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Study sets matching "the normal newborn"

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Study sets matching "the normal newborn"

19 terms
Normal Newborn
Components of prenatal history
Definition: full-term
Definition: post-term
Definition: preterm
- Did the mother receive prenatal care? ... - What lab studies w…
37-40 weeks gestation
> 42 weeks gestation
< 37 weeks gestation
Components of prenatal history
- Did the mother receive prenatal care? ... - What lab studies w…
Definition: full-term
37-40 weeks gestation
47 terms
the normal newborn
what are the chemical stimuli that cau…
normal respiratory rate
signs of respiratory distress
fetal circulation before birth
transitory asphyxia... elevation of PCO2... decrease in PH... clamping…
30-60 min
grunting... retracting ... flaring... color change
ductus venosis... ductus arteriosis... foramen ovale... close after bi…
what are the chemical stimuli that cau…
transitory asphyxia... elevation of PCO2... decrease in PH... clamping…
normal respiratory rate
30-60 min
51 terms
Normal Newborn
The pulmonary physiological transition…
After birth the pulmonary resistance i…
What two actions increase vascular res…
Delivery room exam components (3)
High to Low
Removed
Umbilical cord clamping and closing of the ductus arteriosis.
Listen: heart and lungs... Palpate: abdomen... Inspect/Palpate: hea…
The pulmonary physiological transition…
High to Low
After birth the pulmonary resistance i…
Removed
40 terms
The Normal Newborn
Indications for Prenatal testing
Basic Prenatal Care: First Visit
Basic Prenatal Care: 15 to 20 wks gest…
Basic Prenatal Care: 26 to 30 wks gest…
-mom >35 yo; previous fetal abnormalities; Ethnic factors (Bl…
-Complete H&P, Blood type, Hep B, Rubella titer, HIV testing,…
-maternal serum marker screening (alpha feto protein
-1 hour glucose tolerance test, hemoglobin and hematocrit, an…
Indications for Prenatal testing
-mom >35 yo; previous fetal abnormalities; Ethnic factors (Bl…
Basic Prenatal Care: First Visit
-Complete H&P, Blood type, Hep B, Rubella titer, HIV testing,…
29 terms
Normal Newborn
10
ductus arteriosis
Airway... Temp... Nutrition... Elimination... Infe…
back
In a newborn the change of temp and environment induce 1 brea…
Foraman ovale closes and the flow pattern change results in c…
Newborn priorities:
Airway: bulb suction, stimulate (rub __________)
10
In a newborn the change of temp and environment induce 1 brea…
ductus arteriosis
Foraman ovale closes and the flow pattern change results in c…
105 terms
Normal Newborn
What is the normal respiration rate fo…
What should be assessed first in a new…
What are potential nursing diagnosis i…
What factors can affect the newborns b…
30-60 breaths per minute
A, B, C... Airway, Breathing, Circulation
Risk for ineffective breathing pattern... Risk for ineffective a…
Surfactant release... Cold stress... Contractions, mild asphyxia, i…
What is the normal respiration rate fo…
30-60 breaths per minute
What should be assessed first in a new…
A, B, C... Airway, Breathing, Circulation
Normal Newborn
Apgar Scoring is?
Normal Newborn Heart Rate?
Normal Newborn Respiratory Rate?
Newborn Assessments?
Evaluating the newborns ability after leaving utero
110-160
30-60
Vital ... Measurements... Meds... Dextrose Stick PRN... Newborn Metabolic…
Apgar Scoring is?
Evaluating the newborns ability after leaving utero
Normal Newborn Heart Rate?
110-160
85 terms
Normal newborn
Neonatal period
highest rate of mortality
most critical time
transition period
first 28 days of life
first 24 hours
first hour
phases of instability during first 6-8 hours of life... 2 period…
Neonatal period
first 28 days of life
highest rate of mortality
first 24 hours
105 terms
Normal Newborn
What is the normal respiration rate fo…
What should be assessed first in a new…
What are potential nursing diagnosis i…
What factors can affect the newborns b…
30-60 breaths per minute
A, B, C... Airway, Breathing, Circulation
Risk for ineffective breathing pattern... Risk for ineffective a…
Surfactant release... Cold stress... Contractions, mild asphyxia, i…
What is the normal respiration rate fo…
30-60 breaths per minute
What should be assessed first in a new…
A, B, C... Airway, Breathing, Circulation
140 terms
Normal Newborn
neonatal period
6 to 8 hours after birth
preterm infants
transplacental gas exchange
begins at birth and ends at 28 days
When do the major adaptions associated with transition from i…
often encounter respiratory difficulties related to immaturit…
during intraurterine life, oxygenation of the fetus occur thr…
neonatal period
begins at birth and ends at 28 days
6 to 8 hours after birth
When do the major adaptions associated with transition from i…
121 terms
The Normal Newborn
Fetal circulation
Extrauterine circulation
Cardiovascular Adaptations
Oxygenated blood returns
The right and left sides of the heart connect at the level of…
- Divided into separate right and left sides... - Independent of…
- Placenta lowers resistance... - Cord clamped leads to higher r…
Left atrium from lungs
Fetal circulation
The right and left sides of the heart connect at the level of…
Extrauterine circulation
- Divided into separate right and left sides... - Independent of…
42 terms
The Normal Newborn
Neonate
Head lag
Moro flex
Rooting reflex
Birth to 4 weeks
Infant lifted from bed and head will fall back
Startle reflex
Infants head turns in direction of nothing touring the cheek
Neonate
Birth to 4 weeks
Head lag
Infant lifted from bed and head will fall back
61 terms
THE NORMAL NEWBORN
6 routine admission orders?
DEEP/QUIET SLEEP
ACTIVITY REM
QUIET ALERT
-V/S ... -Measurements ... -Meds ... -Dextrose Stick PRN ... -Labs prn ... -…
Regular Breathing/No movement except sudden body jerks
Irregular breathing/body twitching/may cry out but no awake
Infant awake and involved with the surroundings (awake and cr…
6 routine admission orders?
-V/S ... -Measurements ... -Meds ... -Dextrose Stick PRN ... -Labs prn ... -…
DEEP/QUIET SLEEP
Regular Breathing/No movement except sudden body jerks
The normal newborn
Lung expansion after birth stimulates…
During vaginal birth, _ expels 1/3 of…
Surfactant decreases...
Intrapulmonary fluid reduces...
surfactant
"thoracic squeeze..
surface tension within alveoli
Reduces pulmonary resistance to blood flow
Lung expansion after birth stimulates…
surfactant
During vaginal birth, _ expels 1/3 of…
"thoracic squeeze..
51 terms
The Normal Newborn
what is the role of the liver?
when does physiologic juandice usually…
what form of jaundice is associated wi…
at what point does breast milk juandic…
iron storage... carb metabolism... conjugation of bilirubin
24 hours after birth
breast feeding jaundice
7 days after birth
what is the role of the liver?
iron storage... carb metabolism... conjugation of bilirubin
when does physiologic juandice usually…
24 hours after birth
52 terms
The Normal Newborn
Ideal ratio of surfactant
Fetal breathing
First Breath
Chemical Stimuli
2:1 of lecithin to sphingomyelin
Practice by breathing amniotic fluid so lungs can stay compli…
inspiratory gasp from CNS inresponse to stimuli of birth... flu…
stimulate chemoreceptors that stimulate the respiratory cente…
Ideal ratio of surfactant
2:1 of lecithin to sphingomyelin
Fetal breathing
Practice by breathing amniotic fluid so lungs can stay compli…
71 terms
The normal newborn
Prenatal history - prenatal care quest…
Prenatal history - lab
Prenatal history- mother
Group B strep
1. receive prenatal care?... 2. When did it start?... 3. Where?... 4.…
1. Were prenatal lab studies done?... 2.Were the results normal…
1. age?... 2. ethnicity and race? - assess risk of complications…
normal vaginal bacteria that can be fatal to neonate and moth…
Prenatal history - prenatal care quest…
1. receive prenatal care?... 2. When did it start?... 3. Where?... 4.…
Prenatal history - lab
1. Were prenatal lab studies done?... 2.Were the results normal…
10 terms
Normal Newborn
Temperature
Awake Heart rate
Respiratory Rate
Sleeping Heart Rate
97.7-99.4
120-170 bpm
30-60 breaths per minute
85-100 bpm
Temperature
97.7-99.4
Awake Heart rate
120-170 bpm
112 terms
The Normal Newborn
Neonate
In the neonate Respiratory System, wha…
What is the ideal L/S ratio?
In utero, what breathing movements doe…
The first 28 days after birth
Surfactant (lecithin and sphingomyelin; L/S) ... it allows for t…
2:1 or greater than 2:1
practiced breathing movements ... Purposes: lungs compliant (abl…
Neonate
The first 28 days after birth
In the neonate Respiratory System, wha…
Surfactant (lecithin and sphingomyelin; L/S) ... it allows for t…
30 terms
The Normal Newborn and Complications of the Newborn
One minute after birth, an infant has…
Five minutes after birth, an infant ha…
An infant is just born and has an irre…
How long does it take the newborn infa…
APGAR score of 5.
APGAR score of 9.
Nothing. This is all normal for the first stage of life.
4 to 8 hours after birth.
One minute after birth, an infant has…
APGAR score of 5.
Five minutes after birth, an infant ha…
APGAR score of 9.
The normal newborn
respiratory function
absorption of fetal lung fluid
respirations
circulatory changes
the most critical extrauterine adjustment air inflates the lu…
during labor air sacs airways remain filled w/ fluid... during b…
lungs increases & pushes fetal lung fluid into lymphatic & ci…
expulsion of the placenta & the cutting of the umbilical cord…
respiratory function
the most critical extrauterine adjustment air inflates the lu…
absorption of fetal lung fluid
during labor air sacs airways remain filled w/ fluid... during b…
79 terms
Normal Newborn
15 - 20 seconds
30 - 60 seconds (sometimes 2 min)
increase in blood volume, reduce need…
30 to 60 seconds after birth, at level…
Early cord clamping at what time after birth
Late cord clamping at what time after birth
4 benefits of late cord clamping (30 to 60 seconds)
EBP cord clamping
15 - 20 seconds
Early cord clamping at what time after birth
30 - 60 seconds (sometimes 2 min)
Late cord clamping at what time after birth
Normal Newborn
First Period of reactivity
Period of decreased responsiveness
Second period of reactivity
Triggers of initial respiration
- lasts about 30 minutes... - baby is most alert... - the nurse sho…
-occurs for about 60-100 minutes... - baby sleeps
- Occurs 4- 8 hours after birth - can last a few minutes or a…
- Changes in pressure gradients because when the baby is comi…
First Period of reactivity
- lasts about 30 minutes... - baby is most alert... - the nurse sho…
Period of decreased responsiveness
-occurs for about 60-100 minutes... - baby sleeps
43 terms
The Normal Newborn
what does surfactant do
where does fetal lug fluid go after bi…
what initiates the first breath for baby
when does ductus arteriosis close
keeps the alveoli open
absorbed by vascular/lymphatic tissue
CHemical --> V in pH & O2 & PCO2^... Mechanical- lungs recoil af…
72 hours functionally but 2 wks permanently
what does surfactant do
keeps the alveoli open
where does fetal lug fluid go after bi…
absorbed by vascular/lymphatic tissue
7 terms
the normal newborn
5 Causes of Post-Op Fever
envisceration
drugs to treat mild N/V
N/V
Wind: atelectasis, pneumonia, etc.... Wound: infection... Water: UT…
wound opens up all the way and organs spill out (highly unusu…
1. antihistamines... 2. anticholinergics... 3. phenothiazines
IV fluids ... NG tube to decompress... Clear liquids 1st: 5-15ml ev…
5 Causes of Post-Op Fever
Wind: atelectasis, pneumonia, etc.... Wound: infection... Water: UT…
envisceration
wound opens up all the way and organs spill out (highly unusu…
33 terms
The Normal Newborn
What causes the head of the newborn to…
Cephalohematoma
does a cephalohematoma cross the sutur…
Symptoms of respiratory distress in th…
Molding
is caused by a collection of blood beneath the periosteum of…
no
Grunting, Nasal flaring, sternal retractions, Resp rate <30 o…
What causes the head of the newborn to…
Molding
Cephalohematoma
is caused by a collection of blood beneath the periosteum of…
54 terms
Normal Newborn
Neonate
4 Dramatic changes newborns make to ad…
The newborn's lungs become the organs…
By 2 hours of life, the respiratory ra…
Newborn during the first 28 days of life
Temperature regulation, circulation, respiration, and source…
as soon as the cord is clamped
less than 60 breaths per minute
Neonate
Newborn during the first 28 days of life
4 Dramatic changes newborns make to ad…
Temperature regulation, circulation, respiration, and source…
46 terms
Normal Newborn
normal reflexes in term infant
what does gestational age evaluation l…
moro reflex
how do you know if a baby has a seizure?
root, suck, moro, palmar, plantar grasp, babinski,
neuromuscular and physical maturity
jolt bassinet or make a noise to see reflex
if you put hands on baby and they stop, it is not a seizure
normal reflexes in term infant
root, suck, moro, palmar, plantar grasp, babinski,
what does gestational age evaluation l…
neuromuscular and physical maturity
83 terms
Normal Newborn
What are the newborn reflexes for surv…
What happens when the infant is over-s…
Newborn vision
Newborn taste
Blink, gag, sneeze... Rooting/sucking... Grasping... Stepping... Moro... Dra…
Sleeps for 5-6hours
can see 8-10inches, usually the distance to arms to face
enjoys sweet, colostrum is sweet and reduces pain
What are the newborn reflexes for surv…
Blink, gag, sneeze... Rooting/sucking... Grasping... Stepping... Moro... Dra…
What happens when the infant is over-s…
Sleeps for 5-6hours
77 terms
The Normal Newborn
Surfactant
First breath
Mechanical events
Chemical stimuli
lectihin and sphigomyelin (2:1) ... helps with fetal breathing m…
inspiratory gasp from CNS response to mechanical, reabsorptiv…
lung fluid decreases prior to onset of labor (only with spont…
stimulate chemoreceptors that stimulate the respiratory cente…
Surfactant
lectihin and sphigomyelin (2:1) ... helps with fetal breathing m…
First breath
inspiratory gasp from CNS response to mechanical, reabsorptiv…
25 terms
Normal Newborn
5v most important systems to remember…
Oxygenated blood in utero comes from...
How is fetal temp regulated?
Several days before delivery, lung flu…
Circulation, Elimination, Respiration, Thermoregulation, Regu…
the placenta, not the baby's lungs.
Through surrounding amniotic fluid.
decrease to to prepare for respirations
5v most important systems to remember…
Circulation, Elimination, Respiration, Thermoregulation, Regu…
Oxygenated blood in utero comes from...
the placenta, not the baby's lungs.
62 terms
The normal newborn
what kind of respiratory pressure has…
What five things need to happen for fe…
Why do newborns have jaundice?
when do fetal lung development form
Low pressure, high pulmonary vascular resistance
increase in systemic vascular resistance (bp), decrease in pu…
Shorter RBC lifespan
20-28 weeks
what kind of respiratory pressure has…
Low pressure, high pulmonary vascular resistance
What five things need to happen for fe…
increase in systemic vascular resistance (bp), decrease in pu…
33 terms
Normal Newborn
Apgar score
Apgar Scores and pH
Immediate Newborn Care at Delivery
The First 24 Hours
Provides index of infant's depression or lack of it by rating…
9-10: pH 7.3-7.4 acidity-normal appraisal- optimal... 7-9: pH 7.…
1) Establish and maintain respirations... 2) Prevent hypothermia…
Respiratory adaptation... Cardiovascular adaptation... Liver adapta…
Apgar score
Provides index of infant's depression or lack of it by rating…
Apgar Scores and pH
9-10: pH 7.3-7.4 acidity-normal appraisal- optimal... 7-9: pH 7.…
11 terms
The Normal Newborn
What are the five parameters of a biop…
What are the categories for the APGAR…
What two things should nursery orders…
What are the three stages of the trans…
- non-stress test... - ultrasound measurement of the amniotic fl…
- color... - heart rate... - response to nose catheter... - respirator…
wieght and gestational age
1. 0-30 minutes is the first period of reactivity... 2. 30 min t…
What are the five parameters of a biop…
- non-stress test... - ultrasound measurement of the amniotic fl…
What are the categories for the APGAR…
- color... - heart rate... - response to nose catheter... - respirator…
20 terms
The Normal Newborn
The newborn transitional period consis…
The nurse anticipates which newborn wi…
What is the danger of heat loss to the…
Normal newborn temperature is ____ = 9…
- 6 to 8 hours of life
- Cesarean delivery; magnesium sulfate given to mother in lab…
- Leads to depletion of glucose (very little glycogen storage…
4. Normal newborn temperature is ____ = 97.7 - 99.4F... Normal…
The newborn transitional period consis…
- 6 to 8 hours of life
The nurse anticipates which newborn wi…
- Cesarean delivery; magnesium sulfate given to mother in lab…
21 terms
Normal Newborn
Usual reflexes
Newborn responses
Esophageal Atresia
Tracheoesophageal fistula
blink, gag, sneeze... rooting, sucking... grasping... stepping... moro... dr…
vision at 8-10 inches... hear, respond to sound... smell, recogniti…
Blind pouch esophagus... Spitting up a lot
food may enter trachea
Usual reflexes
blink, gag, sneeze... rooting, sucking... grasping... stepping... moro... dr…
Newborn responses
vision at 8-10 inches... hear, respond to sound... smell, recogniti…
45 terms
Normal Newborn
surfactant
thermoregulation
thermogenesis
nonshivering thermogenesis
protein manufactured in type II cells of the lungs that reduc…
maintenance of balance between heat loss and heat production
generation of heat
heat production process unique to newborn accomplished primar…
surfactant
protein manufactured in type II cells of the lungs that reduc…
thermoregulation
maintenance of balance between heat loss and heat production
44 terms
normal newborn
what are the parameters for a normal n…
what can a baby see at birth?
if there is an unmedicated labor and t…
what are useful reflexes that babies a…
full term, apgar greater than 7
round dark objects 8-10 inches away
crawl to the nipple
blink, gag, sneeze, rooting, sucking, grasping, stepping, mor…
what are the parameters for a normal n…
full term, apgar greater than 7
what can a baby see at birth?
round dark objects 8-10 inches away
Normal Newborn
surfactant production/alveolar expansi…
fetal lungs continuously produce fluid…
newborn BP
systemic BP
24 weeks/ 35 weeks
last half of gestation
80/40. much lower when in utero
increases with decrease in resistance--> dramatic increase in…
surfactant production/alveolar expansi…
24 weeks/ 35 weeks
fetal lungs continuously produce fluid…
last half of gestation
59 terms
Normal Newborn
low birth weight
very low birth weight
extremely low birth weight
appropriate for gestational age
<2500 g
<1500 g
<1000 g
b/w 10th-90th percentiles
low birth weight
<2500 g
very low birth weight
<1500 g
16 terms
Normal Newborn
Initiation of breathing
thermal stimuli
chemical stimuli
sensory stimuli
chemical stimuli ... thermal stimuli
change in environmental temp.... stimulation of skin
decreased pH and ^ pCO2 causes stimulation of aortic chemo-re…
tactile, visual, and auditory
Initiation of breathing
chemical stimuli ... thermal stimuli
thermal stimuli
change in environmental temp.... stimulation of skin
20 terms
Normal Newborn
Temp
RR
Pulse
Glucose
97.7-99.5
30-60
110-160
40-60 1st day... 50-90 after that
Temp
97.7-99.5
RR
30-60
12 terms
normal newborn
Activity... (apgar score)
Pulse... (apgar score)
Grimace... (APGAR score)
Appearance... (APGAR score)
0- absent... 1- flexed arms and legs... 2- active
0- absent... 1- below 100 bpm... 2-over 100 bpm
0- floppy... 1- minimal response to stimulation... 2- Prompt respon…
0- blue: pale... 1- pink body, blue extremities... 2- pink everywhere
Activity... (apgar score)
0- absent... 1- flexed arms and legs... 2- active
Pulse... (apgar score)
0- absent... 1- below 100 bpm... 2-over 100 bpm
57 terms
Normal Newborn
vital signs to get
how do you measure respiratory status
tachypnea <60 bpm... grunting... retractions…
how do you assess cardiovascular status
temp, respiratory rate, heart rate
auscultate with stethoscope
respiratory distress in newborn
auscultate with stethoscope
vital signs to get
temp, respiratory rate, heart rate
how do you measure respiratory status
auscultate with stethoscope
15 terms
Normal Newborn
Convection
Radiation
Evaporation
Conduction
heat lost to cooler ambient air
heat lost to surfaces not in direct contact with
heat lost when water converted to vapor
heat lost to surface in direct contact with
Convection
heat lost to cooler ambient air
Radiation
heat lost to surfaces not in direct contact with
53 terms
Normal Newborn
APGAR scoring
APGAR color
APGAR heartbeat
APGAR respirations
color, heartbeat, respiration, grimace (response to stimuli),…
0 - blue or pale grey... 1 - pink body, blue extremities ... 2 - pi…
0 - absent ... 1 - less than 100... 2 - more than 100
0 - absent... 1 - slow, irregular, gasping... 2 - normal
APGAR scoring
color, heartbeat, respiration, grimace (response to stimuli),…
APGAR color
0 - blue or pale grey... 1 - pink body, blue extremities ... 2 - pi…
58 terms
Normal Newborn
Onset of breathing
Biochemical Changes at Birth
Thermal Changes at Birth
Thermal Stimulus
most critical and immediate change required by the neonate; c…
low oxygen, high carbon dioxide, low pH (excite medulla to st…
sudden chilling excites sensory impulses in skin which transf…
The abrupt change in environmental temperature excites sensor…
Onset of breathing
most critical and immediate change required by the neonate; c…
Biochemical Changes at Birth
low oxygen, high carbon dioxide, low pH (excite medulla to st…
32 terms
Normal Newborn
Neonatal Period
Vital Statistics
APGAR Score
-At 1 minute and 5 minutes... -If <7, rep…
Lasts from birth to 4 weeks (First 28 days of life)
Weight, length, head & chest circumference
-Immediate assessment of the infant, 10 is a perfect score... -*…
When is APGAR score assessed?
Neonatal Period
Lasts from birth to 4 weeks (First 28 days of life)
Vital Statistics
Weight, length, head & chest circumference
71 terms
normal newborn
first breath of life is a gasp in resp…
what is the purpose of the first breat…
surfactant
first breath of life: mechanical events
mechanical events... chemical events... thermal events... sensory events
initiates opening of alveoli to air and begin transition from…
contains phospholipids which are critical for alveolar expans…
active exhalation initiates removal of fluid from the lungs... d…
first breath of life is a gasp in resp…
mechanical events... chemical events... thermal events... sensory events
what is the purpose of the first breat…
initiates opening of alveoli to air and begin transition from…
197 terms
Normal Newborn
transition period
when is first period of reactivity?
What to do during first period of reac…
Period of decreased responsiveness
adapting to life outside of utero
within 30 minutes after birth
have baby breastfeed, bond
can last from 60-100 minutes, baby is sleepy
transition period
adapting to life outside of utero
when is first period of reactivity?
within 30 minutes after birth
1 of 10