele: fluid- filled sac around a testicle that swells within the scrotum - Hypospadias: misplaced meatus: urinary opening - Cryptorchidism: an undescended testicle that is typically NOT concerning since most will descend on their own by 6 months

Answer 3

* Sacral dimples -> spina bifida occulta * Myelomeningocele

Answer 4

* Plantar creases up the the foot entire sole of the foot. * Acrocyanosis

Answer 5

* Preterm: very smooth sole of the foot. * Club foot: talipes equinovarus * Syndactyly: fused fingers or toes

Answer 6

* When the bottom of the foot is stroked from the heel upward, the big toe dorsiflexes and the other toes spread out * Should disappear after 1 year of age

Answer 7

* When the baby's mouth is stroked, the baby will turn its head and open the mouth. This helps the baby find the food source when feeding. E.g., breastfeeding. * Should disappear after 3-4 months.

Answer 8

* Can be triggered by a sudden loud noise or unexpected movement. The infant will extend the arms with palms up and then move the arms back to the body. * Should disappear after 6 months.

Answer 9

* When an infant is lying on its back and quickly turns its head to one side, the leg and arm on that side will EXTEND, while the leg and arm on the opposite side will FLEX. * Should disappear after 3-4 months.

Answer 10

* PALMAR: When a finger is touching the inside of the infant's palm, the hand will close. PALMAR: Response should lessen around 3–4 months. * PLANTAR: When a finger is placed or touching under the toes, the toes will curl. * PLANTAR: Response should lessen around 8 months.

Answer 11

* RYTHROMYCIN OPHTHALMIC OINTMENT (antibiotic ointment) - Given to all newborns as a prophylaxis for Ophthalmia Neonatorum (conjunctivitis of the newborn) -> BLINDNESS. - Given within 1 hour of birth. - Ophthalmic (eye). * VITAMIN K - A newborn's gut is sterile, meaning they do not have any intestinal flora that produce vitamin K until 7 days after birth. Vitamin K is essential for blood clotting. Given to all newborns to prevent hemorrhage and bleeding within 6 hours after birth. - IM in the vastus lateralis. * HEPATITIS B VACCINE - Given to immunize against hepatitis B virus (HBV). Given within 24 hours after birth. - IM in the vastus lateralis.

Answer 12

* Is a common procedure performed on newborns to collect a small blood sample for screening tests. * Are typically taken in newborn 24 HOURS AFTER BIRTH (should be done before discharge) * Helps detect metabolic and genetic disorders early (e.g., PKU, hypothyroidism, sickle cell disease and cystic fibrosis).

Answer 13

1. Warm the heel before to increase blood flow (e.g., apply a cloth soaked in warm water) 2. Put on gloves 3. Clean the area with an antiseptic and allow to dry 4. Hold the infant’s foot with the free hand 5. Puncture the site ( side of the heels ) 6. Collect the sample 7. Apply gentle pressure with a gauze and cover the site with an adhesive bandage.

Answer 14

* Phenylketonuria (PKU): a metabolic disorder that prevents the breakdown of phenylalanine, leading to intellectual disability if untreated. * Congenital Hypothyroidism: a deficiency of thyroid hormones, essential for neurological development. * Sickle Cell Disease and Other Hemoglobinopathies: abnormal hemoglobin production, which can cause severe anemia and complications. * Cystic Fibrosis: affects bodily secretions, leading to lung and digestive issues. * Congenital Adrenal Hyperplasia (CAH): a disorder affecting adrenal hormone production, potentially causing severe dehydration. * Enzyme Deficiencies: such as galactosemia and biotinidase deficiency, impacting sugar and vitamin metabolism.

Answer 15

* GOAL: prevent infection and hemorrhage * INTERVENTIONS: - 24 – 48 hours: cord clamp can be removed when cord is DRY - Clean cord stump with WATER and AIR DRY (NOT alcohol) - Assess for SIGNS OF INFECTION: redness; swelling; drainage

Answer 16

* Fold diaper down and away from the stump * NO bathing in a tub (submerged) until cord stump falls off * Let cord fall of on its own * DO NOT PULL CORD (infection + hemorrhage risk) * NO alcohol to clean the cord only water

Answer 17

* Newborn circumcision is an elective procedure that removes the foreskin from the male infant's penis using the clamp method or the plastic ring. * It can be performed before discharge on the postpartum unit or on an outpatient basis with a pediatrician

Answer 18

1. Hand washing before care 2. Petroleum Jelly application at diaper changes 3. Normal healing: yellow exudate after the first day 4. Signs to report: - Bleeding exceeding the size of a quarter - Dry diaper or no voiding 6 – 8 hours after circumcision 5. Cleaning: - Warm water without soap. - AVOID alcohol- based wipes or soap water

Answer 19

* Breastfeeding is very important for both the mother and newborn. * NOT ONLY does it contain powerful nutrients like fats, protein, and antibodies to which help strengthen the newborn’s immune system to fight infection, as well as lowering rates of allergies, sudden infant death syndrome (SIDS), and other disorders. * Helps the mother and baby to bond with skin to skin - which should be done soon after birth.

Answer 20

* Prolactin helps to produce milk and oxytocin helps with the let down of the milk. * Breastfeeding helps the mother, too, primarily in reducing uterine bleeding and preventing severe postpartum hemorrhage. * The act produces natural oxytocin release in the mother, which stimulates uterine contractions to prevent postpartum hemorrhage. * Along with other added benefits like reduced risk of certain cancers, osteoporosis, arthritis, heart disease, and other disorders.

Answer 21

* Initially, the breast makes - a yellowish fluid that is rich in antibodies. * Immune cells coat the newborn’s GI tract, helping the baby to pass meconium - the baby’s first stool. * Colostrum is secreted during pregnancy and for 2-3 days after delivery. * Milk is produced 3-5 days after delivery and has higher fat content than colostrum.

Answer 22

* BEFORE: - Wash hands prior to feeding * DURING: - Good latch: - Baby’s mouth wide open covering nipple both the areola and the nipple - Ensure the bottom of the areola is in baby’s mouth. - Nipple up against the roof of the mouth - Baby’s tongue against the bottom of the areola - Reposition the baby’s latch → always use 1 finger to break the suction first - The client should hold the infant "tummy to tummy," with the mouth positioned in front of the nipple. The head should be facing forward keeping the body in alignment

Answer 23

* DURING: - Good latch: - Baby’s mouth wide open covering nipple both the areola and the nipple - Ensure the bottom of the areola is in baby’s mouth. - Nipple up against the roof of the mouth - Baby’s tongue against the bottom of the areola - Reposition the baby’s latch → always use 1 finger to break the suction first - The client should hold the infant "tummy to tummy," with the mouth positioned in front of the nipple. The head should be facing forward keeping the body in alignment

Answer 24

* AFTER: - Fully empty the breasts with each feeding. Use a breast pump if needed. - Initially: feed every 1- 3 hours x 8 – 12 feeds per day - The mother should awaken the baby at least every 3 hours during the day to feed.

Answer 25

* Bad latch : shallow latch * Only the tip of the nipple inside the baby’s mouth * Causes less milk flow and nipple soreness, cracking and bleeding. * Apply breast milk to sore nipples and allow to air dry

Answer 26

* Encourage fluid intake for adequate milk production * Wear a supportive bra

Answer 27

* Mastitis signs: - Flu like symptoms: fever and muscle aches - Unilateral breast swelling, pain and inflammation (redness, warmth, edema) - Blocked milk duct - Before breastfeeding: Apply warm compress to breasts to open milk ducts and prevent blockage - After: Apply cool compresses

Answer 28

* Feed or pump more regularly (at least every 1-3 hours) * Recognize feeding cues from the baby: rooting reflex, suckling motion, hand-to-mouth movements. * Use chilled, fresh cabbage leaves on breasts throughout the day * Before breastfeeding or pumping: * Feed or pump more regularly (at least every 1-3 hours) * Recognize feeding cues from the baby: rooting reflex, suckling motion, hand-to-mouth movements. * Use chilled, fresh cabbage leaves on breasts throughout the day * Before breastfeeding or pumping: warm, compresses or a warm shower * Apply breast milk to sore nipples and allow to air dry after feeding

Answer 29

* Alcohol (wait 2 hours or more after consumption to breastfeed) * Smoking * Drugs * Newborn weight loss during the first 3 to 4 days of life * Normal newborn weight loss is 5 – 6% * REPORT weight loss OVER 7% within 3 to 4 days of life

Answer 30

1. Wash the top of 2. Refrigerate unused formula and discard after 48 hours 3. Formula after feeding 4. Broil or wash in a dishwasher: bottles, nipples, caps and other parts 5. Before feeding, warm the formula and test the temperature on the inner wrist before serving. It should be lukewarm, not hot! 6. NEVER over dilute or over concentrate the formula

Answer 31

* Gastroesophageal Reflux Disease: * Burp during and after feeds * Hold baby upright 20 – 30 minutes after each feeding * Offer smaller, frequent fees

Answer 32

*Cold babies with low body temperature, although easy to treat, it is VERY dangerous and can lead to hyperbilirubinemia, hypoxia (low oxygen), and hypoglycemia (low blood sugar). * This is because oxygen consumption and metabolism are increased leading to an unstable baby.

Answer 33

* Thin layer of subcutaneous fat * Wet infant: evaporation

Answer 34

* Altered mental status “irritability or lethargy” * Hypotonia * Bradycardia, tachypnea and hypoxia * Hypoglycemia and feed intolerance * NO shivering ability

Answer 35

* Skin- to- skin contact: newborn and mother * Dry the newborn immediately after delivery and place hat * Provide care under radiant warmers * Cover scale with warmed blankets before with warmed blankets * Use prewarmed incubator when transporting.

Answer 36

* The newborn must transition quickly from a fluid-filled environment to an air- filled environment so the lungs must expand with the help of surfactant which prevents collapse of the alveoli within the lungs.

Answer 37

* Fluid or mucus obstruction * Prematurity (lack of surfactant) * Cardiac Defect (PDA or PFO)

Answer 38

* Pathologic apnea * Intercostal retractions * Central cyanosis * Nasal flaring * Grunting, wheezing

Answer 39

* Dry, stimulate, suction * Support ventilation * Give surfactant (bethamethasone) * Monitor and surgery

Answer 40

* Newborn blood glucose should be kept above 40mg/dL at all times. * Newborns are at risk for hypoglycemia because the placenta (the source of maternal glucose) is removed and the infant’s pancreas is still producing insulin at a rate that matches the levels of maternal glucose during pregnancy.

Answer 41

* Mom with diabetes (all types) * Hypothermia * Sepsis

Answer 42

* Less than 40 mg/dL * Shaking, sweating and irritability * Lethargy * High- pitched or weak cry * Seizures

Answer 43

* Breast feeding is FIRST * Identify high risk newborns * Keep infant warm

Answer 44

* This is an inflammatory disease of the gastrointestinal mucosa due to ischemia (low oxygenation), resulting in necrosis (dead tissue within the GI tract), and perforation of the bowel (basically an explosion of the bowel).

Answer 45

* Prematurity * Polycythemia * Myelomeningocele

Answer 46

* Feeding intolerance * Abdominal distention * Bloody stools

Answer 47

* Daily abdominal girth measurements

Answer 48

* This growth failure is defined as a state of malnutrition, inadequate growth, or weight less than 80% ideal for age within the first 3 years of life.

Answer 49

* SOCIOECONOMIC: - Poverty: “unemployed” - Primary caregiver cognitive disabilities - Abuse: child or spousal - Lack of nutritional knowledge - Parents social or emotional isolation * PHYSIOLOGICAL: - Anorexia nervosa prior to having children - Preterm birth - Breast feeding difficulties - Gastroesophageal reflux - Cleft palate

Answer 50

* Signs of malnutrition * Developmental delays * Abnormal feeding behaviors * Increased metabolism * No eye contact

Answer 51

* Observe the child feeding * Develop a structured routine for bathing, sleeping, and playing * Assess overall parenting skill

Answer 52

* This is a very SERIOUS respiratory disorder in newborns that is typically due to lung immaturity related to surfactant deficiency! * Surfactant helps the baby’s lungs to be lubricated and expand in order to help get oxygen in! * Most full term babies can naturally produce surfactant, but is not always the case with premature infants.

Answer 53

* Preterm birth * IUGR - Intrauterine growth restriction * PPROM * Maternal DM, HTN, or drug use * Neonatal sepsis

Answer 54

* Absent breathing or crying at birth * Nasal flaring * Intercostal retractions * Audible grunting * Cyanosis and tachypnea

Answer 55

* Steroids * Betamethasone * Surfactant (via ET tube) * Admit to NICU for stabilization

Answer 56

* Is the unexpected death of an infant less than 1 year old. * It occurs most frequently during sleeping in infants less than 6 months. A: Alone (no pillows, blankets, stuffed animals) B: Back (supine) C: Crib (no bed sharing or co- sleeping)

Answer 57

* Boys are at higher risk than girls * Low apgar score at birth * Infants with a caregiver that smoke

Answer 58

* Place infants in supine position during sleep: “put to sleep on their back” in a safe crib; dress newborn in “wearable blanket” “sleep sack” * Breastfeed the infant * Have up to date vaccinations * Ensure a smoke- free environment * Provide a firm sleep surface for the infant

Answer 59

- AVOID sleeping with the infant (NO bed sharing, NO cosleeping - NO pillows - NO loose or soft items: blankets, toys, stuffed animals - NO bumper pads on the sides of the crib

Answer 60

* Avoid overheating * Smoke-free environment * Room-sharing without bed-sharing * Pacifier use * Supine position (sleeping on the back) * Flat, firm sleeping surface * No soft objects (e.g., pillows) or crib bumper pads

Answer 61

* Infection contracted by the neonate before, during, or after delivery, due to the newborn’s limited immunity and inability to localize infection, infections can spread quickly into the bloodstream.

Answer 62

* Premature birth, PROM, prolonged labor * Maternal TORCH infection * Meconium aspiration

Answer 63

* Lethargy, irritability, poor muscle tone * Respiratory distress: apnea or tachypnea * Heart rate instability * Temperature instability * Vomiting/ diarrhea -> sunken fontanelles * Poor feeding * Blood glucose instability

Answer 64

* Assess infection risks * Draw labs/ cultures * IV access

Answer 65

* Yellow discoloration of the skin, mucous membranes, and/ or sclera caused by increased in bilirubin levels. * Bilirubin is caused by the breakdown of red blood cells (RBCs)

Answer 66

* Happens within the FIRST 24 HOURS of life

Answer 67

* “Nonpathological Jaundice” * Happens AFTER 24 HOURS of age (begins to see jaundice around day 2- 4 of life)

Answer 68

* Immature liver * Increased RBCs * A newborn’s RBCs have a shorter lifespan * Vacuum Assisted Birth: this often causes hematomas to the scalp = increased RBCs = more TBCs for the body to breakdown = jaundice

Answer 69

* Hemolytic diseases: RH / ABO incompatibility * Premature infants (the liver is not fully developed) * Failure to pass meconium * Sepsis

Answer 70

* Yellowish hues * Face or eyes (sclera) * Trunk and extremities

Answer 71

* Fluorescent light is used to convert the bilirubin to a water- soluble substance so it can be excreted by the body via stool or urine * The newborn should be fully exposed, except for a diaper.

Answer 72

1. Skin care: - Monitor skin temperature closely - Reposition every 2 hours - Lotions and ointments should not be applied as they can absorb the heat and cause burns. Maintaining skin integrity. 2. Temperature should be monitored closely, with the incubator placed on a low-heat setting. 3. Dehydration risk -> give fluids every 2 hours. Allowing parents to feed the newborn promotes bonding. The newborn should not be removed from the lights except during feedings for optimal effect of the phototherapy. 4. Eye care -> cover infants' eyes with protective pads -> to prevent retinal damage or cataracts

Answer 73

* The excess bilirubin (if untreated) can cause brain damage * Is a severe and permanent neurological condition caused by the deposition of unconjugated bilirubin in the basal ganglia and brainstem nuclei. * It occurs when neonatal hyperbilirubinemia exceeds the albumin-binding capacity, allowing free bilirubin to cross the blood- brain barrier, leading to bilirubin-induced neurotoxicity (BIND).

Answer 74

* Phototherapy: the first-line treatment for neonatal jaundice. * Exchange Transfusion: removes circulating bilirubin and replaces the baby’s blood with donor blood. * Intravenous Immunoglobulin (IVIG): reduces hemolysis and bilirubin production.

Answer 75

* Is a preventable congenital disorder caused by alcohol, leading to physical, neurological, and cognitive impairments in the baby. * Fetal exposure to alcohol (from maternal drinking) is the leading cause of intellectual disability and developmental delay. * Alcohol crosses the placenta, affecting fetal brain development and organ formation. * RISK FACTORS: ANY alcohol consumption in pregnancy

Answer 76

* Intellectual disability * Developmental delay - Hypotonia (weak muscle tone) - Poor sucking reflex and feeding - Abnormal palmar creases * infant irritability * Minimal response to stimuli * Distinct facial characteristics: - Indistinct philtrum - Thin upper lip - Short palpebral fissures - Epicanthal folds - Flat midface

Answer 77

* History of prenatal alcohol exposure * Growth deficiency * Neurological symptoms like microcephaly

Answer 78

* Educate the mother on NO alcohol consumption during pregnancy. * Monitor the newborn’s response to feeding and weight gain pattern

Answer 79

* Is a withdrawal condition that occurs in newborns exposed to or other addictive substances during pregnancy. * Opioid abuse including those with the like HydrOcOdOne, MethadOne, mOrphine and even HerOin, but sedatives like benzOs can also contribute to this condition. * Symptoms typically present within 24-72 hours of birth, but can take days to weeks to appear.

Answer 80

* CNS findings: irritability, restlessness, high-pitched cry abnormal sleep pattern (sleeping very short intervals) * ANS findings: nasal congestion and frequent sneezing, tachypnea * GI: poor feeding and diarrhea “loose stools”

Answer 81

* Swaddle and gently rock * Side-lying position for feeding * Small, frequent feedings * Skin protectants

Answer 82

* MEDICATION: - Morphine or Methadone: used to ease severe withdrawal symptoms

Answer 83

* The APGAR score is a rapid assessment tool used to evaluate a newborn’s overall condition immediately after birth. * It helps determine if the baby needs immediate medical intervention or routine care. * Each category is scored from 0 to 2, with a maximum total score of 10 points.

Newborn Flashcards

(108 cards)