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32 terms

56-1

STUDY
PLAY
-12 inches to 13 inches in circumference
-Nipples may secrete whitish fluid (witches' milk)
-Heart murmurs may be normal
-Diaphragmatic breathing pattern
-Respirations are irregular with brief periods of apnea
Chest
-Lub-dub
-Slurring on one sound (usually lub) may indicate murmur
-Considered normal and disappears in few mo.
heart sounds
-Noisy for first few hours after birth
-Periodic breathing irregular with 5-15 sec pauses
lung sounds
-Soft, rounded without palpable masses
-Umbilical cord should have 3 vessels
-Bowel sounds present in all 4 quadrants
-Meconium stools for 2 - 3 days
-Voids: 5-8 times a day
Bladder holds 30-50 mL of urine
Abdomen
-Clitoris large, similar to penis, hormone influenced
-Pseudomenstruation-hormones
-Smegma- secretion in labial folds, don't remove
-Anus- check for patency
Genitalia
-Symmetrical bilaterally
-Each extremity ends with 5 digits
-Strong muscle tone
-Full range of motion
-No hip displacement
Extremities
presence of more than 5 fingers per hand/toes per foot
polydactyly
the fusion of 2/more digits
syndactyly
skin between 2/more digits
webbing
stroke cheek
rooting reflex
lips touched
sucking reflex
hold tight-4 months
palmar grasp reflex
feet grab-8 months; must disappear before walking occurs
plantar grasp reflex
big toe dorsiflex & toes flare
Babinski reflex
newborn walk
stepping reflex
head turned to 1 side and newborn will extend the arm & leg on that side & the opposite arm & leg will flex
tonic neck reflex
occurs when newborns have a sence of falling "C"
moro reflex/startle reflex
Behavioral state
Sleep state-20-22 hours a day
Quiet alert state-looking around
Crying state-strong, lusty, medium pitch
Hygiene: Bathing
-No tub bath until cord falls off
-Skin becomes dry and peels, little lotion
-Slippery little things
-Change diaper q2hrs
-Don't pull back foreskin, takes 3-5 years
Hygiene: Eye care
-Ophthalmia neonatorum-inflammation of the eyes
-Antibiotic ointment applied-contact with gonorrhea/chlamydia -MANDATORY
Hygiene: Umbilical cord care
-Assess for redness and drainage
-Cord care- triple blue dye, antimicrobial ointment
-Falls off in 7-14 days
-Skin should be pink
-Fold diaper below cord
Common Neonate Medications
-AquaMEPHYTON IM (to prevent hemorrhagic disorders).: Unable to produce Vit. K &
Given within 1 hour of birth
-Hepatitis B immunization may be administered in the newborn nursery with parental consent.
Neonate Nutrition
-A full-term infant needs 50 to 55 kcal/lb (110 to 120 kcal/kg) that equals 20 oz (600 mL) of breast milk or formula per day.
-At birth, the newborn's stomach will hold 20 mL, or slightly less than an ounce:
Weight loss 5%-7%
End of first week-can hold 60-90 mL
Feed q2-4 hours
Nutrition:
infant need to be fed q2-4hrs
breast mild recommended for the 1st year
give parents info. about the benefits of breastfeeding & bottle-feeding
-Colostrum contains protein, calories, immune globulins & Acts like a laxative
-Breastfeeding:
10 to 30 minutes a side per feeding
8 to 12 times a day
Breastfeeding
-Feed 15 mL first few days, then increase gradually
-Position head higher than stomach
-Burp when half of feeding consumed
Bottlefeeding
-Breastfeeding mothers receive a greater quantity and variety of foods than mothers who fully formula feed their infants, with mothers fully breastfeeding their infants receiving the most substantial food package.
-Breastfeeding mothers are eligible to participate in WIC longer than nonbreast feeding mothers.
-Breastfeeding mothers may receive follow-up support through peer counselors.
-Breastfeeding mothers may receive breast pumps and other aides to help support the initiation and continuation of breastfeeding.
WIC
Neonatal Screening Tests:
**Accomplished through heel sticks for blood draw to test for:
Hypoglycemia( SGA/LGA assessed)
Phenylketonuria (PKU)
Bilirubin
-Required in all 50 states
-Unable to break down phenylalanine
-Results devastating mental function and health
-Best results after milk received 48-72 hours
Phyenylketonuria (PKU)
check for liver function
Bilirubin
-is the surgical removal of the foreskin (prepuce) of the penis.
-Before the procedure begins, an informed consent must be signed by the parents.
-The penis should be washed with warm water with each diaper change.
-NPO for several hours
-EMLA cream -Tylenol drops
Circumcision
Discharge Teaching
Topics that require client teaching prior to discharge include the following:
Nutrition
Elimination
Diapering
Hygiene
Placing infant on back to sleep
Perineal care
Circumcision care
Umbilical cord care
Safety