Term
| Amount of fluid that remains in the passageway of a full-term newborn at birth |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Inspiratory gasp triggers... |
|
Definition
| Brain's respiratory center |
|
|
Term
| As air enters the lungs... |
|
Definition
| The 02 content rises in the alveoli and stimulates the relaxation of the pulmonary arteries. |
|
|
Term
| Events that precipitate closing of the Ductus Arteriosus and Foramen Ovale |
|
Definition
Increased oxygenated pulmonary blood
Loss of placenta
Increased systemic blood flow |
|
|
Term
| Nonshivering thermogenesis |
|
Definition
| Occurs when skin receptors perceive a drop in environmental temperature. |
|
|
Term
|
Definition
|
|
Term
| Primary source of heat in the newborn |
|
Definition
| Brown Adipose Tissue (BAT) |
|
|
Term
|
Definition
Loss of heat from the warm body surface to the cooler air currents.
Think: removal of baby from incubator; cool air blowing in room. |
|
|
Term
|
Definition
Loss of heat that occurs when heat is transferred from the heated body surface to cooler surfaces and objects NOT in direct contact with the body.
Think: Placing cold objects near the infant or isolette near a cold window |
|
|
Term
|
Definition
Loss of heat incurred when water is converted to vapor.
Think: Happens immediately after birth when the baby is wet with amniotic fluid. |
|
|
Term
|
Definition
Loss of heat to a cooler surface by direct skin contact.
Think: Cold stethoscope, cool scales.
Preheat bed, instruments! |
|
|
Term
|
Definition
Caused by:
Accelerated destruction of fetal RBCs
Impaired conjugation of bilirubin
Increased bilirubin reabsorption from intestinal tract |
|
|
Term
| Reasons for increased amounts of bilirubin in the liver |
|
Definition
Bruising with forceps or vacuum extraction
Increased blood volume from delayed cord clamping |
|
|
Term
| Reasons for impaired conjugation of bilirubin |
|
Definition
Newborn doesn't take in enough calories
Mother may be breastfeeding
Defect in bilirubin excretion because of decreased GI motility |
|
|
Term
| Reasons for increased bilirubin reabsorption |
|
Definition
Reduced bowel motility: intestinal obstruction or delayed passage of meconium
This causes increased circulation of bilirubin in enterohepatic pathways...higher bilirubin levels. |
|
|
Term
| Unsafe bilirubin levels even up to 6 days |
|
Definition
15-16 may go to the lights to break down the bilirubin
Some doctors will let it go as high as 17-20
Above 20 - to the lights! |
|
|
Term
| First Period of Reactivity |
|
Definition
| Lasts approximately 30 minutes after birth (may extend up to 60 minutes after birth, p. 553, text) |
|
|
Term
| Characteristics of First Period of Reactivity |
|
Definition
Newborn awake and active
Newborn appears hungry
Newborn has strong reflex
VS elevated
Perfect opportunity to start breastfeeding |
|
|
Term
| Period of Inactivity to Sleep Phase |
|
Definition
|
|
Term
| Characteristics of Inactivity to Sleep Phase |
|
Definition
Newborn's activity gradually decreases
Heart rate and respiration rate decreases
Will be difficult to awaken
No interest in sucking |
|
|
Term
| Second period of reactivity |
|
Definition
|
|
Term
| Characteristics of Second Period of Reactivity |
|
Definition
Heart and respiratory rates increase
Possible apneic periods
Newborn passes meconium
Newborn roots, sucks, swallows |
|
|
Term
| Sleep states: what do you see and why are they so important? |
|
Definition
Deep or quiet sleep AND REM sleep
Growth hormone secretion depends on regular sleep patterns |
|
|
Term
| Visual Ability of Newborn |
|
Definition
Orientation: ability to be alert, follow and fixate on visual stimuli.
Prefers human face and bright shiny objects.
May follow stimulus from side to side. |
|
|
Term
| Auditory Ability of Newborn |
|
Definition
Responds to auditory stimulation
Cardiac rate rises and startle reflex may be noted as newborn hears the sound.
LACK of auditory development is associated with an increased risk of SIDS |
|
|
Term
Assessment of Newborn:
Temperature |
|
Definition
|
|
Term
Assessment of Newborn:
Heart Rate |
|
Definition
Normal Range: 120-160
as low as 100 when sleeping
as high as 180 when crying
Assess for 1 full minute when NOT crying |
|
|
Term
Assessment of Newborn:
Respiration |
|
Definition
30-60 breaths per minute
Obligatory nose breathers...keep nose and mouth clear! |
|
|
Term
| Normal short periods of apnea: episodic breathing |
|
Definition
| Pause in breathing for less than 15 seconds |
|
|
Term
|
Definition
| Pause in breathing for more than 20 seconds |
|
|
Term
Assessment of Newborn:
Weight range |
|
Definition
2500-4000 g (5lb 8oz-8lb 13oz)
Average: 3405 g (7 lb 8 oz) |
|
|
Term
| Physiologic Weight Loss in Newborns: Term Babies |
|
Definition
5-10% in first few days, should be regained in 1-2 weeks
Large babies tend to lose more weight b/c of greater fluid loss |
|
|
Term
| Physiologic Weight Loss in Newborns: Preemies |
|
Definition
| up to 15% loss in first few days |
|
|
Term
| Newborn Assessment: Length Range |
|
Definition
46-56 cm (18-22")
Average: 50 cm. |
|
|
Term
Normal growth for first 6 months:
Weight
Length |
|
Definition
Weight: 198 g. or 7 oz. per week (1 oz. per day)
Length: 2.5 cm. (1") per month |
|
|
Term
| Newborn Assessment: Head Circumference |
|
Definition
32-37 cm. (12.5-14.5")
Should be approximately 2 cm. larger than chest circumference
Should be 1/4 of the body length |
|
|
Term
| Risks when baby's temperature drops |
|
Definition
Baby may drop sugar level
Baby may go into respiratory distress |
|
|
Term
Closure of Fontanelles
Anterior
Posterior |
|
Definition
Anterior: closes by 18 months
Posterior: closes between 8-12 weeks
Both should be flat and NOT bulging. |
|
|
Term
|
Definition
Blood from ruptured vessels between the skull bone and the external covering (periosteum)
Does NOT cross suture line
Appears on 1st and 2nd day
Disappears in weeks to months
Does not increase in size when baby cries |
|
|
Term
|
Definition
Swelling of soft tissue over the presenting part of the fetal head
Overlaps or crosses suture line
Long, difficult birth
Fluid is reabsorbed within 12 hours to days after delivery
Present at birth or shortly therafter
Boggy, edematous swelling |
|
|
Term
| Appearance of true eye color |
|
Definition
| Usually doesn't appear until 6 months of age |
|
|
Term
|
Definition
| In most babies. Will open around 2 months and baby will start to cry tears. Can use a warm compress to massage until then. |
|
|
Term
| 2-cord vessel, what test will be done? |
|
Definition
|
|
Term
| Erb-Duchenne Paralysis (Erb's Palsy) |
|
Definition
| Paralysis of arm and chest wall from a birth injury to the brachial plexus or 5th/6th cervical nerves |
|
|
Term
|
Definition
Manual procedure performed to rule out congenital hip dysplasia (p. 583, text)
When infant's spine and knees are flexed and hips are abducted, a click is heard or felt. |
|
|
Term
|
Definition
Baby acne.
Usually on nose/chin.
Tiny, white pustules from obstructed sebaceous glands
Leave it alone! |
|
|
Term
|
Definition
Eruption of lesions surrounding a hair follicle that are firm, vary in size from 1-3 mm and consist of a white or pale yellow papule or pustule with a red base.
Known as Newborn Rash or "Flea Bite" dermatitis |
|
|
Term
|
Definition
| Turns head and open mouth to suck when one side of face is stroked. |
|
|
Term
|
Definition
| When object is inserted into mouth, baby automatically begins to suck |
|
|
Term
| Tonic Neck Reflex (Fencer position) |
|
Definition
| With head turned to one side, arm and leg on that side of body will be in extension while extremities on the opposite side will be flexed. |
|
|
Term
| Palmar Grasp or Grasp Reflex |
|
Definition
| Pressure on palm elicits grasp |
|
|
Term
|
Definition
| Pressure applied with finger against the ball of the infant's foot elicits curling of toes or "monkey toes" |
|
|
Term
|
Definition
Sudden disturbance will startle the newborn
Flexion of the knees
Stiffening of the body
Arms in tense extension
Slowly the arms return to the chest as in an embrace.
Fingers spread to form a "C" |
|
|
Term
|
Definition
| Stroking of the sole upward and across the ball of the foot elicits fanning and extension of the toes. |
|
|
Term
|
Definition
| When held upright with one foot touching a flat surface the newborn will "step" |
|
|
Term
| Trunk Incurvature or Galant Reflex |
|
Definition
| Stroking the spine causes the pelvis to turn to that side |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Well-flexed with elbow, hip and knee joints at 90-degree angle |
|
|
Term
|
Definition
Wrist- flex the newborn's hand toward the forearm until resistance is felt and then measure the angle.
90-degree = 28-32 weeks (preemie)
30-40-degree = 38-40 weeks (term)
0-degree angle = 40-42 weeks (term-postterm) |
|
|
Term
|
Definition
Supine position
Elbows are flexed and held for 5 seconds, then extended at newborn's side. Term newborn will form an angle less than 90-degrees and recoil back to the flexed position. |
|
|
Term
|
Definition
| Thigh is flexed on the abdomen and chest with one hand. Using the index finger of the other hand behind the ankle, try to extend the lower leg until resistance is felt. No resistance in immature infant up to an 80-degree angle in the term newborn. |
|
|
Term
|
Definition
| Draw an arm across the chest towards the opposite shoulder until resistance is felt; note the location of the elbow in relation to the midline of the chest. Preterm will cross the midline whereas a full-term's elbow will NOT cross the midline. |
|
|
Term
|
Definition
Gently draw the foot toward the ear on the same side until resistance is felt.
Knee may bend; hold the bottom down to avoid rolling the newborn. Preterm - leg will remain straight and foot will go to ear and beyond. Older babies will have increasing resistance to this maneuver. |
|
|
Term
|
Definition
Forefinger and middle finger to the breast area and measuring the tissue between them.
Term: 0.5-1 cm. (5-10mm)
GENTLY! |
|
|
Term
Vitamin K injection.
Why is it needed? |
|
Definition
Newborn lacks intestinal bacterial flora necessary for production of Vitamin K.
Prothrombin levels are low during first few days after birth. |
|
|
Term
| Site of Vitamin K Injection |
|
Definition
Intramuscularly in the middle third of the vastus lateralis - lateral aspect of thigh OR
rectus femoris muscle in anterior aspect of thigh (BE CAREFUL here because of sciatic nerve and femoral artery!) |
|
|
Term
|
Definition
Gonorrhea prophylaxis
Erythromycin opthalmic ointment
This can be delayed for one hour for bonding. |
|
|
Term
| Signs and symptoms of respiratory distress |
|
Definition
WETFROG
Wheezing
Effort
Tachypnea
Flaring
Retractions
Oxygenation
Grunting |
|
|
Term
| Dangerous glucose level for infant |
|
Definition
< than 40 is dangerous.
The hospital likes it above 50. |
|
|
Term
| VS during the first 4 hours of life |
|
Definition
Monitor every hour.
After first four hours, then monitor every 6-8 hours |
|
|
Term
| Breastfeeding Advantages (VAMPIRE) |
|
Definition
V - vitamin provision for baby is greater
A - Attachment/bonding strengthened
M - Money savings (up to $3000)
P - Preparation NONE
I - Immunologic protection
R - Recommended by AAP
E - Easier digestion for infants |
|
|
Term
|
Definition
Cow milk proteins
Soy protein-based
Specialized therapeutic formulas: the amino acids are already broken down in these. |
|
|
Term
| Postpartum Assessment: BUBBLE-HEB |
|
Definition
Breasts
Uterus
Bladder
Bowel
Lochia
Episiotomy or perineal lacerations
Homan's sign
Emotional status
Bonding - eye contact, whole hand |
|
|
Term
|
Definition
Lochia rubra
Lochia serosa
Lochia alba |
|
|
Term
| Suppressing lactation in non-nursing mothers |
|
Definition
Tight-fitting bra
Ice packs
Cabbage leaves- enzyme in this helps relieve engorgement
NO hot showers |
|
|
Term
|
Definition
No soap on nipples, leave a small amount of milk on them.
Redness or swelling can indicate infection: assess it! |
|
|
Term
|
Definition
Relaxed position for mom
Both breasts should be offered at each feeding.
Break suction with one finger, don't just pull off
Proper latch is with areola and nipple in mouth
Do not breastfeed by the clock
Usually 20-30 minutes on each side. |
|
|
Term
|
Definition
1. Empty bladder
2. Lie flat on bed
3. Nurse places non-dominant hand on lower uterine segment (just above symphysis pubis)
4. Dominant hand gently palpates the top of fundus |
|
|
Term
| REEDA (check for this with wound healing/C-section) |
|
Definition
R - redness
E - edema
E - ecchymosis
D - discharge/drainage
A - approximation |
|
|
Term
| Fundus - postpartum position |
|
Definition
Position: 1 cm/finger-breadth above or even with umbilicus for the 1st 12 hours after delivery, then descent of 1 finger-breadth per day afterwards.
Day 10 - should be returning to pelvic organ |
|
|
Term
| Fundus - postpartum condition |
|
Definition
Firm: Hard as a rock!
Midline of abdomen - if deviated, see if client needs to urinate. |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Patient should void 6-8 hours after delivery. |
|
|
Term
|
Definition
| Lots of urinating, especially in women who had edema |
|
|
Term
|
Definition
Days 1-3
Bloody with fleshy odor
May contain clots |
|
|
Term
|
Definition
Days 4-9
Pink/brown with fleshy odor |
|
|
Term
|
Definition
|
|
Term
Psychosocial Adjustment
Taking In |
|
Definition
1-2 days after delivery
Needy, dependent, talkative, passive |
|
|
Term
Psychosocial Adjustment
Taking Hold |
|
Definition
2-3 days after delivery
Moving from dependency to independence
Open to teaching and instructions |
|
|
Term
Psychosocial Adjustment
Letting Go |
|
Definition
5-6 weeks
Independent
New role
Adjustment to accommodate for infant |
|
|
Term
|
Definition
Transient depression
Usually 3-7 days postpartum and resolves by days 10-14
roller coaster emotions |
|
|
Term
Maternal Attachment
Acquaintance Phase |
|
Definition
Fingertip exploration
En face position
Responds verbally to sounds of infant |
|
|
Term
Maternal Attachment
Mutual Regulation |
|
Definition
| Adjustment between needs of mother and needs of infant |
|
|
Term
Maternal Attachment
Reciprocity |
|
Definition
| Mutually gratifying interaction among mother, baby, father |
|
|
Term
|
Definition
Father-baby interaction
Sense of absorption
Preoccupation - interest in infant |
|
|
Term
|
Definition
ability to send out clotting factors goes away...overstimulation of clotting and anti-clotting mechanisms.
Bleeding from puncture sites, mucus membranes |
|
|
Term
| Definition of postpartum hemorrhage |
|
Definition
blood loss of greater than or equal to 500 mL with vaginal
blood loss of greater than or equal to 1000 mL with C/S
10 point drop in hematocrit |
|
|
Term
|
Definition
Uterine atony
Lacerations
Subinvolution
Uterine rupture
Uterine inversion |
|
|
Term
| Risk factors for Uterine Atony |
|
Definition
Large baby, multiparity, multiple gestation
Retained placental fragments
Precipitous or prolonged labor
Low platelet count d/t PIH
Taking: Mag sulfate or Pitocin |
|
|
Term
| Uterus is firm and there is still bleeding...consider what? |
|
Definition
|
|
Term
| Medications for Uterine Atony |
|
Definition
Methergine (IM) - do not use with hypertensive patients
Oxytocin - IV |
|
|
Term
| Risk factors for lacerations |
|
Definition
Forceps/vacuum
Precipitous labor |
|
|
Term
|
Definition
PIH
Abruptio placentae
Prolonged intrauterine fetal demise
Excessive blood loss |
|
|
Term
|
Definition
| Any infection in the reproductive tract within 6 weeks of delivery. |
|
|
Term
|
Definition
Inflammation of a vein wall causes a thrombus
If it is attached firmly to vein wall, less likely to become an embolus.
More COMMON after C/S |
|
|
Term
| Factors contributing to thromboembolic disorders |
|
Definition
Increased amount of clotting factors in blood
Stickier platelets after delivery
Release of thromboplastin substances from placenta and fetal membranes |
|
|
Term
| Predisposing factors for Thromboembolic Disorders |
|
Definition
Advanced maternal age
Obesity
High parity
Cigarettes
Hypothermia
Varicosities
DVT history |
|
|
Term
| Types of Thromboembolic Disorders |
|
Definition
Thrombophlebitis (more common)
DVT
Septic-pelvic thrombophlebitis - in conjunction with infections of reproductive tract
Pulmonary embolism (PE) usually fatal within 30 minutes |
|
|
Term
| Assessment for Thromboembolic Disorders |
|
Definition
Homan's sign
Peripheral pulses
Abdominal or flank pain
Is there tenderness, redness or warmth on calf? |
|
|
Term
|
Definition
7-30% of women
4th week up to a year postpartum
more severe in first-time moms |
|
|
Term
| Risk Factors for Postpartum Depression |
|
Definition
Any history of depression
Primiparity
Lack of social support |
|
|
Term
| Treatment for Postpartum Depression |
|
Definition
Meds (SSRIs)
Drug of choice: Zoloft (sertraline)
Next: Paxil
Last: Prozac (may have to stop breastfeeding) |
|
|
Term
| Assessment Tool for Postpartum Depression |
|
Definition
Edinburgh Postnatal Depression Scale
Score that is greater than 12-13 indicates that the woman is suffering from some depression. |
|
|
